What is it about?
To be able to determine the fairness of public spending, we look at all tax financed expenditures on public health programmes. We follow the funds on the basis of how much is spent on regional levels, inpatient and outpatient services and total health care resources which we examine by different groups of the population based on the wealth and income status such that we have five groups of the population from the poorest to the richest and compare how much they use services and how much this translates into in monetary value. We then also consider how different efforts of how resources are mobilised and allocated over time in Zambia and if at all this has influenced how households have accessed health care based on the above mentioned approach.
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Why is it important?
This is important because it is able to show us at first sight how resources are allocated to different geographical regions and how within these regions and at national level, the different income groups access different services in terms of the monetary value and also in relation to their need. This helps explain differences we may see in health outcomes, how poverty is to a certain extent influenced and how government policies and programmes shape social, economic and health equity in the country. It also raises areas for further research and policy analysis.
Perspectives
Strengthening health systems in developing countries remains an ever challenging task. Health systems continue to be fragmented, weak and offer poor responsiveness to routine and also other shocks on the health system e.g. ebola, etc. However, on a much lesser complex base, the distributional aspects of financing policy measures and the equity that is necessary to develop a self sustaining, resilient and robust health system are sometimes not consistent with the policy expressions and so there is an acute dichotomy between policy and implementation. In order to begin to demonstrate this, it is essential to show with less complex analytical frameworks how and at what stage the health system is. Then having established some basic understanding of the issues more complex analysis could as a matter of logic and sequencing follow.
Bona Chitah
Department of Economics, The University of Zambia
Read the Original
This page is a summary of: Myriad of Health Care Financing Reforms in Zambia: Have the Poor Benefited?, Health Systems & Reform, September 2018, Taylor & Francis,
DOI: 10.1080/23288604.2018.1510286.
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