查看更多>>摘要：This April 2021 issue of the Africa Health Journal (AHJ) has a focus on health financing, a subject described by Sam Okuonzi as the "most intractable challenge of health systems in LMICs". His article is one of the most educative summaries on the topic of health financing that I have ever seen and should be a must-read for all. This is followed by a review of the National Health Insurance Scheme in Ghana by veteran health system experts, Delanyo Dovlo and Chris Atim. This is one of the oldest such schemes in Africa, founded in 2004 and is now a major source of financing for health care in Ghana. It was estimated to cover approximately 35.8% of the population in 2018. There are lessons here for all African countries on their respective challenging journeys towards UHC.
查看更多>>摘要：Budget negotiations with national parliaments are going on right now in a number of African countries. Difficult decisions are being made on which aspects of health budgets should be prioritised for funding. This issue of the AHJ has a focus on health financing, which gives us an opportunity to contribute to these budget discussions. Health financing is "the raising, pooling and spending of financial resources with the primary intention of improving health". Its sources are general tax, donor aid, deficit funding (or borrowing), ear-marked taxes, and social and private health insurance. This should exclude out-of-pocket spending by individuals usually at the point of receiving health care. Expenditures are made in health facilities, on community and out-reach services, pharmacies, drug shops, sanitation, nutrition, training and research. From the origins and evolution of health financing, many lessons have been learned. Today, health financing remains the most intractable challenge for the health and development globally. Indeed, some have argued that Universal Health Coverage (UHC) in poor countries cannot be funded internally.
查看更多>>摘要：The 4th edition of the Africa Health Agenda International Conference (AHAIC) was hosted virtually from 8-10 March 2021 under the theme, "Decade for Action: Driving Momentum to Achieve UHC in Africa." AHAIC is an African-led biennial global health conference hosted by Amref. It attracted about 3,000 participants logging in from 98 countries across the African continent and beyond, including high profile speakers such as the President of Kenya, H.E. Uhuru Kenyatta, World Health Organization (WHO) Director General Dr Tedros Adhanom Ghebreyesus and the WHO-Afro Director Dr Matshidiso Moeti, among others. Held against the backdrop of COVID-19 recovery efforts, AHAIC 2021 provided a platform to explore the continent's health challenges, identify opportunities and propose sustainable solutions for and by Africa.
查看更多>>摘要："We live in a globalised world. COVID-19 has made it evident that a problem in one corner of the world is a problem across the world. Therefore, we have no choice but to partner and ensure that the world is a better place. This is what the Sustainable Development Goals (SDGs) are about, it is what universal health coverage (UHC) is about." This was one of the messages from Professor Francis Omaswa as he gave concluding remarks at the second COVID-19 partnerships conference on 19 March 2021. The virtual conference was hosted by THET UK in partnership with the African Centre for Global Health and Social Transformation (ACHEST) and Esther Alliance. It was held under the theme: "COVID-19 Partnerships in the International Year of Health and Care Workers: Protect. Invest. Together." This is in line with the World Health Organization year-long campaign to recognise health workers for their dedication and resilience in fighting the COVID-19 pandemic. Participants had the opportunity to reflect on what has been achieved by the health partnership community since the first conference in April 2020, and also to look into the future, recognising the immense pressure that is now falling on health workers in every country due to the pandemic. With the worrying increases in infections and the slow pace of vaccination campaigns in sub-Saharan Africa observed since the start of 2021, the conference discussed afresh how the Health Partnership community is pulling together, especially now, when solidarity is more important than ever.
查看更多>>摘要：Uganda is currently in a unique position. As several different national, continental, and global agendas and plans are ending and others beginning, an opportunity exists to re-examine its systems and processes of development. Uganda has recently started its third National Development Plan in 2020 as the continental African Union Agenda 2063 continues, and the endpoint of the Sustainable Development Goals in Agenda 2030 is fast approaching. Historically, most discussions regarding sustainable development in Uganda have focused on technical solutions to its various challenges, whether economic, political, or social. However, the effectiveness of these solutions has consistently been impeded by their implementation. One of the more under-appreciated aspects of implementation has been a collective mindset that owns and actively participates in development. The active participation and leadership in the development process by Ugandans creates the foundation for sustainable development because individuals, communities, and institutions build the necessary confidence to pursue increasingly complex and challenging solutions to their problems.
查看更多>>摘要：The Ghana Ministry of Health in 2020 developed a Roadmap for attaining Universal Health Coverage, which emphasised the importance of ensuring universal access to quality health care for all residents. The act of parliament (Act 650) that approved the National Health Insurance Scheme and Authority for Ghana was passed in 2003 as part of a scheme to improve financing of health services and to reduce the burden on the population occasioned by an existing policy of out-of-pocket payment for services initiated in the mid 1990s. It was revised by parliament through Act 852 in 2012. The National Health Insurance Scheme and its managing Authority was founded in 2004 and is now fully established as a major source of financing for health care in Ghana, with funding from both premium contributions and a general NHIS levy on Value Added Tax. It was estimated to cover approximately 35.8% of the population in 2018, which was a decline from 2016 coverage which was reported at about 40% of the population.
查看更多>>摘要：Diagnostics Medical Imaging plays an important role in diagnosis, treatment, and prognosis of disease, with imaging required for 30% of all medical conditions. For imaging to be performed, radiology equipment has to be available. Imaging is an important part of Universal Health Coverage (UHC). Despite the growth in medical imaging there remains considerable global inequality in access to it. The United Nations 2030 Agenda for Sustainable Development calls for unified global action to address the economic, social and environmental priorities reflected in the 17 Sustainable Development Goals (SDGs). Healthcare is particularly addressed in SDG3 - Good Health and Wellbeing. This goal has 13 targets, covering all major health imperatives, including UHC. The vision of UHC is to provide all people with quality essential health services. This is especially important for the African countries where most are far from achieving UHC.
查看更多>>摘要：Health workers play a critical role in the provision of health care and represent the single largest cost element in providing health services in low-income countries; from health promotion to prevention, treatment, rehabilitation and palliative care. Many of the poorest countries in the world lack the resources, both human and financial, to meet the pressing health needs of their populations. Millions of people die prematurely, or suffer from illness or disability unnecessarily, because appropriate Human Resources for Health (HRH) to provide care are not available or accessible to them.
Osita OkonkwoPasipanodya Ian MachinguraRichard F HellerOmo Oaiya Bpharm...
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查看更多>>摘要：African countries, as with other countries in the Global South, have major public health problems with an insufficient trained workforce and research leadership to respond to these problems. While African healthcare in general suffers from a lack of sufficient human resource in the health sector, there is also a particular lack of research capacity to address the health challenges. Part of this is due to over reliance on the Global North for research leadership, and a resulting failure to develop research which is appropriate to the local context. Reidpath and Allotey identify a need to "engage more effectively with the growing, if disempowered, talent in the Global South to support the building of enabling environments to raise the leadership, quality and volume of home grown, contextually driven and sustainable solutions". A paper in Times Higher Education 'Are research links with the developing world still a one-way street?' demonstrates the need for research leadership to come from the Global South.
查看更多>>摘要：Health financing is the raising and spending of financial resources with the primary intention of improving health. Typically, the sources of health financing are general taxation, donor aid, deficit funding (or borrowing), ear-marked taxation, and social and private health insurance. Expenditures are made in health facilities, on community and out-reach services, pharmacies, drug shops, sanitation, nutrition, training and research. From the origins and evolution of health financing, a lot of difficulties have been faced and many lessons learned.
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