London School of Hygiene and Tropical Medicine, Keppel Street, London, WC1E 7HT, UK.
Health Policy Plan. 2012 Mar;27 Suppl 1:i4-12. doi: 10.1093/heapol/czs002.
A desire to enhance protection against health care costs and improve equity of access to health care lies at the core of many health sector financing initiatives. Until recently, international debates about financing and health equity have focused primarily on mechanisms to promote equity in relation to very specific elements of health systems. However, in recent years there has been growing interest in considering these equity challenges from a more systemic perspective. In this context, universal health coverage is becoming a rallying call, with a focus on how best universal coverage can be financed. This paper is the first in a special issue which presents a body of research whose overall aim was to critically evaluate existing inequities in health care financing and provision in Ghana, South Africa and Tanzania, and the extent to which health insurance mechanisms (broadly defined) could address financial protection and equity of access challenges. In this first paper we introduce the countries' health systems, with a special emphasis on existing mechanisms for financial protection. We also identify in broad terms the key challenges for universal coverage, setting the scene for the subsequent papers.
提高医疗成本保护和改善医疗保健获取公平性是许多医疗部门融资计划的核心。直到最近，关于融资和卫生公平性的国际辩论主要集中在促进卫生系统特定要素公平性的机制上。然而，近年来，人们越来越有兴趣从更系统的角度考虑这些公平性挑战。在这种情况下，全民健康覆盖正在成为一个号召，重点是如何最好地为全民健康覆盖提供资金。本文是一个特刊的第一篇，该特刊介绍了一组研究成果，这些研究的总体目标是批判性地评估加纳、南非和坦桑尼亚在医疗保健融资和提供方面现有的不平等现象，以及广义定义的医疗保险机制在多大程度上能够解决财务保护和获取公平性挑战。在第一篇文章中，我们介绍了这些国家的卫生系统，特别强调了现有的财务保护机制。我们还从广义上确定了实现全民覆盖的主要挑战，为后续的论文奠定了基础。
