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Section outline
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Aim of the Unit
This unit aims to build the competency of students in describing a health financing system. This unit will take an in-depth look at important issues in health financing in low and middle-income countries and develop students’ skills to critically analyze health financing systems.
Learning outcomes- Explain health financing functions: revenue collection, pooling, and purchasing and discuss its relation and interaction with other functions of the health system
- Assess the major health financing challenges faced by developing countries and discuss the available options for improving financing of health services and for including the poor.
- Discuss the policy implications of health financing for reaching “Universal Health Coverage”.
Learning activities
In this unit, students will be engaged in different activities including forum discussion, short quizzes and written assignments. Students are expected to complete all the unit's activities.
Learning resources
Learning resources include powerpoint presentations summarizing the content of each session, web links to video and readings.
Structure of the unit
This course is organized around activities that will most likely ensure that students acquire the expected knowledge and skills. The unit comprises 6 sessions organized as follow:
Session 1: Introduction to Health Systems and Universal Health Coverage
Session 2: Revenue Collection
Session 3: Pooling of funds
Session 4: Purchasing of health services
Session 5: Health financing challenges
Session 6: Monitoring and accountability for UHC
This is an online course. However, we will set up 2 weekly online sessions to go over questions students have and discuss other challenges encountered during online teaching. These meetings will start at 6 pm and last for an hour. The choice of the days will be made with students.
Assessment modalities
Students will be assessed through quizzes, individual and group written assignments. Students are also expected to actively participate in forum discussions and interact with their classmates and instructors. Assessment modalities are as follow:
– Participation in forum discussion: 15%
– Quizzes:15%
– Individual assignment: 30%
– Group assignment: 30%-
Students mustMark as done
At the end of this session, you should be able to answer the following questions:
- What are health system function?
- what does the health financing function?
- How would you explain the Universal Health Coverage concept?
Reading resources:
- World Health Organization. World Health Report 2000 – Chap 1– Why do health systems matter? Geneva: World Health Organization, 2000. Available from: https://www.who.int/whr/2000/en/
- World Bank definitions of health systems: WORLD BANK 2007. Healthy development: the World Bank strategy for health, nutrition, & population results, World Bank. (Annex F: What is a health system?). Available from: http://documents.worldbank.org/curated/en/102281468140385647/pdf/409280PAPER0He101OFFICIAL0USE0ONLY1.pdf
- WHO Strategy on strengthening health systems: WHO 2007. Everybody's Business: Strengthening Health Systems to Improve Health Outcomes: WHO's Framework for Action, World Health Organization. Available from: http://bit.ly/A8s7PD
- Summary of Bismark, Beveridge & National Health Insurance models. Available from: http://to.pbs.org/wLPitf
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Students mustMark as done
The purpose of this activity is to introduce students to health system building blocks and the concept of Universal Health Coverage (UHC). Students will watch a short video below and read the resources available under Session1 above:
Short video:
Task:
1. Write a brief essay that will respond to the following questions
a. How can you define a health system?
b. What is the difference between a health system and a health care system?
c. What does Universal Health Coverage mean?
2. Instructions for submission: 1000 words maximum
3. Post your work on the discussion forum board by Sunday, November 15, 2020 at 11:59 pm.
4. Read other students’ posts and comment at least three of them -
Students mustMark as done
Here is the forum discussion where you will post your work on E-tivity 4.1.
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Students mustMark as done
At the end of the session, students will be able to:
- Define what revenue collection is.
- Describe the existing mechanisms for revenue collection.
- Assess every revenue collection mechanism.
Reading resources:
- World Health Organization. World Health Report 2000 Chap 5 – Who pays for health systems? Pooling and Purchasing. Geneva: World Health Organization, 2000. Available from: https://www.who.int/whr/2000/en/
- Roberts M., Hsiao W., Berman P., Reich M.R. Ch 8 – Financing. Getting Health Reform Right: a guide to improving performance and equity. Oxford: Oxford University Press, 2004: 190- 211.
- https://pdfs.semanticscholar.org/1279/c87e7ea6e47f87e3d52410c88a3a0489caad.pdf
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Students mustMark as done
The purpose of this activity is to further deepen students understanding of the first health financing function- revenue collection and existing mechanisms for mobilizing resources for health. Students will read the resources under Session 2 above.
Task- Write a brief essay identifying and describing the existing revenue collection mechanisms implemented in Rwanda.
- Instructions: 1,500 words maximum, Font: Times New Roman, Size:12. This assignment will be assessed for content and similarities with existing work. Carefully cite your sources and provide a list of references.
- Submit your work by Sunday, November 22, 2020 11:59 pm.
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Students mustMark as done
At the end of the session, students will be able to:
- Define fund pooling and how it relates to UHC
- Describe the characteristics of an effective risk pool
Reading resources:
- World Health Organization. World Health Report 2000 Chap 5 – Who pays for health systems? Pooling and Purchasing. Geneva: World Health Organization, 2000. Available from: https://www.who.int/whr/2000/en/
- Gottret P, Schieber G. Ch 3 – Risk pooling mechanisms. Health Financing Revisited. Washington DC: The international Bank for Reconstruction and Development/ World Bank, 2006: 73-121.
- https://equityhealthj.biomedcentral.com/articles/10.1186/s12939-019-1088-x
- https://www.who.int/healthsystems/topics/financing/healthreport/FragmentationTBNo5.pdf?ua=1
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Students mustMark as done
At the end of this session, students will be able to:
- Explain what is purchasing of health services: “Who are the purchasers?”, “What do we purchase?”, “From whom do we purchase?” and “How do we purchase?”.
- Understand the rationale for purchasing more strategically
- Describe purchasing or payment methods, their advantages and disadvantages.
Reading resources:
- World Health Organization. World Health Report 2000 Chap 5 – Who pays for health systems? Pooling and Purchasing. Geneva: World Health Organization, 2000. Available from: https://www.who.int/whr/2000/en/
- https://www.who.int/publications-detail/purchasing-health-services-for-universal-health-coverage-how-to-make-it-more-strategic
- https://www.who.int/publications-detail/strategic-purchasing-for-universal-health-coverage-key-policy-issues-and-questions
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Students mustMark as done
The purpose of this activity is to deepen students’ knowledge in regards to the concept of purchasing health services. Students will have to read the resources under Session 4, watch a video and participate in a discussion forum.
Video:
Task:
1. Write a brief essay that will respond to the following questions
a. What is strategic purchasing?
b. Why should we purchase health services more strategically?
c. Discuss one challenge when implementing strategic purchasing.
2. Instructions for submission: 1000 words maximum
3. Submit your work by Sunday at 11:59pm of week 2 of teaching. -
Students mustMark as done
At the end of this session, students will be able to:
1. Discuss the global health financing issues in low-income countries
2. Understand the potential solutions available
3. Critically discuss the possible solutions
Reading resources- Gottret P, Schieber G. Ch 7 – Financing Health in Low Income Countries. Health Financing Revisited. Washington DC: The international Bank for Reconstruction and Development/ World Bank, 2006: 209-248.
- Cavagnero E., Lane C., Evans D.B., Carrin G. (2008). Development assistance for Health: Should policy-makers worry about its macro-economic impact? Bulletin of the World Health Organization. 86 (11) 864-70.
- Lu C and all. (2010). Public financing of health in developing countries: a cross national systematic analysis. The Lancet. 375:1375-87.
- Piva P., Dodd R. (2009). Where did all the aid go? An in-depth analysis of increased health aid flows over the past 10years. Bulletin of the World Health Organization. 87: 930-939.
- Powell-Jackson T., Mills A. (2007). A review of health resource tracking in developing countries. Health Policy and Planning. 2007; 1-10.
- https://www.worldscientific.com/doi/pdf/10.1142/9789813140493_0005
- https://www.who.int/publications-detail/public-spending-on-health-a-closer-look-at-global-trends
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Students mustMark as done
At the end of the session, students will be able to:
- Assess country’s progress in regards to UHC
- Assess country’s progress towards financial protection
- Describe the different methods used to measure countries’ health expenditures
Reading resources
- https://equinetafrica.org/sites/default/files/uploads/documents/GWAehs.pdf
- https://bmcinthealthhumrights.biomedcentral.com/track/pdf/10.1186/s12914-017-0121-7
- https://www.hsprj.com/health-maintanance/catastrophic-health-expenditure-among-developing-countries.pdf
- https://www.thelancet.com/action/showPdf?pii=S2214-109X%2817%2930429-1
- https://www.healthpolicy-watch.org/wp-content/uploads/2019/09/Full-report.pdf
- https://apps.who.int/iris/bitstream/handle/10665/330357/WHO-HIS-HGF-HF-WorkingPaper-19.4-eng.pdf?ua=1
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