Is protection a suitable system for advancing SRH? Encounters from Bolivia, Egypt and Rwanda.


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Is protection a reasonable procedure for advancing SRH? Encounters from Bolivia, Egypt and Rwanda Tania Dmytraczenko Abt Partners Inc., Accomplices for Wellbeing Change in addition to Leeds, UK September 8-11, 2003 Layout of Presentation Foundation Bolivia: Wellbeing arrangement methodology in Bolivia
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Is protection a reasonable system for advancing SRH? Encounters from Bolivia, Egypt and Rwanda Tania Dmytraczenko Abt Associates Inc., Partners for Health Reform in addition to Leeds, UK September 8-11, 2003

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Outline of Presentation Background Bolivia: Health arrangement method in Bolivia Results from Bolivia Contributions and next steps Rwanda: Health approach procedure in Rwanda Results from Rwanda Contributions and next steps Concluding comments

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Poverty and Health Bolivia Poverty USD 950 for each capita salary Maternal Mortality Rate 371 for each 100,000 live births Rwanda Poverty USD 100 mean fiscal utilization uses per capita every year Maternal Mortality Rate 1071 for every 100,000 live births

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Bolivia: Equity in Access to Institutional Care by Pregnant Women Source: DHS Bolivia, 1998

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Rwanda: Equity in Access to Curative Care for Women User Fee System Source: Household and Living Condition Survey 1999/2001

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The consistent idea in the middle of Bolivia and Rwanda Recognition that budgetary requirements are a hindrance to get to Health strategy methodologies went for reducing so as to lessen maternal and tyke mortality monetary obstructions to get to Health protection as a distinct option for client expenses

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Health Insurance in Bolivia Insurance for Mothers and Children (SNMN) – mid 1996 Women and kids under 5 get treatment complimentary for set administrations MOH offices at all levels, some standardized savings clinics, not very many NGOs Financed from general levy 20% of government incomes exchanged to regions 3.2% of city stores (for venture) reserved for wellbeing Facilities are repaid on a for every administration premise by metropolitan government Drugs, supplies, hospitalization, lab exams

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Evolution of the Insurance Program Basic Health Insurance (SBS) – 1999 Beneficiary populace widened Package of advantages extended Participating offices expanded Social security offices Health Insurance for Mothers and Children (SUMI ) – 2003 Return to unique target populace Universality of administrations secured Facilities still repaid on a for each administration premise by civil government Increase in reserve for wellbeing SMNM: 3.2% SBS: 6.4% SUMI: 10%

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Increased conveyances in wellbeing offices

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Increased conveyances in wellbeing offices in provincial regions

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Increase in conveyances went to by talented faculty

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Increase in conveyances went to by gifted staff

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At minimum a build\'s percentage can be ascribed to the Insurance Program Source : SNIS, MSPS

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Contributions of Health Insurance in Bolivia Utilization of maternal and tyke wellbeing administrations expanded The rustic poor are utilizing protection administrations Government special endeavors educated people in general Primary level offices expanded medication accessibility Utilization of general wellbeing base expanded

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Next Steps In Bolivia Some of the increment out in the open administrations is because of exchanges from the private segment Address issues identified with suitable open private blend Costs vary crosswise over office sort, yet repayment rates don\'t Differentiate repayment rates over the diverse administration conveyance levels Reimbursement rates don\'t take care of work expenses Issues identified with wellbeing laborer inspiration Free administrations urge patients to look for consideration at larger amount offices Establish a referral framework

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Increased usage of more elevated amount offices

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Rwanda: Health Policy Strategy Pilot-Test Micro-Health Insurance in 3 Rural Districts (with 1 million populace) Evaluate Effectiveness of Insurance Function in Improving Equity in Access and in Health Financing Sustainability Community Participation

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Equity in Access to Care: Sick MHI Members Use Modern Health Facilities at a Higher Rate Across Consumption Quartiles Source: HH-overview

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Members will probably get proficient help amid conveyance

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Equity in Health Financing: Members Pay Lower Price at Time of Consumption Source: Patient post employment surveys

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Contributions of Micro-Health Insurance in Rwanda Lifted money related boundaries in access to maternal, preventive and corrective administrations Families with kids and ladies in tyke bearing age were destined to enlist, and have completely profit by better budgetary openness

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Next Steps In Rwanda To react to the interest of different locale and scale up the prepayment arranges across the country To grow the advantage bundle to full area scope To sponsor the interest of yearly premiums for the poor through a group reserve

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Concluding comments Organizational and authoritative document of wellbeing protection inserted in country’s financial setting Political suitability Design stage is discriminatingly critical Appropriate motivating forces Adverse choice, good peril, cream skimming, and so on. Wellbeing specialist inspiration Human and hierarchical limit building Monitoring and assessment

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Partnerships for Health Reform is actualized by Abt Associates Inc. under contract No. HRN-C-95-00024 with the U.S. Organization for International Development (USAID)

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