Showing papers by "Walaiporn Patcharanarumol published in 2008"

Innovative Financing of Health Promotion

Abstract: This paper synthesizes financing health care in general and health promotion in particular, and reviews experiences of innovative financing of health promotion in selected countries that have a specific dedicated tax for health promotion. The paper also draws on lessons from an in-depth case study in Thailand, a lower-middle income country, of the Thai Health Promotion Foundation which has been established since 2001, focusing on innovative financing and a multisectoral and multidisciplinary approach to health promotion. Results show that there is no innovative financing model for health promotion in low-income countries. The historical evolution of innovative financing for health promotion reveals a close link with existing strong tobacco control measures, especially in price increases and dedicated taxes for health promotion, as in Australia, the U.S., and Thailand. Another financing source is earmarking from social health insurance premiums which are quite limited in low-income countries. It is concluded that achieving success in effective financing of health promotion requires legislation to endorse a fund, and often an independent agency with greater flexibility in the organization and management of funding health promotion projects.

Can earmarking mobilize and sustain resources to the health sector

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Innovative Financing of Health Promotion

Abstract: Despite a pivotal role in improving health of the population, little has been known on how much is spent on health promotion. This paper synthesizes financing health care in general and health promotion in particular and reviews experiences of innovative financing mechanisms for health promotion in selected countries. The Thai experience in using a dedicated tax to finance health promotion is also demonstrated. The study found spending on health promotion in 2003 was very low, especially in Africa and Southeast Asia regions, and such a low level of spending cannot meet the challenges of the current disease burden in many countries. There is no innovative financing model in low-income countries, while two models, using dedicated taxes and social health insurance, to finance health promotion were found in middle- and high-income nations. In all cases, achieving success in effective financing for health promotion requires legislation to endorse a fund, and often an independent agency with great flexibility in granting and managing health promotion projects and activities.

Health care financing for the poor in Lao PDR

Abstract: As in many other developing countries, an official policy of user fees was adopted for the Lao health system in the 1990s. In principle, the poor were to be exempted from paying user fees at public health providers. This study aimed to contribute to policy on financial protection of the poor by (1) improving understanding of health care utilization and strategies adopted by households to deal with costs of Illness; (2) examining attitudes of policy makers and actual practice of public health care providers on fee exemptions of the poor; and (3) proposing better ways of protecting the poor. Both quantitative and qualitative methods were employed. Data were collected from 172 households of 4 villages in Savannakhet Province; 26 public providers in Savannakhet Province and 3 public providers in Vientiane capital; and 22 policy makers in Vientiane capital, between October 2005 and July 2006. The exemption policy has been ineffectively implemented. In practice, criteria for identifying the poor were not specified and no budget was provided to hospitals to finance exemptions. Providers preserved exemptions for 'the destitute'. The payment of user fees could be delayed without interest when 'the poor' had insufficient cash. Villagers strongly believed in the principle of paying user fees to providers either at the point of service or through delayed payment, even though they lived In difficult conditions and their average consumption was below $US1.00 a day. Importantly, they did not perceive exemption from fees to be possible for 'the poor'. The majority of households did not access health care services when III for reasons such as financial and geographical barriers; some of them suffered adverse health consequences as a result such as death or disability. The better the socio-economic group, the better was access to health care services. Among a total of 172 sampled households, twelve households were faced with catastrophic health expenditure, most from the middle and poorest socio-economic group. The villagers managed health crises themselves mainly through drawing on social networks within the community in order to sell assets, borrow, and get other forms of support from neighbours. Although the study of households was small in scale, it was likely to echo households' difficulties elsewhere as the studied villages were similar to other rural areas without roads of Lao PDR. This study suggests that there is an urgent need for the government to improve two main areas: accessibility to adequate health care for everyone, everywhere; and reform of the nationwide policy on health financial risk protection for the poor and the less-poor in order to reduce catastrophic health expenditure.