scholarly journals Including undocumented migrants in universal health coverage: a maternal health case study from the Thailand-Myanmar border

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Naomi Tschirhart ◽  
Wichuda Jiraporncharoen ◽  
Rojanasak Thongkhamcharoen ◽  
Kulyapa Yoonut ◽  
Trygve Ottersen ◽  
...  
Keyword(s):  
Low Cost ◽  
Border Region ◽  
Insurance Fund ◽  
Undocumented Migrants ◽  
Health Coverage ◽  
Non Profit ◽  
Cross Border ◽  
Emergency Interventions ◽  
Universal Health

Abstract Background Many countries aspiring to achieve universal health coverage struggle with how to ensure health coverage for undocumented migrants. Using a case study of maternal health care in a Thailand-Myanmar border region this article explores coverage for migrants, service provision challenges and the contribution of a voluntary health insurance program. Methods In 2018 we interviewed 18 key informants who provided, oversaw or contributed to maternal healthcare services for migrant women in the border region of Tak province, Thailand. Results In this region, we found that public and non-profit providers helped increase healthcare coverage beyond undocumented migrants’ official entitlements. Interview participants explained that Free and low-cost antenatal care (ANC) is provided to undocumented migrants through migrant specific clinics, outreach programs and health posts. Hospitals offer emergency birth care, although uninsured migrant patients are subsequently billed for the services. Care providers identified sustainability, institutional debt from unpaid obstetric hospital bills, cross border logistical difficulties and the late arrival of patients requiring emergency lifesaving interventions as challenges when providing care to undocumented migrants. An insurance fund was developed to provide coverage for costly emergency interventions at Thai government hospitals. The insurance fund, along with existing free and low-cost services, helped increase population coverage, range of services and financial protection for undocumented migrants. Conclusions This case study offers considerations for extending health coverage to undocumented populations. Non-profit insurance funds can help to improve healthcare entitlements, provide financial protection and reduce service providers’ debt. However, there are limits to programs that offer voluntary coverage for undocumented migrants. High costs associated with emergency interventions along with gaps in insurance coverage challenge the sustainability for NGO, non-profit and government health providers and may be financially disastrous for patients. Finally, in international border regions with high mobility, it may be valuable to implement and strengthen cross border referrals and health insurance for migrants.

Exploring Subbordia – the impact of suburbanisation in cross-border metropolitan regions. The case study of Szczecin and its German hinterland

2018 ◽  
Vol 60 (1) ◽  
pp. 5-13 ◽  
Author(s):  
Martin Barthel ◽  
Ewelina Barthel
Keyword(s):  
Border Region ◽  
Metropolitan Region ◽  
Metropolitan Regions ◽  
Grass Roots ◽  
Planning Support ◽  
Cross Border ◽  
Connected Area ◽  
The Impact ◽  
Local Narratives

Abstract This paper focuses on the largely unexamined phenomenon of the developing trans-national suburban area west of Szczecin. Sadly the local communities in this functionally connected area struggle with national planning policies that are unsuitable for the region. The paper examines the impact of those processes on the border region in general and on the localities in particular. The paper investigates the consequences for local narratives and the cohesive development of the Euroregion and what position Polish and German communities took to develop the region, even without the necessary planning support. The region has succeeded in establishing grass-roots planning mechanisms which have helped to create a metropolitan-region working from the bottom up.

scholarly journals Analyzing efforts to synergize the global health agenda of universal health coverage, health security and health promotion: a case-study from Ethiopia

2021 ◽  
Vol 17 (1) ◽  
Author(s):  
Amare Worku Tadesse ◽  
Kassu Ketema Gurmu ◽  
Selamawit Tesfaye Kebede ◽  
Mahlet Kifle Habtemariam
Keyword(s):  
Health Promotion ◽  
Global Health ◽  
Health System ◽  
Universal Health Coverage ◽  
World Health ◽  
Health Coverage ◽  
Health Security ◽  
Universal Health ◽  
Health Agenda

Abstract Background Evidence exists about synergies among universal health coverage, health security and health promotion. Uniting these three global agendas has brought success to the country’s health sector. This study aimed to document the efforts Ethiopia has made to apply nationally synergistic approaches uniting these three global health agendas. Our study is part of the Lancet Commission on synergies between these global agendas. Methods We employed a case study design to describe the synergistic process in the Ethiopian health system based on a review of national strategies and policy documents, and key informant interviews with current and former policymakers, and academics. We analyzed the “hardware” (using the World Health Organization’s building blocks) and the “software” (ideas, interests, and power relations) of the Ethiopian health system according to the aforementioned three global agendas. Results Fragmentation of health system primarily manifested as inequities in access to health services, low health workforce and limited capacity to implementation guidelines. Donor driven vertical programs, multiple modalities of health financing, and inadequate multisectoral collaborations were also found to be key features of fragmentation. Several approaches were found to be instrumental in fostering synergies within the global health agenda. These included strong political and technical leadership within the government, transparent coordination, and engagement of stakeholders in the process of priority setting and annual resource mapping. Furthermore, harmonization and alignment of the national strategic plan with international commitments, joint financial arrangements with stakeholders and standing partnership platforms facilitated efforts for synergy. Conclusions Ethiopia has implemented multiple approaches to overcome fragmentation. Such synergistic efforts of the primary global health agendas have made significant contributions to the improvement of the country’s health indicators and may promote sustained functionality of the health system.

scholarly journals The importance of socialization in achieving universal health coverage: case study of Jaminan Kesehatan Nasional (JKN) implementation in two different region in Central Java province

2019 ◽  
Vol 10 (2) ◽  
pp. 110-120
Author(s):  
Ema Nur Fitriana ◽  
Ari Natalia Probandari ◽  
Eti Poncorini Pamungkasari ◽  
Tonang Dwi Ardyanto ◽  
Rizky Amalia Puspitaningrum
Keyword(s):  
Universal Health Coverage ◽  
Health Coverage ◽  
Central Java ◽  
Universal Health ◽  
Central Java Province

scholarly journals Trends in Glaucoma Medication Expenditures under Universal Health Coverage: A National Population-Based Longitudinal Survey in Taiwan

2015 ◽  
Vol 2015 ◽  
pp. 1-6 ◽  
Author(s):  
Shin-Lin Chiu ◽  
Chiao-Lee Chu ◽  
Chih-Hsin Muo ◽  
Chiu-Liang Chen ◽  
Shou-Jen Lan
Keyword(s):  
High Efficiency ◽  
Low Cost ◽  
Insurance Coverage ◽  
Health Insurance Coverage ◽  
Population Based ◽  
Medical Expenditures ◽  
Health Coverage ◽  
Blue Collar Workers ◽  
Universal Health Insurance Coverage ◽  
Universal Health

Medical care in Taiwan is well known for its low cost, high efficiency, high quality, excellent medical accessibility, and high equity. We investigate the trends in medication expenditures for glaucoma from 1997 to 2010. The results show that higher medical expenditures were incurred by patients who were aged ≥40 years, male patients, and patients in the highest salary population whereas lower medical expenditures were incurred by blue-collar workers. The medications with the most significant increases in expenditure were prostaglandin analogs (PGAs),α-agonists, and fixed combinations, whereas the medications with the most significant decreases in expenditure wereβ-blockers and cholinergic agonists. The number of trabeculectomies shows two downward break points in 1999 and 2000 when PGAs were listed and were reimbursed. These results suggest socioeconomic disparities in glaucoma care, as well as understanding of the changes in the expenditure of glaucoma medications under such universal health insurance coverage system.

Cross-Border Cooperation and Transformation of Regional Identities in the Ukrainian–Russian Borderlands: Towards a Euroregion “Slobozhanshchyna”? Part 2*

2004 ◽  
Vol 32 (2) ◽  
pp. 497-514 ◽  
Author(s):  
Tatiana Zhurzhenko
Keyword(s):  
Border Region ◽  
The Other ◽  
Cross Border ◽  
Symbolic Resources ◽  
Cultural Specificity ◽  
The Cross ◽  
Administrative Units ◽  
Cross Border Cooperation

Let us now have a closer look at the Kharkiv-Belgorod (potential) cross-border region as a case study of Ukrainian-Russian cross-border cooperation. Not only is the case of Kharkiv-Belgorod special because of the historical and cultural specificity of the region, which provides additional symbolic resources for its “reinvention” as a borderland (this will be discussed in the last section of the paper); it also represents an interesting combination of (remaining) cultural closeness and (growing) social and economic differences between the two bordering territories; significantly, these two administrative units became the initiators of the cross-border cooperation between Ukraine and Russia and see themselves as pioneers whose experience can be used for the other parts of the border.

scholarly journals Access to and Quality of Primary Healthcare: a Multi-Country Qualitative Case Study in West and East Africa

2020 ◽  
Author(s):  
Soter Ameh ◽  
Bolarinwa Oladimeji Akeem ◽  
Caleb Ochimana ◽  
Abayomi Olabayo Oluwasanu ◽  
Shukri F Mohamed ◽  
...  
Keyword(s):  
East Africa ◽  
Universal Health Coverage ◽  
Primary Healthcare ◽  
Qualitative Case Study ◽  
Financial Burden ◽  
Cost Of Care ◽  
Health Coverage ◽  
Universal Health

Abstract Background: Universal health coverage is one of the Sustainable Development Goal targets known to improve population health and reduce financial burden. There is little qualitative data on access to and quality of primary healthcare in West and East Africa. We elicited in-depth viewpoints of healthcare users and providers, and other stakeholders regarding access to and quality of healthcare.Methods: A qualitative case study was conducted in four communities in Nigeria, and one community each in Kenya, Uganda and Tanzania in 2018. Purposive sampling was used to recruit 155 participants for 24 focus group discussions, 24 in-depth interviews, and 12 key informant interviews. The conceptual framework in this study combined elements of the Health Belief Model, Health Care Utilisation Model, four ‘As’ of access to care, and pathway model to better understand health-seeking behaviours of the study participants. The data were analysed with MAXQDA 2018 qualitative software to identify three themes identified a priori and one emerging theme.Results: Access to primary healthcare in the seven communities was limited. Quality of care was perceived to be unacceptable in public facilities whereas cost of care was unaffordable in private facilities. Patients and health providers and stakeholders highlighted shortage of equipment, frequent drug stock-outs and long waiting times as major issues, but had varying opinions on satisfaction with care. Use of herbal medicines and other traditional treatments delayed or deterred seeking modern healthcare in Nigerian sites. Conclusions: There was a substantial gap in primary healthcare coverage and quality in the selected communities in rural and urban East and West Africa. Alternative models of healthcare delivery should be used to fill this gap and facilitate achieving universal health coverage.

scholarly journals Synergies and Fragmentation in Country Level Policy and Program Agenda Setting, Formulation and Implementation for Global Health Agendas: A Case Study of Health Security, Universal Health Coverage, and Health Promotion in Ghana and Sierra Leone

2020 ◽  
Author(s):  
Irene Akua Agyepong ◽  
Fredline A.O. M’Cormack-Hale ◽  
Hannah Brown-Amoakoh ◽  
Abigail N.C. Derkyi-Kwarteng ◽  
Theresa Ethel Darkwa ◽  
...  
Keyword(s):  
Health Promotion ◽  
Global Health ◽  
Sierra Leone ◽  
Agenda Setting ◽  
Structural Constraints ◽  
Health Coverage ◽  
Health Security ◽  
Country Level ◽  
Universal Health

Abstract Background: Global health agendas have in common the goal of contributing to population health outcome improvement. In theory therefore, whenever possible, country level policy and program agenda setting, formulation and implementation towards their attainment should be synergistic such that efforts towards one agenda promote efforts towards the other agendas. Observation suggests that this is not what happens in practice. Potential synergies are often unrealized and fragmentation is not uncommon. In this paper we present findings from an exploration of how and why synergies and fragmentation occur in country level policy and program agenda setting, formulation and implementation for the global health agendas of Universal Health Coverage (UHC), Health Security (HS) and Health Promotion (HP) in Ghana and Sierra Leone. Our study design was a two country case study. Data collection involved document reviews and Key Informant interviews with national and sub-national level decision makers in both countries between July and December 2019. Additionally, in Ghana a stakeholder workshop in December 2019 was used to validate the draft analysis and conclusions. This study is part of a series of country case studies to inform the Lancet Commission on synergies between UHC, HS and HP.Results: National and global context, country health systems leadership and structure including resources were drivers of synergies and fragmentation. How global as well as country level actors mobilized power and exercised agency in policy and program agenda setting and implementation processes within country were also important drivers. Conclusions: There is potential in both countries to pull towards synergies and push against fragmentation in agenda setting, formulation and implementation of global health agendas despite the resource and other structural constraints. It however requires political and bureaucratic prioritization of synergies, as well as skilled leadership. It also requires considerable mobilization of country level actor exercise of agency to counter sometimes daunting contextual, systems and structural constraints.

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