Estimating Universal Health Coverage for Ensuring Health Services Accessibility
Estimating universal health coverage (UHC) is crucial for ensuring all individuals have access to quality health services without experiencing financial hardship. Dr. N. Devadasan from the Institute of Public Health in Bangalore, India, emphasizes the need to move towards 100% coverage and develop strategies to achieve this goal. The presentation covers aspects like indicators for financial coverage, examples from select Southeast Asian countries, and population coverage quintiles.
Download Presentation
Please find below an Image/Link to download the presentation.
The content on the website is provided AS IS for your information and personal use only. It may not be sold, licensed, or shared on other websites without obtaining consent from the author. Download presentation by click this link. If you encounter any issues during the download, it is possible that the publisher has removed the file from their server.
E N D
Presentation Transcript
Estimating Universal Health coverage Dr. N. Devadasan, Institute of Public Health, Bangalore, India
UHC Universal health coverage ? Universal health care ? Ensuring that ALL people can use the health services they need of sufficient quality to be effective, while also ensuring that the use of services do not expose the use to financial hardship 3/01/2013 Presentation at NHSRC 2
Coverage 3/01/2013 Presentation at NHSRC 3
Why estimate? UHC is about moving from point A to point B We need to know where we are currently Point B is usually 100% coverage We need to develop the strategy to reach Point B 3/01/2013 Presentation at NHSRC 4
WHR 2010 3/01/2013 Presentation at NHSRC 5
What to estimate Financial Population Services Quantitative Qualitative 3/01/2013 Presentation at NHSRC 6
Indicators for financial coverage Indicator % of population who are insured % of population who are covered under a pooled fund THE as a % of GDP OOP as a % of THE Incidence & Intensity of CHE Incidence & Intensity of Impoverishment % of patients who make OOP Source of data IRDA reports Census NHA NHA NSSO NSSO ? NSSO, NFHS, Simple studies 3/01/2013 Presentation at NHSRC 7
Examples Proportion of insured among select SE Asian Countries 100% 90% 80% 70% 60% Uninsured 50% Insured 40% 30% 20% 10% 0% Thailand Philipines Indonesia Vietnam Cambodia Laos Malaysia 3/01/2013 Presentation at NHSRC 8
Examples OOP payments as a proportion of THE 70% 62% 60% 60% 55% 55% 50% 41% 40% 30% 30% 19% 20% 10% 0% Thailand Philipines Indonesia Vietnam Cambodia Laos Malaysia 3/01/2013 Presentation at NHSRC 9
Population coverage Indicator Quintiles / MPCE Population Attributable risk Concentration index SC / ST ? Source of data National surveys National surveys National surveys ? 3/01/2013 Presentation at NHSRC 10
Examples 95% 100% 91.00% 90% 78% 80% 70% 58% 60% 50% 40% 34% 25.00% 30% 20% 10% 0% Ailments treated - urban Institutional delivery Admissions* Lowest Highest 3/01/2013 Presentation at NHSRC 11
Indicators for service coverage Ideally one needs to define the essential health package 3/01/2013 Presentation at NHSRC 12
Indicators for service coverage ILO s access deficit method MDG countdown method SARA method Composite coverage index 3/01/2013 Presentation at NHSRC 13
Indicators for service coverage - Quantitative Indicator % of antenatals with full ANC % of institutional deliveries % of unmet FP needs % of children fully immunised % of children who received ORT % of children who received ARI Rx TB Case detection rate % of children who slept under a ITN ? Source of data NFHS, DLHS, CEC NFHS, DLHS, CEC NFHS, DLHS NFHS, DLHS, CEC NFHS NFHS RNTCP reports 3/01/2013 Presentation at NHSRC 14
Indicators for service coverage - Quantitative Indicator OP contact rate IP admission rate % of diabetics on regular treatment ? % of women screened for CA Cervix ? % of households with access to toilets % of households with access to potable water in their house ? 3/01/2013 Source of data NSSO 60th round NSSO 60th round Census Census Presentation at NHSRC 15
Indicators for service coverage Quality of care Indicator Drop out rate ANC Drop out rate Immunisation Drop out rate TB Infection rate in hospitals Drop out rate IUCD ? Source of data 3/01/2013 Presentation at NHSRC 16
Service coverage: Examples 80% 70% 60% 50% 40% 30% 20% 10% 0% Full ANC Institutional delivery Full immunisation Unmet FP needs 3/01/2013 Presentation at NHSRC 17 Annual health survey 2012. X state
Service coverage: Examples.. 90% 80% 70% 60% 50% 40% 30% 20% 10% 0% Treated for ARI % of ailments treated Admission rate* TB case detection rate 3/01/2013 Presentation at NHSRC 18 DLHS, NSSO 60th Round, RNTCP 2012. India
What to do All indicators? A single composite indicator? A mixture? 3/01/2013 Presentation at NHSRC 19
Services + Population Drinking water at home 100% 75% Admission rate* Full ANC 50% 25% Lowest Highest 0% Institutional delivery rate Full immunisation Ailment treated Met FP needs 3/01/2013 Presentation at NHSRC 20
Services + OOP Drinking water at home 100% 75% Admission rate* Full ANC 50% 25% Lowest 0% Institutional delivery rate Full OOP immunisation Ailment treated Met FP needs 3/01/2013 Presentation at NHSRC 21
Financial coverage Incidence of OOP 100% 75% 50% 25% OOP as a % of THE Incidence of CHE 0% Incidence of impoverishment Presentation at NHSRC 3/01/2013 22
Financial coverage CURRENT STATUS Population coverage 3/01/2013 Presentation at NHSRC 23
Limitations Agreement on package Agreement on indicators Availability of disaggregated data Validation of this tool 3/01/2013 Presentation at NHSRC 24
Disclaimer Please note that this is a work in progress Suggestions and criticisms are welcome 3/01/2013 Presentation at NHSRC 25
Thank you Dr. N. Devadasan, MBBS, MPH, PhD Institute of Public Health, Bangalore
ILOs access deficit method Take stock of all existing financing mechanisms Affordability of the health services Availability Quality of HR and infrastructure Estimate access deficit Developing a coverage plan to fill the gaps 3/01/2013 Presentation at NHSRC 27
ILOs access deficit Pop % that can access % of the group whose services are funded by Govt HS Pvt HS General revenue Social securit y Comm based Fin Employer based initiatives PHI OOP Subcont racting Public employees Private employees Self employed Self employed agri Unemploye d 3/01/2013 Presentation at NHSRC 28
