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首页> 外文期刊>Health policy and planning >Sustainability of recurrent expenditure on public social welfare programmes: Expenditure analysis of the free maternal care programme of the Ghana National Health Insurance Scheme
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Sustainability of recurrent expenditure on public social welfare programmes: Expenditure analysis of the free maternal care programme of the Ghana National Health Insurance Scheme

机译：公共社会福利计划的经常性支出的可持续性：加纳国家健康保险计划的免费孕产妇保健计划的支出分析

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Objective: Sustainability of public social welfare programmes has long been of concern in development circles. An important aspect of sustainability is the ability to sustain the recurrent financial costs of programmes. A free maternal care programme (FMCP) was launched under the Ghana National Health Insurance Scheme (NHIS) in 2008 with a start-up grant from the British Government. This article examines claims expenditure under the programme and the implications for the financial sustainability of the programme, and the lessons for donor and public financing of social welfare programmes. Methods: Records of reimbursement claims for services and medicines by women benefitting from the policy in participating facilities in one sub-metropolis in Ghana were analysed to gain an understanding of the expenditure on this programme at facility level. National level financial inflow and outflow (expenditure) data of the NHIS, related to implementation of this policy for 2008 and 2009, were reviewed to put the facility-based data in the national perspective. Findings: A total of US$936 450.94 was spent in 2009 by the scheme on FMCP in the sub-metropolis. The NHIS expenditure on the programme for the entire country in 2009 was US$49.25 million, exceeding the British grant of US$10.00 million given for that year. Subsequently, the programme has been entirely financed by the National Health Insurance Fund. The rapidly increasing, recurrent demands on this fund from the maternal delivery exemption programme-without a commensurate growth on the amounts generated annually-is an increasing threat to the sustainability of the fund. Conclusions: Provision of donor start-up funding for programmes with high recurrent expenditures, under the expectation that government will take over and sustain the programme, must be accompanied by clear long-term analysis and planning as to how government will sustain the programme.
机译：目标：公共社会福利计划的可持续性一直是发展界关注的问题。可持续性的重要方面是承受计划经常性财务费用的能力。根据英国政府的启动赠款，2008年根据加纳国家健康保险计划（NHIS）推出了免费的孕产妇保健计划（FMCP）。本文研究了该计划下的索赔支出，以及该计划对财务可持续性的影响，以及为社会福利计划的捐助者和公共筹资提供的经验教训。方法：分析了从加纳一个大都会参与设施的政策中受益的妇女对服务和药品的报销记录，以了解该计划在设施级别的支出。审查了与2008年和2009年该政策的实施有关的国家医疗保险体系的国家级资金流入和流出（支出）数据，以将基于设施的数据纳入国家观点。调查结果：该计划在2009年共花费936 450.94美元用于该大都市的FMCP。 2009年，全国NHIS计划的支出为4925万美元，超过了当年英国提供的1000万美元。随后，该计划完全由国家健康保险基金资助。产妇免除方案对该基金的经常性需求迅速增长，而每年产生的数额却没有相应增长，这对该基金的可持续性构成了越来越大的威胁。结论：在预期政府将接管并维持该计划的同时，为经常性支出较高的计划提供捐助者启动资金，必须伴随着对政府如何维持该计划的明确长期分析和计划。

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