Health systems and reform
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Health systems and reform · Jan 2016
The New Era of Health Goals: Universal Health Coverage as a Pathway to the Sustainable Development Goals.
Abstract-The inclusion of universal health coverage (UHC) as a target in the health Sustainable Development Goals speaks to its importance as both a foundational and an end goal for global health. Across the globe, countries are in varying stages of progress toward UHC. ⋯ For countries in the midst of economic transition with greater capacity and resources, we must focus on mobilizing domestic resources to ensure sustainable financing for UHC. As members of the global health community, we must continue to invest in global public goods to properly support monitoring and measurement to track progress on UHC.
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Health systems and reform · May 2015
Political Strategies for Health Reform in Turkey: Extending Veto Point Theory.
Abstract-This qualitative case study uses primary interview data to investigate the political processes of how Turkey established a unified and universal health coverage system. The goal of providing health coverage to all citizens through a unified system has been adopted by many low- and middle-income countries, but few have achieved it; Turkey is a notable exception. We use institutional veto point theory to identify four institutional obstacles to a unified and universal coverage system in Turkey between 2003 and 2008: (1) the Ministry of Finance and Treasury, (2) the Ministry of Labor and Social Security, (3) the Office of the President, and (4) the Constitutional Court. ⋯ Where possible they avoided institutional veto points by using ministerial authority to adopt policies. When adoption required approval of others with veto power, they delayed putting forward legislation while working to facilitate institutional change to remove opposition; persuaded or made strategic compromises to gain support; or overpowered opposition by calling on the prime minister to intervene. Our findings propose an extension to institutional veto point theory by showing how the exercise of political strategies can overcome opposition at institutional veto points to facilitate policy adoption.
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Health systems and reform · Feb 2015
Agenda Setting and Policy Adoption of India's National Health Insurance Scheme: Rashtriya Swasthya Bima Yojana.
Abstract-Rashtriya Swasthya Bima Yojana (RSBY) is India's largest health insurance scheme. Launched in 2007, it now covers over 37 million, mostly poor, families. This massive scheme represents a major departure from past approaches to government support for health care in India. ⋯ Technological advancements offered the reformers both new options and new experiences on which to base their innovations. A group of policy entrepreneurs, including Congress Party leaders, technocrats, and senior government officials, collaborated with international agencies to develop the RSBY approach, place it on the agenda, and assure its adoption as national policy. This analysis explores factors that made this significant equity-oriented health reform possible in India and provides lessons for health reformers in other countries who seek to learn from India's experiences in moving toward universal health coverage. Finally, we suggest some adjustments in Kingdon's framework to help apply his ideas in different contexts.