...
  • 主题
高级搜索  >
历史搜索 清空历史
首页> 外文期刊>BMC International Health and Human Rights >Achieving universal health care coverage: Current debates in Ghana on covering those outside the formal sector
【24h】

Achieving universal health care coverage: Current debates in Ghana on covering those outside the formal sector

机译：实现全民医疗覆盖：加纳目前关于覆盖正规部门以外人群的辩论

获取原文
           
页面导航
  • 摘要
  • 著录项
  • 相似文献
  • 相关主题

摘要

Background Globally, extending financial protection and equitable access to health services to those outside the formal sector employment is a major challenge for achieving universal coverage. While some favour contributory schemes, others have embraced tax-funded health service cover for those outside the formal sector. This paper critically examines the issue of how to cover those outside the formal sector through the lens of stakeholder views on the proposed one-time premium payment (OTPP) policy in Ghana. Discussion Ghana in 2004 implemented a National Health Insurance Scheme, based on a contributory model where service benefits are restricted to those who contribute (with some groups exempted from contributing), as the policy direction for moving towards universal coverage. In 2008, the OTPP system was proposed as an alternative way of ensuring coverage for those outside formal sector employment. There are divergent stakeholder views with regard to the meaning of the one-time premium and how it will be financed and sustained. Our stakeholder interviews indicate that the underlying issue being debated is whether the current contributory NHIS model for those outside the formal employment sector should be maintained or whether services for this group should be tax funded. However, the advantages and disadvantages of these alternatives are not being explored in an explicit or systematic way and are obscured by the considerable confusion about the likely design of the OTPP policy. We attempt to contribute to the broader debate about how best to fund coverage for those outside the formal sector by unpacking some of these issues and pointing to the empirical evidence needed to shed even further light on appropriate funding mechanisms for universal health systems. Summary The Ghanaian debate on OTPP is related to one of the most important challenges facing low- and middle-income countries seeking to achieve a universal health care system. It is critical that there is more extensive debate on the advantages and disadvantages of alternative funding mechanisms, supported by a solid evidence base, and with the policy objective of universal coverage providing the guiding light.
机译：背景技术在全球范围内，向正规部门以外的人员提供金融保护和平等获得卫生服务的机会是实现全民覆盖的主要挑战。尽管有些人赞成缴费型计划，但另一些人则为正规部门以外的人接受了税收资助的医疗服务。本文从利益相关者对加纳拟议的一次性保险费（OTPP）政策的观点的角度审视了如何覆盖正规部门之外的人的问题。加纳于2004年进行了讨论，该国基于贡献模式实施了国家健康保险计划，其中服务福利仅限于做出贡献的人（某些群体被豁免贡献），作为迈向全民覆盖的政策方向。在2008年，建议使用OTPP系统，以确保覆盖正规部门就业以外的人员。对于一次性保险金的含义以及如何筹集和维持一次性保险金，利益相关者有不同的看法。我们的利益相关者访谈表明，正在辩论的根本问题是，是否应维持针对正规就业部门以外人员的现行NHIS贡献性模式，还是应为该群体的服务提供税款。但是，尚未以明确或系统的方式探讨这些替代方案的优缺点，并且由于对OTPP政策的可能设计存在相当大的困惑而将其掩盖。我们试图通过展开其中的一些问题，并指出需要的经验证据，以进一步阐明全民卫生系统的适当筹资机制，从而为关于如何最好地为正规部门以外的人群提供医疗保险的广泛辩论做出贡献。小结加纳关于OTPP的辩论与中低收入国家寻求实现全民医疗保健体系所面临的最重要挑战之一有关。至关重要的是，在可靠的证据基础的支持下，关于替代性供资机制的优缺点的辩论将更加广泛，并且全民覆盖的政策目标将提供指导。

著录项

相似文献

  • 外文文献
  • 中文文献
  • 专利
获取原文

客服邮箱：kefu@zhangqiaokeyan.com

京公网安备：11010802029741号 ICP备案号：京ICP备15016152号-6 六维联合信息科技 (北京) 有限公司©版权所有

  • 客服微信

  • 服务号