Back in the 1930s, Sri Lanka thought it would be a good idea to give everyone free access to health care. More than 75 years later, as the global health community bangs the drum for universal health coverage (UHC), Sri Lankans can be forgiven for letting out a yawn and wondering what all the fuss is about. But as shown by a workshop organized in Colombo last week to mark the first World UHC Day, the concept of universal health coverage (“all people receive the health services they need without suffering financial hardship”) does still have relevance here.
Start with the history. By 1960 Sri Lanka’s health indicators were already well above the curve for its income level, and it was close to having the best health outcomes in developing Asia. It started the MDG era in 1990 with a level of child mortality that was lower than where most Asian countries – including Vietnam, Philippines, Indonesia, and its South Asian neighbors India, Pakistan and Bangladesh – will finish it in 2015. Vaccination rates are above 99%. And all this was achieved without results-based financing, conditional cash transfers, or today’s other proposed silver bullet solutions for improving health.
Hospitals in France deliver services for acute care. Except for surgery, the consumption of hospital care is predominantly public. The sector accounts for half of the national consumption of medical goods and services and is mostly funded through the Health Insurance system.
The public hospital sector has been facing recurrent deficits over the last three decades, associated with weak managerial print and uneven performance. Since the 80s, global budget was the norm, leading to rent seeking within and across public Hospitals in the absence of incentives for quality and efficiency. Thus, the French Government launched a massive reform initiative starting 2004 to strengthen hospital efficiency and quality of care in a resource-constrained environment.
Disasters, whether natural or man-made, destroy and disable healthcare systems just when they’re needed most. But disaster can also create an opportunity to make healthcare better, even in the world’s most troubled places.
I pay through the nose for health insurance for my family, and I’m not happy about it. As a U.S. citizen, I don’t have the luxury of government-backed healthcare. Since I’m technically self-employed, I have to pay the full premium myself. Want some figures? It costs me $830 a month for a family of four, with a high deductible. Besides being expensive, it takes a huge effort to deal with insurance issues, and I find that my provider is expert at finding reasons not to reimburse me for medical expenses. This is chewing a gaping hole in my budget. The only way I’ll ever get value for my money is if I’m hit by a bus.
I could tell something wasn’t quite right with the electrician. He was standing stiffly, poking at the wires in the circuit breaker panel, his face pale, his breathing labored. My wife offered him a cup of tea and asked if he was OK.
“I’m fine,” he said. “I just had a little surgery yesterday.” He kept working until he fixed the wiring; only then did he accept the tea. Then he told us his story.
With only five years left until the 2015 deadline to achieve the Millennium Development Goals, one particular topic in transport that I believe should gather more collaboration and contributions from both the health and the transport sectors is the unfinished agenda of maternal and child health. The completion date of the MDGs is fast approaching but the discussions and research surrounding specific MDGs have been uneven
- South Asia
- Middle East and North Africa
- Latin America & Caribbean
- Europe and Central Asia
- East Asia and Pacific
- under-five mortality
- Millenium Development Goals
- maternal mortality
- Maternal health
- intensive care
- health facility
A recent article by Timothy Ogden (Computer Error?) provides a pretty clear answer: forget the glitzy computers, and put your scarce resources into the provision of deworming pills. The One Laptop per Child (OLPC) program provides computers at around $200 a pop, while deworming pills cost between 50 cents and 4 dollars per student per year. All the control trials of computers in classrooms have given—at best—ambiguous results.
Call them taxpayers, citizens, or just simply the public—they are the reason why public private partnerships (PPPs) are created. They are the users and the ultimate financiers, whether by paying taxes or tolls, and they want to have a bigger role in decisions about what infrastructure shall be built and how. It’s no surprise that public opinion is the ultimate judge of the success of PPP projects.
Any social media evangelist surely knows the objection all too well: you try to make the case for Web 2.0 and the power of conversations that it enables when someone inevitably comes up with "conversations are all very well, but what about real work? And real impacts?"