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乌干达卫生筹资改革:消除对引入国家健康保险计划的恐惧和误解 评“乌干达的卫生覆盖和财务保护:政治经济学视角”

Health Financing Reforms in Uganda: Dispelling the Fears and Misconceptions Related to Introduction of a National Health Insurance Scheme Comment on "Health Coverage and Financial Protection in Uganda: A Political Economy Perspective".

机构信息

School of Medicine, Uganda Christian University, Mukono, Uganda.

School of Public Health, Gudie University Project, Kampala, Uganda.

出版信息

Int J Health Policy Manag. 2023;12:7348. doi: 10.34172/ijhpm.2022.7348. Epub 2022 Jul 3.

Abstract

Uganda introduced health financing reforms that entailed abolition of user fees, and in due process planned to introduce a National Health Insurance Scheme (NHIS). This paper accentuates a contextual and political-economic analysis that dispels the fears and misconceptions related to introduction of the insurance scheme. The Grindle and Thomas model is used to depict how various factors affect decision making by policy elites concerning a particular policy at a particular time. Drawing lessons from the sub-Sahara region and in particular, Ghana and Rwanda's experience, it is clear that the political will of the executive led by the president in many countries is a key determinant in bringing about health reforms. In this paper, we provide insights based on contextual and political-economic analysis to countries in similar setting that are interested in setting up NHISs.

摘要

乌干达实施了医疗融资改革,包括取消医疗服务收费,并计划适时推出国家健康保险计划(NHIS)。本文重点进行了背景和政治经济分析,以消除对该保险计划引入的担忧和误解。本文使用 Grindle 和 Thomas 模型来描述各种因素如何在特定时间影响政策精英对特定政策的决策。借鉴撒哈拉以南非洲地区,特别是加纳和卢旺达的经验,很明显,总统领导的行政部门的政治意愿是推动医疗改革的关键决定因素。本文基于背景和政治经济分析,为那些有兴趣建立 NHIS 的类似国家提供了一些见解。

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