Eskinder Eshetu Ali1. 1. Department of Pharmaceutics and Social Pharmacy, School of Pharmacy, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia. Electronic address: eskinder.eshetu@aau.edu.et.
Abstract
BACKGROUND: The Ethiopian health care system is under tremendous reform. One of the issues high on the agenda is health care financing. In an effort to protect citizens from catastrophic effects of the clearly high share of out-of-pocket expenditure, the government is currently working to introduce health insurance. OBJECTIVE: This article aims to highlight the components of the Ethiopian health care financing reform and discuss its implications on access to essential medicines. METHODS: A desk review of government policy documents and proclamations was done. Moreover, a review of the scientific literature was done via PubMed and search of other local journals not indexed in PubMed. RESULTS: Revenue retention by health facilities, systematizing the fee waiver system, standardizing exemption services, outsourcing of nonclinical services, user fee setting and revision, initiation of compulsory health insurance (community-based health insurance and social health insurance), establishment of a private wing in public hospitals, and health facility autonomy were the main components of the health care financing reform in Ethiopia. Although limited, the evidence shows that there is increased health care utilization, access to medicines, and quality of services as a result of the reforms. CONCLUSIONS: Encouraging progress has been made in the implementation of health care financing reforms in Ethiopia. However, there is shortage of evidence on the effect of the health care financing reforms on access to essential medicines in the country. Thus, a clear need exists for well-organized research on the issue.
BACKGROUND: The Ethiopian health care system is under tremendous reform. One of the issues high on the agenda is health care financing. In an effort to protect citizens from catastrophic effects of the clearly high share of out-of-pocket expenditure, the government is currently working to introduce health insurance. OBJECTIVE: This article aims to highlight the components of the Ethiopian health care financing reform and discuss its implications on access to essential medicines. METHODS: A desk review of government policy documents and proclamations was done. Moreover, a review of the scientific literature was done via PubMed and search of other local journals not indexed in PubMed. RESULTS: Revenue retention by health facilities, systematizing the fee waiver system, standardizing exemption services, outsourcing of nonclinical services, user fee setting and revision, initiation of compulsory health insurance (community-based health insurance and social health insurance), establishment of a private wing in public hospitals, and health facility autonomy were the main components of the health care financing reform in Ethiopia. Although limited, the evidence shows that there is increased health care utilization, access to medicines, and quality of services as a result of the reforms. CONCLUSIONS: Encouraging progress has been made in the implementation of health care financing reforms in Ethiopia. However, there is shortage of evidence on the effect of the health care financing reforms on access to essential medicines in the country. Thus, a clear need exists for well-organized research on the issue.
Authors: Toby Freeman; Hailay Abrha Gesesew; Clare Bambra; Elsa Regina Justo Giugliani; Jennie Popay; David Sanders; James Macinko; Connie Musolino; Fran Baum Journal: Int J Equity Health Date: 2020-11-10
Authors: Chol Chol; Joel Negin; Alberto Garcia-Basteiro; Tesfay Gebregzabher Gebrehiwot; Berhane Debru; Maria Chimpolo; Kingsley Agho; Robert G Cumming; Seye Abimbola Journal: Glob Health Action Date: 2018 Impact factor: 2.640