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March 05, 2012

Will performance-based financing survive universal health coverage?

 
  Photo Credit Dominic Chavez

This blog originally appeared on the blog Health Financing in Africa. 

 

This year’s theme of the 20th Prince Mahidol Award Conference (PMAC) in Bangkok organized in January 2012 by the Thai Government, was: “Towards Universal Health Coverage (UHC) – health financing matters”. The conference included 48 sessions in 5 days – including one on P/RBF. With so much going on, it was  impossible to attend it all, so I will limit myself to some general comments on UHC and what could be of interest for P/RBF in PMAC.
 
What is hot – and what’s not
Thailand is one of the success stories where UHC has been attained over the last 10 years. There was a high level of “UHC – yes we can” emotions, with UHC promoted as something that can be achieved by all countries. It gave the impression – which was acclaimed by several speakers – that we’ve moved on to the Rio agenda of “development” rather than poverty eradication, and that the MDGs have had their time in the spotlight. 
Even Health System Strengthening seems no longer “hot” for some actors – as observed  by Dr Hercot on the IHP blog (you can also access his post on theUHC-forward website that was launched by R4D that same week of the PMAC). 
Even if UHC is hot now, there was still quite some discussion on what it is, and what it’s not. UHC may sound like the 1978 “Health for All” agenda of Alma Ata, but the strategy looks different this time around. According to the WHO definition, UHC focuses on making health care available for 100% of the population, increasing the health care package to essential care, while making it financially accessible. Yes, health financing matters, but many raised the issue thatequity should be better anchored in UHC. Tim Evans from BRAC University defined UHC as “intolerance to inequities in health care – ending the injustice that too many have no access”. Also, UHC seems to be about providing health services only, with little regard for what we have learned the last decades that improving health outcomes does not depend on health services only but also on the socio-economic determinants of health (education, water and sanitation, nutrition, …). Little of this was discussed in Bangkok. 
Continue reading at Health Financing in Africa. 

This year’s theme of the 20th Prince Mahidol Award Conference (PMAC) in Bangkok organized in January 2012 by the Thai Government, was: “Towards Universal Health Coverage (UHC) – health financing matters”. The conference included 48 sessions in 5 days – including one on P/RBF. With so much going on, it was  impossible to attend it all, so I will limit myself to some general comments on UHC and what could be of interest for P/RBF in PMAC.

What is hot – and what’s not

Thailand is one of the success stories where UHC has been attained over the last 10 years. There was a high level of “UHC – yes we can” emotions, with UHC promoted as something that can be achieved by all countries. It gave the impression – which was acclaimed by several speakers – that we’ve moved on to the Rio agenda of “development” rather than poverty eradication, and that the MDGs have had their time in the spotlight. 

Even Health System Strengthening seems no longer “hot” for some actors – as observed  by Dr Hercot on the IHP blog (you can also access his post on the UHC-forward website that was launched by R4D that same week of the PMAC). 

Even if UHC is hot now, there was still quite some discussion on what it is, and what it’s not. UHC may sound like the 1978 “Health for All” agenda of Alma Ata, but the strategy looks different this time around. According to the WHO definition, UHC focuses on making health care available for 100% of the population, increasing the health care package to essential care, while making it financially accessible. Yes, health financing matters, but many raised the issue thatequity should be better anchored in UHC. Tim Evans from BRAC University defined UHC as “intolerance to inequities in health care – ending the injustice that too many have no access”. Also, UHC seems to be about providing health services only, with little regard for what we have learned the last decades that improving health outcomes does not depend on health services only but also on the socio-economic determinants of health (education, water and sanitation, nutrition, …). Little of this was discussed in Bangkok. 

Continue reading at Health Financing in Africa.