Adam Wagstaff - Böcker

This volume presents the results of research which represent a significant contribution to the knowledge of equity in the finance and delivery of health care in ten countries. It compares the experience of nine European countries and the US using a consistent methodology to draw out comparable results from ten very different health care systems.Such an approach facilitates not only a greater understanding of the performance of the health care systems of other countries but also the identification of the lessons that can be learnt from international comparisons. In recent years it has been recognized that many health and health care problems are similar across many countries and their solution can be usefuly informed by the abandonment both of isolation and the belief that an individual country's problems are unique.The contents of this book demonstrate that given efficient research teams, research funding can produce both significant new knowledge of direct relevance to the reform of health care systems world-wide, and also collaborative, mutually informative work between Europeans and others living outside the EEC.

This volume presents eleven case studies that document how well or poorly health, nutrition, and population programs have reached disadvantaged groups in the countries of Africa, Asia, and Latin America where they were undertaken. The studies were commissioned by the Reaching the Poor Program, undertaken by the Word Bank in cooperation with the Bill and Melinda Gates Foundation and the Dutch and Swedish governments, in an effort to find better ways of ensuring that health, nutrition, and population programs benefit the neediest. These case studies, reinforced by other material gathered by the Reaching the Poor Program, indicate clearly that health programs do not have to be inequitable. Although most health, nutrition, and population services achieve much lower coverage among disadvantaged groups than among the better-off, many significant and instructive exceptions exist. These show that the poor can be reached much more effectively than at present and point to potentially promising strategies for doing so.

Have gaps in health outcomes between the poor and better off grown? Are they larger in one country than another? Are health sector subsidies more equally distributed in some countries than others? Are health care payments more progressive in one health care financing system than another? What are catastrophic payments and how can they be measured? How far do health care payments impoverish households? Answering questions such as these requires quantitative analysis. This in turn depends on a clear understanding of how to measure key variables in the analysis, such as health outcomes, health expenditures, need, and living standards. It also requires set quantitative methods for measuring inequality and inequity, progressivity, catastrophic expenditures, poverty impact, and so on. This book provides an overview of the key issues that arise in the measurement of health variables and living standards, outlines and explains essential tools and methods for distributional analysis, and, using worked examples, shows how these tools and methods can be applied in the health sector. The book seeks to provide the reader with both a solid grasp of the principles underpinning distributional analysis, while at the same time offering hands-on guidance on how to move from principles to practice.

Vietnam's successes in the health sector are legendary. Its rates of infant and under-five mortality are comparable to those of countries with substantially higher per capita incomes. Vietnam continues to be an over-achiever in the health sector according to data assembled in this book. Like other countries, though, Vietnam faces challenges in its health system. By international standards, for example, Vietnam has a high incidence of catastrophic household health spending-a large fraction of households make out-of-pocket payments for health care that exceeds a reasonable fraction of their income. To address this and related issues, Vietnam has been extending the breadth of health insurance coverage. Questions remain, however, about how to further expand coverage, and how to put downward pressure on health care costs, which are rising rapidly, and upward pressure on the quality of care, which some evidence suggests is low. This book generates new evidence and new insights on these topics, and sets out some ideas for further reforming Vietnam's health system.

Assesses China's rural health system before and during the reforms of the 2000s. This book outlines ideas for building on these reforms to further strengthen the system including over the long-term.

This Policy Research Report examines one specific policy approach to improving effective coverage: financial incentives in the form of performance-based financing (PBF) or financial incentives to health workers on the front lines.