Financing Health Services in Developing Countries: An Agenda for Reform, Volume 34
World Bank Publications, Jan 1, 1987 - Business & Economics - 93 pages
This report discusses several different approaches that support reforming health care services in developing countries. For some time now, health care services have been supported by government funds. As demands for improving health care services continue to increase additional demands will be placed on governments to respond. This, however, will not be easy. Slow economic growth and record budget deficits in the 1980's have forced reductions in public spending. Alternative approaches to finance health care services are needed. Such possible changes could involve: decentralization of federal government involvement; the promotion of nongovernment involvement; the imposition of user fees; and, establishing health insurance. Finally, the role of the Bank in pursuing new financing strategies is discussed.
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additional life saved Africa allocation Arab Rep average Bangladesh benefits Botswana budget Burkina Faso Burundi capita China clients clinics collected Colombia consumers copayments cost-effective costs Cote d'lvoire coun cover curative services decentralization developing countries Ecuador ernment estimates fees Free Free Free funds health care health expenditures health facilities health financing health programs health sector health spending health system hospitals households incentives income India Indonesia inpatient insurance schemes Latin America Lesotho low-income Malawi ment middle-income Ministry of Health nongovernment sector nurses outpatient patients payments percent personnel Peru Philippines physicians plans policies poor population primary health problems public health public sector referral reforms revenues risk coverage risk-sharing rural areas rural health Rwanda Senegal social insurance social security Somalia subsidies Table Tanzania Thailand tion U.S. dollars urban user charges village health workers World Bank Yemen Zambia Zimbabwe
Page 78 - Life expectancy at birth indicates the number of years a newborn infant would live if prevailing patterns of mortality at the time of its birth were to stay the same throughout its life.
Page 80 - The infant mortality rate is the number of infants who die before reaching one year of age, per thousand live births in a given year. The data are from a variety of sources— including issues of UN Demographic Yearbook, and Population and Vital Statistics Report, and UN "Infant Mortality: World Estimates and Projections, 1950-2025" Population Bulletin of the United Nations (1983), and from the World Bank.
Page 77 - ... conversion factor underlying the Atlas method of converting the remaining components of GNP. Current population estimates and estimates of fertility and mortality are made by the World Bank from data provided by the UN Population Division, the UN Statistical Office, country statistical offices, and other sources. In many cases, the data take into account the results of recent population censuses. Refugees not permanently settled in the country of asylum are generally considered to be part of...
Page 80 - ... population. Food supplies comprise domestic production, imports less exports, and changes in stocks; they exclude animal feed, seeds for use in agriculture, and food lost in processing and distribution. The daily calorie requirement per capita refers to the calories needed to sustain a person at normal levels of activity and health, taking into account age and sex distributions, average body weights, and environmental temperatures.
Page 1 - A case certainly could be made for more public spending on health in developing countries . . . even if this money were spent as cost-effectively as possible, it would probably be insufficient to meet critical health needs. But in most countries the general budget stringency makes it difficult to argue for more public spending. For the foreseeable future, government efforts to improve health are unlikely to rely on increases in public spending financed by debt or taxes, or on the reallocation of...
Page 78 - ... crosscountry comparability of GNP per capita estimates cannot be achieved. Beyond the classic, strictly intractable "index number problem," two obstacles stand in the way of adequate comparability. One concerns GNP numbers themselves. There are differences in the national accounting systems of countries and in the coverage and reliability of underlying statistical information between various countries. The other relates to the conversion of GNP data, expressed in different national currencies,...
Page 80 - A hospital bed is one regularly maintained and staffed for the accommodation and full-time care of a succession of inpatients and is situated in a ward or a part of the hospital where continuous medical care for inpatients is provided.
Page 5 - Bank (1987: 5) advises governments to encourage private physicians, pharmacists and other health practitioners to provide health services for which consumers are willing to pay.
Page 2 - ... currently have only limited access to services of this nature. Health Sector Problems The characteristics and performance of the health sector vary tremendously among developing countries. In most cases, however, the sector faces three main problems. It is argued here that each of these problems is due in part to the efforts of governments to cover the full costs of health care for everyone from general public revenues. The three problems are: • Allocation: insufficient spending on cost-effective...