ABSTRACT
The Alma-Ata declaration and global strategy of Health for All by the year 2000 have given political and practical momentum to the delivery of primary health care in developing countries. WHO has provided leadership for this process; with support from other UN agencies and international donor organizations. Primary health care is based on the concept of a District Health System which provides comprehensive services. Community participation and intersectoral collaboration are the cornerstones of primary health care. Using Malawi; Uganda; India and Indonesia as examples; the article explores experiences of health problems and of health care delivery to underprivileged populations in African and Asian countries
Subject(s)
Delivery of Health Care/economics , Delivery of Health Care/organization & administration , Developing Countries/economics , Primary Health Care/economics , Primary Health Care/organization & administrationABSTRACT
Face a la dure crise economique qui secoue l'Afrique en general et le Cameroun en particulier; face aux poids ecrasant des budgets de sante que consentent encore quelques entreprises; et face enfin aux limites economiques du financement assignables aux travailleurs; il apparait imperatif de limiter la croissance des depenses de sante; et dans leurs composantes; celles des depenses hospitalieres qui equivalent a plus de la moitie de l'ensemble. Le poids des couts de sante pese lourdement sur ceux censes les supporter. Mais en limitant les couts; la finalite hospitaliere devra demeurer identique; a la seule difference que desormais; le meilleur soin devrait etre acquitte a mointre cout
Subject(s)
Delivery of Health Care/economics , Health Policy/economics , Health Services/economicsABSTRACT
On March 7; 1995; the Child Health and Development Centre; Makeree University; in collaboration with the Ministry of Finance and Economic Planning and the Minsitry of Health; organised a dissemination seminar on health care financing in Uganda. The seminar was supported by UNICEF and SIDA. The venue was International Conference Centre; Kampala. Participatants represented key line ministries; districts; hospitals; NGOs and interventional organisations; community programmes; research institutions and the media. The specific objectives of the seminar were:- to present research and work undertaken on policy and planning issues related to health care financing in Uganda; - to bring actors; such as politicians; donors; NGOs; researchers and practitioners interested in these topics together to discuss them; - to identify gaps and/or researchable topics related to health care financing; - to directly influence health economic planning and policy. The seminar was divided into our sessions: - Session I: Household spending patterns and non-investment in vulnerable groups; - Session II: Cost recovery at health facility level; - Session III: Community participation and financing initiatives; Session IV: Way forward - implications for research; planning and policy. In order to encourage interactive discussions; three main methodological approaches were used. Presenters were invited to present papers on specific topics and a cluster of papers was discussed by a discussant. The role of the discussant was to highlight major topics and to stimulate the following plenary discussion. The major achievements of the seminar were dissemination of research findings; sharing of experiences; and discussions on priority issues related to the financing of health services and laternative financing options for the future. Furthermore; the development of a core database on health fainancing and net-warking of persons with shared interest in these topics was initiated. By the end of the day; research needs and priorities aimed at influencing planning and policy were set. In the course of the seminar; a number of priority research topics was identified. Participants identified a need to find out more about household' sepending patterns on health care in relation to other expenditure. Research aimed at identifying alternative health financing mechanisms was priotised; as well as the development of indicators for monitoring these mechanisms. Furthermore; studies providing information towards development of district guidelines on cost-sharing were noted as important. In addition; the gap between resources available and resources neded must be identified. It was also emphasised that research findings must be disseminated in an appropriate forum in order to provide a valuable planning and policy tool. In terms of planning and policy; the need to develop and implement a coherent national policy on health care financing was clearly underscored