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Health care funding sources

Health care funding sources. How are funds pooled. Payment mechanism. Services included in the benefit package: NHIF- ‘hotel costs’ Private insurance- all but depends on the premium. Govt-all? Equitable financing and delivery Who bears the burden?

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Health care funding sources

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  1. Health care funding sources

  2. How are funds pooled

  3. Payment mechanism • Services included in the benefit package: • NHIF- ‘hotel costs’ • Private insurance- all but depends on the premium. • Govt-all? Equitable financing and delivery Who bears the burden? • OOP- the poor( no discrimination at the point of purchase)-inequitable • Govt (Taxes)- All • NHIF-inequitable-there is a “cap” after a cont of Kshs.320 • Private insurance-the rich-inequitable

  4. Who benefits from health care • Govt- (Rich)70% of Govt resources goes to hosp care-based in urban where the rich are found. • Utilization of health care at hosp. is dominated by the rich while at primary health care facilities by the poor (BIA). • OOP- Rich?? • Private insurance-rich • NHIF-Relatively rich

  5. Factors contribute to equity/inequity in financing • What factors contribute to equity/inequity in financing in your country • Distribution of facilities • Distribution of financial &human resources • Quality of care • Mechanisms to protect the poor are not working • To what extend does the system protect the poor • Waivers &exemption mechanisms • 10/20 policy • Free health care for the under five/maternity ?? • Free health care for HIV/AIDS patient-only ARVs, pay for CD4 count & other tests

  6. Way forward towards universal coverage • Phased implementation • Define the package and keep on expanding it as the contributions and economy improves • Distribution of health personnel • Rehabilitate facilities • Address the issue of quality of care • Improve governance efficiency issues-NHIF and MoH

  7. Lesson learnt • Sustained economic growth • Stakeholders involvement • Political will • Policy champion

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