The accounting framework for health care financing is a key component of A System of Health Accounts 2011, published by OECD, Eurostat and WHO in October 2011.1 The framework makes health accounts more adaptable to rapidly evolving health financing systems, further enhances crosscountry comparabilit...y of health expenditures and financing data, and ultimately improves the information base for the analytical use of national health accounts (NHAs). It is hoped that SHA 2011 – including its financing framework – will make health accounts a more useful assessment and monitoring tool for health systems and health expenditure in the economy as a whole.
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This report started with a simple question—“How can we tell how much funding is devoted to global health programs?”—and ended (more than two years later) with an answer that is far from simple. As those who have tried know well, tracking health-related funding is challenging in any setting, ...given the range of public and private sources and the many types of services and programs that fall within the definition of “health sector.” It is made all the more complicated when significant external support from donors and private charities plus in-kind donations of drugs and other inputs are taken into account. The task is made yet harder by inadequate public expenditure management systems in countries where public agencies’ capacity is stretched very thin and by donor accounting structures that are not designed to respond in a timely way
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In Kenya, 12.7 percent of sick Kenyans do not seek health care when they are ill with high cost of services being one of the major barriers that accounted for upto 21 percent of those who did not seek care in 2013. Further, 2.6 million Kenyans (6.2 percent) of households were at risk of impoverishme...nt as a consequence of expenditure on health care depleting household savings and were at a risk of falling into poverty (Republic of Kenya 2015b).
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UNHCR’s Public Health Strategy 2021-2025 is based on the lessons learnt, and builds on the achievements, of the Global Strategy for Public Health 2014-2018.
Progress was made on policies favouring inclusion and integration into national systems3 with 92% of 48 operations surveyed reporting refuge...es having access to national primary health care facilities under the same conditions as nationals and 96% reporting refugees having access to all relevant vaccines under the same conditions as nationals. While many refugee hosting countries have policies that allow refugees to access national health services, many face partial access, prohibitive out-of-pocket expenditures and other barriers including distance to facilities, language and provider acceptance. Furthermore, more work is needed on strengthening these systems to be able to meet the needs of both host communities and refugees.
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Tobacco kills up to half of its users who don’t quit (1-3).
Tobacco kills more than 8 million people each year, including an estimated 1.3 million non-smokers who are exposed to second-hand smoke Around 80% of the world's 1.3 billion tobacco users live in low- and middle-income countries.In 2020,... 22.3% of the world’s population used tobacco: 36.7% of men and 7.8% of women.
To address the tobacco epidemic, WHO Member States adopted the WHO Framework Convention on Tobacco Control (WHO FCTC) in 2003. Currently 182 countries are Parties to this treaty.
The WHO MPOWER measures are in line with the WHO FCTC and have been shown to save lives and reduce costs from averted healthcare expenditure.
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Key facts
- A healthy diet helps to protect against malnutrition in all its forms, as well as noncommunicable diseases (NCDs), including diabetes, heart disease, stroke and cancer.
- Unhealthy diet and lack of physical activity are leading global risks to health.
- Healthy dietary practices start... early in life – breastfeeding fosters healthy growth and improves cognitive development, and may have longer term health benefits such as reducing the risk of becoming overweight or obese and developing NCDs later in life.
- Energy intake (calories) should be in balance with energy expenditure. To avoid unhealthy weight gain, total fat should not exceed 30% of total energy intake (1, 2, 3). Intake of saturated fats should be less than 10% of total energy intake, and intake of trans-fats less than 1% of total energy intake, with a shift in fat consumption away from saturated fats and trans-fats to unsaturated fats (3), and towards the goal of eliminating industrially-produced trans-fats (4, 5, 6).
- Limiting intake of free sugars to less than 10% of total energy intake (2, 7) is part of a healthy diet. A further reduction to less than 5% of total energy intake is suggested for additional health benefits (7).
- Keeping salt intake to less than 5 g per day (equivalent to sodium intake of less than 2 g per day) helps to prevent hypertension, and reduces the risk of heart disease and stroke in the adult population (8).
- WHO Member States have agreed to reduce the global population’s intake of salt by 30% by 2025; they have also agreed to halt the rise in diabetes and obesity in adults and adolescents as well as in childhood overweight by 2025 (9, 10).
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The Lancet Planetary Health, Volume 2, ISSUE 9, Pe398-e405, September 01, 2018.
Reduction of antibiotic consumption will not be sufficient to control antimicrobial resistance because contagion—the spread of resistant strains and resistance genes—seems to be the dominant contributing factor. Im...proving sanitation, increasing access to clean water, and ensuring good governance, as well as increasing public health-care expenditure and better regulating the private health sector are all necessary to reduce global antimicrobial resistance.
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Background: At the MDG Summit in September 2010, the UN Secretary-General launched the Global Strategy for
Women’s and Children’s Health. Central within the Global Strategy are the ambitions of “more money for health”
and “more health for the money”. These aim to leverage more resource...s for health financing whilst simultaneously
generating more results from existing resources - core tenets of public expenditure management and governance.
This paper considers these ambitions from a human resources for health (HRH) perspective
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Ethiopia has seen high economic growth over the last decade, but remains a poor country with a high burden of disease. It has made considerable health gains in recent years, mainly by having health policies that focus on extending primary healthcare, using health extension workers. It... has made good use of existing resources,but has a low health expenditure (of around US$21 per capita, and totalling 4per centof GDP). It has a federal system with devolved healthcare financing, whereby block grants are allocated to sectors at regional and woreda(district) level. The challenge now,with the epidemiological transition (and a sense that the ‘low-hanging fruits’have already been gathered in relation to public health), is how Ethiopia, still poor, continuesto invest in health improvements?Human resources for health (HRH) are a critical pillar within any health system –the health staff combine inputs to provide the services, thus affecting how all other resources are used, and they make frontline (and back-office) decisions thatare importantdeterminants of servicequality,effectiveness and equity. HRH is usually the most resource-intensive element within the health system –commonly absorbing 50–70per centof public expenditure onhealth, although the proportions are very varied by individual countries and across regions. As they are commonly part of the public administration, reforms to HRH are also part of a complex political economy in most countries.Assessing value for money (VfM) in relation to HRH is correspondingly complex;across the value chain, manyfactors influence the conversion of inputs into outputs and outcomes (see Figure 1).A more detailed description of the HRH value chain can be found in Annex1.
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Primary health care offers a cost–effective route to achieving universal health coverage (UHC). However, primary health-care systems are weak in many low- and middle-income countries and often fail to provide comprehensive, people-centred, integrated care. We analysed the primar...y health-care systems in 20 low- and middle-income countries using a semi-grounded approach. Options for strengthening primary health-care systems were identified by thematic content analysis. We found that: (i)despite the growing burden of noncommunicable disease, many low- and middle-income countries lacked funds for preventive services; (ii)community health workers were often under-resourced, poorly supported and lacked training; (iii)out-of-pocket expenditure exceeded 40% of total health expenditure in half the countries studied, which affected equity; and (iv)health insurance schemes were hampered by the fragmentation of public and private systems, underfunding, corruption and poor engagement of informal workers. In 14 countries, the private sector was largely unregulated. Moreover, community engagement in primary health care was weak in countries where services were largely privatized. In some countries, decentralization led to the fragmentation of primary health care. Performance improved when financial incentives were linked to regulation and quality improvement, and community involvement was strong. Policy-making should be supported by adequate resources for primary health-care implementation and government spending on primary health care should be increased by at least 1% of gross domestic product. Devising equity-enhancing financing schemes and improving the accountability of primary health-care management is also needed. Support from primary health-care systems is critical for progress towards UHC in the decade to 2030.
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In Latin America and the Caribbean (LAC), one maternal death was registered every hour in 2020. That same year, the trend in the maternal mortality ratio (MMR) for the Region of the Americas regressed alarmingly and unprecedentedly to the levels seen two decades ago. In addition to indicating a wors...ening of health outcomes, these figures also signal a deepening of inequalities, representing thousands of individual, unacceptable tragedies that in most cases could have been preventable. Maternal death is the result of a multifactorial process in which structural elements such as the economic system, environmental conditions, and culture interact. Other factors related to social inequality are also present, such as racism, poverty, gender inequality, and lack of access to the education system. The current situation calls for urgent mobilization of the health systems of LAC countries in order to strengthen efforts to combat maternal mortality, especially in countries that are still far from achieving the SHAA2030 regional target. For this reason, a preventive, health-promoting, life-course-based approach is needed, with models of care centered on women, families, and the community Scientific evidence shows that health systems with a solid foundation in primary health care (PHC) achieve better outcomes, greater equity, and reduced health expenditures. To address this, PAHO proposes a strategy, aimed primarily at women who are in the most vulnerable situation, who are the ones who represent the greatest burden of maternal mortality, to accelerate the reduction of maternal mortality in the Region of the Americas, based on the expansion and strengthening of PHC.
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The OECD carries out work on health data and indicators to improve international comparisons and economic analyses of health systems.
Accessed 26 February 2019.
Panorama de la Salud: Latinoamérica y el Caribe 2020 presenta indicadores clave sobre la salud y los sistemas de salud en 33 países de Latinoamérica y el Caribe. Esta primera edición del Panorama de la Salud sobre Latinoamérica y el Caribe fue preparada en conjunto por la OCDE y el Banco Mundia...l. Los análisis se basan en los datos comparables más recientes de alrededor de 100 indicadores sobre equidad, situación de salud, determinantes de la salud, recursos y actividades, gasto y financiación, y calidad en la atención de salud. El editorial discute los principales desafíos para la región en el contexto de la pandemia de COVID-19, incluyendo tanto el manejo de la epidemia como la movilización y el uso eficiente de recursos para asegurar una respuesta efectiva
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