From: <b class="gmail_sendername">Ruggiero, Mrs. Ana Lucia (WDC)</b> <span dir="ltr"><<a href="mailto:ruglucia@paho.org">ruglucia@paho.org</a>></span><br><div class="gmail_quote">crossposted from: <a href="mailto:EQUIDAD@listserv.paho.org">EQUIDAD@listserv.paho.org</a><br>
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<p class="MsoNormal" style="margin-left:.5in"><b><font color="maroon" face="Arial"><span style="font-size:10.0pt;font-family:Arial;color:maroon;font-weight:bold">R</span></font></b><b><font color="maroon" face="Arial"><span style="font-family:Arial;color:maroon;font-weight:bold">esearch to support
universal coverage reforms in <u></u>Africa<u></u>: the
SHIELD project<br>
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</span></font></b><u></u><u></u></p>
<p style="margin-left:.5in"><b><font color="black" face="Arial"><span style="font-size:10.0pt;font-family:Arial;font-weight:bold">Guest Editors: Di McIntyre and Anne Mills<br>
</span></font></b><cite><b><i><font color="black" face="Arial"><span style="font-size:10.0pt;font-family:Arial;font-weight:bold">Health
Policy Plan. </span></font></i></b></cite><span><b><i><font color="black" face="Arial"><span style="font-style:italic;font-size:10.0pt;font-family:Arial;font-weight:bold">(</span></font></i></b></span><span><b><i><font color="black" face="Arial"><span style="font-style:italic;font-size:10.0pt;font-family:Arial;font-weight:bold">2012</span></font></i></b></span><span><b><i><font color="black" face="Arial"><span style="font-style:italic;font-size:10.0pt;font-family:Arial;font-weight:bold">)</span></font></i></b></span><span><b><i><font color="black" face="Arial"><span style="font-style:italic;font-size:10.0pt;font-family:Arial;font-weight:bold"> </span></font></i></b></span><span><b><i><font color="black" face="Arial"><span style="font-style:italic;font-size:10.0pt;font-family:Arial;font-weight:bold">27</span></font></i></b></span><span><b><i><font color="black" face="Arial"><span style="font-style:italic;font-size:10.0pt;font-family:Arial;font-weight:bold">(</span></font></i></b></span><span><b><i><font color="black" face="Arial"><span style="font-style:italic;font-size:10.0pt;font-family:Arial;font-weight:bold">suppl 1</span></font></i></b></span><span><b><i><font color="black" face="Arial"><span style="font-style:italic;font-size:10.0pt;font-family:Arial;font-weight:bold">):</span></font></i></b></span><span><b><i><font color="black" face="Arial"><span style="font-style:italic;font-size:10.0pt;font-family:Arial;font-weight:bold"> </span></font></i></b></span><b><font color="black" face="Arial"><span style="font-size:10.0pt;font-family:Arial;font-weight:bold">Volume 27 March 2012 <br>
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<p class="MsoNormal" style="margin-left:.5in"><b><font face="Arial"><span style="font-size:10.0pt;font-family:Arial;font-weight:bold">Editorial </span></font></b><font color="black" face="Arial"><span style="font-size:10.0pt;font-family:Arial"><a href="http://bit.ly/wULww0" target="_blank"><font color="black"><span style>http://bit.ly/wULww0</span></font></a> </span></font><font face="Arial"><span style="font-size:10.0pt;font-family:Arial"><br>
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<p style="margin-left:.5in"><font face="Arial"><span style="font-size:10.0pt;font-family:Arial">“…….With the release of the 2010
World Health Report (World Health Organization 2010), universal coverage has
been placed high on the global health policy agenda. We understand universal
coverage to involve two key elements: first, ensuring financial protection for
all from the costs of health care; and second, enabling access to needed health
care for all citizens. <br>
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<u></u><u></u></span></font></p>
<p style="margin-left:.5in"><font face="Arial"><span style="font-size:10.0pt;font-family:Arial">Pre-payment financing mechanisms (such as tax and
various forms of health insurance), rather than direct out-of-pocket payments
by individuals, are required to ensure financial protection. Indeed, most of
the attention in recent health policy debates has been on the alternative ways
of generating financial resources for health care, and to some extent on the
pooling of these financial resources, to provide financial protection.
Considerably less attention has been paid to the second element of universal
coverage—how to improve access to, and the use of, quality health
services. <u></u><u></u></span></font></p>
<p style="margin-left:.5in"><font face="Arial"><span style="font-size:10.0pt;font-family:Arial"><br>
To date, relatively limited progress towards universal coverage has been made
in African countries. There is generally a heavy reliance on out-of-pocket
payments in Africa, with some countries (such as <u></u>Guinea<u></u>,
<u></u>Nigeria<u></u> and <u></u><u></u>Cameroon<u></u><u></u>)
funding 70% or more of total health care expenditure through this means (WHO
National Health Accounts database). A number of African countries (such as
Uganda, Zambia and South Africa) have implemented initiatives to reduce
out-of-pocket payments, particularly through removing some or all user fees at
public sector facilities, but these policies have generally not been
accompanied by parallel initiatives to increase domestic pre-payment funding of
health services. The two African countries that are commonly regarded as having
taken the most dramatic steps towards providing universal financial protection
through pursuing increased domestic pre-payment financing mechanisms are <u></u>Ghana<u></u> and <u></u><u></u>Rwanda<u></u><u></u>. <u></u><u></u></span></font></p>
<p style="margin-left:.5in"><font face="Arial"><span style="font-size:10.0pt;font-family:Arial"><br>
Where progress has been made towards universal financial protection in <u></u>Africa<u></u>, the emphasis has been on introducing or expanding
insurance schemes. In very few cases have there also been efforts to increase
tax funding of health care. A key challenge that plagues African countries
seeking to pursue increased financial protection through contributory insurance
schemes is how to ensure that those outside the formal sector are included
under these arrangements......"<br>
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</span></font><u></u><u></u></p>
<p style="margin-left:.5in"><font face="Arial"><span style="font-size:10.0pt;font-family:Arial">"......While there remains a massive research
agenda to inform universal coverage reforms in Africa, the findings of the
SHIELD project presented in this special issue not only provide evidence of
value to current reform debates, but also illustrate the range of technical and
policy analyses that should be undertaken to comprehensively assess equity in
existing health systems and appropriate reforms to promote universal
coverage...."<br>
</span></font><u></u><u></u></p>
<p style="margin-left:.5in"><b><font face="Arial"><span style="font-size:10.0pt;font-family:Arial;font-weight:bold">Content: Full text at: <a href="http://bit.ly/xpGRIK" target="_blank">http://bit.ly/xpGRIK</a> <br>
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<p class="MsoNormal" style="margin-left:1.0in"><u></u><font face="Symbol"><span style="font-size:10.0pt;font-family:Symbol"><span>·<font face="Times New Roman" size="1"><span style="font:7.0pt "Times New Roman"">
</span></font></span></span></font><u></u><font face="Arial"><span style="font-size:10.0pt;font-family:Arial">Research to support universal
coverage reforms in <u></u>Africa<u></u>: the SHIELD project<br>
</span></font><u></u><u></u></p>
<p class="MsoNormal" style="margin-left:1.0in"><u></u><font face="Symbol"><span style="font-size:10.0pt;font-family:Symbol"><span>·<font face="Times New Roman" size="1"><span style="font:7.0pt "Times New Roman"">
</span></font></span></span></font><u></u><font face="Arial"><span style="font-size:10.0pt;font-family:Arial">Progress towards universal coverage:
the health systems of <u></u>Ghana<u></u>,
<u></u>South Africa<u></u> and <u></u><u></u>Tanzania<u></u><u></u> <br>
</span></font><u></u><u></u></p>
<p class="MsoNormal" style="margin-left:1.0in"><u></u><font face="Symbol"><span style="font-size:10.0pt;font-family:Symbol"><span>·<font face="Times New Roman" size="1"><span style="font:7.0pt "Times New Roman"">
</span></font></span></span></font><u></u><font face="Arial"><span style="font-size:10.0pt;font-family:Arial">Progressivity of health care
financing and incidence of service benefits in <u></u><u></u>Ghana<u></u><u></u> <br>
</span></font><u></u><u></u></p>
<p class="MsoNormal" style="margin-left:1.0in"><u></u><font face="Symbol"><span style="font-size:10.0pt;font-family:Symbol"><span>·<font face="Times New Roman" size="1"><span style="font:7.0pt "Times New Roman"">
</span></font></span></span></font><u></u><font face="Arial"><span style="font-size:10.0pt;font-family:Arial">Who pays and who benefits from
health care? An assessment of equity in health care financing and benefit
distribution in <u></u><u></u>Tanzania<u></u><u></u>
<br>
</span></font><u></u><u></u></p>
<p class="MsoNormal" style="margin-left:1.0in"><u></u><font face="Symbol"><span style="font-size:10.0pt;font-family:Symbol"><span>·<font face="Times New Roman" size="1"><span style="font:7.0pt "Times New Roman"">
</span></font></span></span></font><u></u><font face="Arial"><span style="font-size:10.0pt;font-family:Arial">Paying for and receiving benefits
from health services in <u></u><u></u>South
Africa<u></u><u></u>: is the health system equitable? <br>
</span></font><u></u><u></u></p>
<p class="MsoNormal" style="margin-left:1.0in"><u></u><font face="Symbol"><span style="font-size:10.0pt;font-family:Symbol"><span>·<font face="Times New Roman" size="1"><span style="font:7.0pt "Times New Roman"">
</span></font></span></span></font><u></u><font face="Arial"><span style="font-size:10.0pt;font-family:Arial">Factors influencing the burden of
health care financing and the distribution of health care benefits in <u></u>Ghana<u></u>, <u></u>Tanzania<u></u>
and <u></u><u></u>South Africa<u></u><u></u>
<br>
</span></font><u></u><u></u></p>
<p class="MsoNormal" style="margin-left:1.0in"><u></u><font face="Symbol"><span style="font-size:10.0pt;font-family:Symbol"><span>·<font face="Times New Roman" size="1"><span style="font:7.0pt "Times New Roman"">
</span></font></span></span></font><u></u><font face="Arial"><span style="font-size:10.0pt;font-family:Arial">Social solidarity and willingness to
tolerate risk- and income-related cross-subsidies within health insurance:
experiences from <u></u>Ghana<u></u>, <u></u>Tanzania<u></u> and <u></u><u></u>South Africa<u></u><u></u> <br>
</span></font><u></u><u></u></p>
<p class="MsoNormal" style="margin-left:1.0in"><u></u><font face="Symbol"><span style="font-size:10.0pt;font-family:Symbol"><span>·<font face="Times New Roman" size="1"><span style="font:7.0pt "Times New Roman"">
</span></font></span></span></font><u></u><font face="Arial"><span style="font-size:10.0pt;font-family:Arial">Using stakeholder analysis to
support moves towards universal coverage: lessons from the SHIELD project <br>
</span></font><u></u><u></u></p>
<p class="MsoNormal" style="margin-left:1.0in"><u></u><font face="Symbol"><span style="font-size:10.0pt;font-family:Symbol"><span>·<font face="Times New Roman" size="1"><span style="font:7.0pt "Times New Roman"">
</span></font></span></span></font><u></u><font face="Arial"><span style="font-size:10.0pt;font-family:Arial">Inside the black box: modelling
health care financing reform in data-poor contexts <br>
</span></font><u></u><u></u></p>
<p class="MsoNormal" style="margin-left:1.0in"><u></u><font face="Symbol"><span style="font-size:10.0pt;font-family:Symbol"><span>·<font face="Times New Roman" size="1"><span style="font:7.0pt "Times New Roman"">
</span></font></span></span></font><u></u><font face="Arial"><span style="font-size:10.0pt;font-family:Arial">Modelling the implications of moving
towards universal coverage in <u></u><u></u>Tanzania<u></u><u></u>
<br>
</span></font><u></u><u></u></p>
<p class="MsoNormal" style="margin-bottom:12.0pt;margin-left:1.0in"><u></u><font face="Symbol"><span style="font-size:10.0pt;font-family:Symbol"><span>·<font face="Times New Roman" size="1"><span style="font:7.0pt "Times New Roman"">
</span></font></span></span></font><u></u><font face="Arial"><span style="font-size:10.0pt;font-family:Arial">Modelling the affordability and
distributional implications of future health care financing options in <u></u><u></u>South Africa<u></u><u></u> <u></u><u></u></span></font></p>
<p class="MsoNormal" style="margin-right:0in;margin-bottom:10.0pt;margin-left:.5in;line-height:115%"><font face="Arial"><span style="font-size:10.0pt;line-height:115%;font-family:Arial"><br>
</span></font><font face="Arial" size="1"><span style="font-size:9.0pt;line-height:115%;font-family:Arial"><br><b><font color="maroon"><span style="color:maroon;font-weight:bold"></span></font></b></span></font><br></p></div>
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