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<DIV dir=ltr align=left><TT><B><FONT face=Arial color=maroon size=2><SPAN
style="FONT-WEIGHT: bold; FONT-SIZE: 10pt; COLOR: maroon; FONT-FAMILY: Arial">EQUINET
Discussion Paper 66: Key issues in equitable health care financing in East and
Southern Africa,</SPAN></FONT></B></TT><U1:P></U1:P><O:P></O:P> <TT><FONT
color=#660000><SPAN
style="FONT-WEIGHT: bold; FONT-SIZE: 10pt; COLOR: rgb(102,0,0); FONT-FAMILY: Arial"><BR>D
McIntyre, V Govender, E Buregyeya, D Chitama, E Kataika, E Kyomugisha, R
Kyomuhangi, T Mbeeli, A Mpofu, S Nzenze, A Walimbwa<SPAN
class=156295016-03112008><EM><FONT color=#000080> </FONT></EM></SPAN>and B
Chitah<ST1:PLACE u14:st="on"><ST1:PLACENAME
u14:st="on"></ST1:PLACENAME><ST1:PLACETYPE
u14:st="on"></ST1:PLACETYPE></ST1:PLACE></SPAN></FONT></TT><U1:P></U1:P><O:P></O:P>
<TT><B><FONT face=Arial color=#660000><SPAN
style="FONT-WEIGHT: bold; FONT-SIZE: 10pt; COLOR: rgb(102,0,0); FONT-FAMILY: Arial"><BR><BR>Cite
as:</SPAN></FONT></B></TT><TT><FONT face="Courier New"><SPAN
style="FONT-SIZE: 10pt"> </SPAN></FONT></TT><TT><FONT face=Arial
color=purple><SPAN
style="FONT-SIZE: 10pt; COLOR: purple; FONT-FAMILY: Arial">McIntyre D, Govender
V, Buregyeya E, Chitama D, Kataika E, Kyomugisha E, Kyomuhangi R, Mbeeli T,
Mpofu A, Nzenze S, Walimbwa A, Chitah B (2008) ‘Key issues in equitable health
care financing in East and Southern Africa,’ EQUINET Discussion Paper Series 66.
Health Economics Unit, UCT and EQUINET: <ST1:CITY w:st="on"><ST1:PLACE
w:st="on">Harare</ST1:PLACE></ST1:CITY>.</SPAN></FONT></TT><B><FONT face=Arial
color=#660000><SPAN
style="FONT-WEIGHT: bold; FONT-SIZE: 10pt; COLOR: rgb(102,0,0); FONT-FAMILY: Arial"><TT><FONT
face=Arial><SPAN style="FONT-FAMILY: Arial"><BR><BR>Available online
at:</SPAN></FONT></TT></SPAN></FONT></B><TT><FONT face=Arial><SPAN
style="FONT-SIZE: 10pt; FONT-FAMILY: Arial"> </SPAN></FONT></TT><U><FONT
face=Arial color=#3333ff><SPAN style="FONT-SIZE: 10pt"><A
class=moz-txt-link-freetext
href="http://www.equinetafrica.org/bibl/docs/DIS66FINresmob.pdf">http://www.equinetafrica.org/bibl/docs/DIS66FINresmob.pdf</A></SPAN></FONT></U><FONT
face="Courier New"><SPAN
style="FONT-SIZE: 10pt; FONT-FAMILY: 'Courier New'"></SPAN></FONT><SPAN
style="FONT-SIZE: 10pt; COLOR: purple; FONT-FAMILY: Arial"><BR><BR>This report
provides an overview of the status of health care financing in seven East and
Southern African (ESA) countries (<ST1:COUNTRY-REGION
w:st="on">Malawi</ST1:COUNTRY-REGION>, <ST1:COUNTRY-REGION
w:st="on">Namibia</ST1:COUNTRY-REGION>, <ST1:COUNTRY-REGION w:st="on">South
Africa</ST1:COUNTRY-REGION>, <ST1:COUNTRY-REGION
w:st="on">Tanzania</ST1:COUNTRY-REGION>, <ST1:COUNTRY-REGION
w:st="on">Uganda</ST1:COUNTRY-REGION>, <ST1:COUNTRY-REGION
w:st="on">Zambia</ST1:COUNTRY-REGION>, <ST1:COUNTRY-REGION w:st="on"><ST1:PLACE
w:st="on">Zimbabwe</ST1:PLACE></ST1:COUNTRY-REGION>)<SPAN
class=156295016-03112008> . </SPAN>It draws on country case-studies and a
collaborative cross-country analysis undertaken at an EQUINET
workshop. <SPAN class=156295016-03112008> H</SPAN>ealth care financing
issues are considered through an equity lens, using a framework that focuses on
the key functions or components of health care financing systems - revenue
collection, pooling of funds and purchasing. The<SPAN
class=156295016-03112008> report notes that there </SPAN> remains a
heavy dependency on donor funding in several countries, and while debt relief
initiatives are translating into increased government funding for health care in
some countries, in other<SPAN class=156295016-03112008>s</SPAN> the health
sector has not benefited much from reduced debt servicing. Due to high levels of
out-of-pocket payments in many ESA countries and a heavy emphasis in the tax
system on V<SPAN class=156295016-03112008>alue </SPAN>A<SPAN
class=156295016-03112008>dded </SPAN>T<SPAN
class=156295016-03112008>ax </SPAN>, individual households carry a heavy
burden<SPAN class=156295016-03112008> for health financing</SPAN>. Health
insurance is growing in popularity<SPAN
class=156295016-03112008> , </SPAN> particularly community-based
health insurance<SPAN class=156295016-03112008> . The latter has
however </SPAN> <SPAN class=156295016-03112008> been found
to </SPAN>place<SPAN class=156295016-03112008> </SPAN>the financing
burden on relatively poor rural communities and those living in informal urban
areas. All the countries under review have poor fund pooling with little in the
way of risk equalisation mechanisms, which severely limits the potential for
income and risk cross-subsidies. To achieve equitable health care financing<SPAN
class=156295016-03112008> the review suggests it is necessary
to</SPAN> eliminate, or at least reduce out-of-pocket payments; increase
the funding of health services from tax revenue; and <SPAN
class=156295016-03112008> to </SPAN>introduce mechanisms to integrate
all forms of pre-payment (i.e. tax funding and health
insurance).</SPAN><O:P></O:P><TT><SPAN
style="FONT-FAMILY: Arial"><BR><BR><B><FONT color=#993300>October
2008</FONT></B></SPAN></TT><FONT color=maroon size=2><SPAN
style="FONT-SIZE: 10pt; COLOR: maroon; FONT-FAMILY: Arial"><BR><BR></SPAN></FONT><TT><FONT
color=purple size=2><SPAN
style="FONT-SIZE: 10pt; COLOR: purple; FONT-FAMILY: Arial">/\/\/\/\/\/\/\/\/\/\/\/\/\/\/\/\/\/\/\/\/\/\/\/\/\/\/\/\/\/\/\/\/\/\/\/\/\/\/\/\/\/\/\/\/\/\/\/\/\/\/\/\/\/\/\/\/\/\/\/\/\/\/\/\/\/\/\/\/\/\</SPAN></FONT></TT><U1:P></U1:P><O:P></O:P><TT><FONT
size=2><SPAN
style="FONT-SIZE: 10pt; COLOR: windowtext; FONT-FAMILY: Arial"><BR><BR>This
email alerts to a new publication from the Regional Network for Equity in Health
in East and Southern Africa (EQUINET).<BR></SPAN></FONT></TT><FONT size=2><SPAN
style="FONT-SIZE: 10pt; COLOR: windowtext; FONT-FAMILY: Arial"><TT><SPAN
style="FONT-FAMILY: Arial">Further information on EQUINET can be found at <A
href="www.equinetafrica.org" moz-do-not-send="true"><SPAN
style="COLOR: windowtext">www.equinetafrica.org</SPAN></A>, where all
publications of the network can be found and
downloaded.<BR></SPAN></TT></SPAN></FONT><FONT face="Courier New" size=2><SPAN
style="FONT-SIZE: 10pt; COLOR: black; FONT-FAMILY: 'Courier New'"></SPAN></FONT><TT><FONT
face=Arial size=2><SPAN
style="FONT-SIZE: 10pt; COLOR: windowtext; FONT-FAMILY: Arial">Comments and peer
review feedback on this or any other EQUINET publication are welcomed and should
be sent to <A href="mailto:admin@equinetafrica.org" moz-do-not-send="true"><SPAN
style="COLOR: windowtext">admin@equinetafrica.org</SPAN></A></SPAN></FONT></TT></DIV>
<BLOCKQUOTE cite=mid:20081028094843.BC8571C00081@mwinf3533.me.freeserve.com
type="cite">
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