Ideas to Action:

Independent research for global prosperity

Tag: Health Systems

 

Global Health "Best Buys": The Key Is in Delivery

Successful investments in global health—or “best buys”— can be defined in many ways: a cost-effective commodity or technology, a well-trained health workforce, an evidence-informed policy, etc. We recently hosted an event in partnership with PSI, PATH, Devex, and Merck to discuss this topic, and noted a reoccurring theme:  service delivery is key.

Is Free Care Good for Health?

A recent article shows that removing fees for health care in rural Ghana has no impact on health.  These results are strikingly similar to another recent study that found expanding the US Medicaid insurance program in Oregon also had no impact on physical health (my colleague Victoria Fan and I even wrote a similarly-titled blog about it here – Déjà vu!)

Experimentation for Better Health: Lessons from the US for Global Health

In recent weeks, the public health world and political pundits alike have been abuzz about results from the “Oregon Experiment,” a study published in the New England Journal of Medicine that finds no statistical link between expanded Medicaid coverage and health outcomes such as high cholesterol or hypertension. Limitations of the study aside, the Oregon Experiment is a good example of the importance of rigorously testing all US health programs, rather than just assuming ‘more care = better health’.  The Innovation Center at the United States Centers for Medicaid and Medicare Services, created under the umbrella of the Affordable Care Act, represents a new and encouraging approach to address this problem, an approach that we think has important lessons for global health.

What Will Universal Health Coverage Actually Cover?

This week the World Health Organization held a major international meeting on universal health coverage (UHC), with Director General Margaret Chan reaffirming her regard for universal coverage “as the single most powerful concept that public health has to offer.” While the term “universal” signals that the entire population will be “covered,” an unanswered question is: covered with what? Another way to put the question: What health benefits or interventions would represent coverage, taking into account UHC’s implicit goals of improved health, equity and financial protection?

What’s in a Pilot? A View from South Africa’s National Health Insurance (NHI)

This is a joint post with Rachel Silverman.

Last week, I attended a conference on South Africa’s national health insurance (NHI), which was hosted in Pretoria by the Human Sciences Research Council (HSRC). A key recurring theme and consensus emerged: South Africa must develop a clearer plan and strategy for the “piloting” phase of its national health insurance.

Some background: In 2011, the government of South Africa committed itself to providing all of its citizens with “a defined package of comprehensive (health) services” through national health insurance. While the details are still up in the air, the government issued a preliminary policy paper which estimated NHI to cost R255 billion (~US$30 billion) per year by 2025, if implemented as planned over a 14-year period.

What the Pre-Post Evaluation of AMFm Can Tell Us

This is a joint post with Heather Lanthorn, a doctoral candidate at Harvard School of Public Health.

In mid-July, amidst the busy global-health month of July, in between the Family Planning summit and the AIDS conference, the near-final draft of the independent evaluation of the Affordable Medicines Facility - Malaria (AMFm) was released.

Financing Universal Access to ART: Reflections From IAC 2012

Two messages reigned supreme at last month’s International AIDS Conference (IAC) in Washington DC: 1) that there should be universal coverage of HIV/AIDS treatment and 2) that international funding for HIV/AIDS has been flat-lining recently and may even shrink. The most optimistic scenario to reach universal coverage will cost $22 billion dollars annually, which means raising an additional $6 billion per year. Clearly, the goal to provide treatment to the 34 million people currently living with AIDS, and the approximately 2.5 million newly infected each year, conflicts with the reality of shrinking aid budgets.

Results-Based Aid in Liberia: USAID Forward (and one step back)

In a recent working paper, Jacob Hughes, Walter Gwenigale and I describe Liberia’s unique experience in pooling donor funds for health in a post-conflict setting, with good results. We also describe a new and complementary agreement between Liberia and USAID, called the Fixed Amount Reimbursement Agreement (FARA). It’s been heartening to see USAID take this step towards implementing results-based aid in Liberia, but the process has also highlighted the problems that such aid faces in the ‘real world’.

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