Stories from Africa: Achieving Health Gains on the Way to Universal Health Coverage

Latest News from the Center, Policy Blog, Stories from Africa Seminar Series
This blog was first published in Brookings Future Development Blog and is part of an ongoing series of blogs based on the Stories from Africa Seminar Series that concluded in November 2018 at Duke University. Health leaders and policymakers around the world have a shared interest and commitment to achieve universal health coverage (UHC) by 2030. Health systems are responding to increased demand due to population growth, aging populations with complex conditions, or prior commitments to achieve UHC. Despite health gains in the last 20 years, problems are particularly acute in Sub-Saharan Africa. As economies grow to middle-income levels, they have to tackle communicable diseases while more people are living with non-communicable diseases like diabetes and hypertension. The burden of disease may be higher in low-income economies, but the complexity of…
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 Reducing out-of-pocket payments for health in order to achieve universal health coverage in Mongolia

Policy Blog
Healthcare costs are among the largest barriers to accessing health services and achieving universal health coverage (UHC) in Mongolia. In 2014, 0.7% or 5,681 households in Mongolia experienced catastrophic health expenditures due to out-of-pocket (OOP) expenses, spending more than 40% of their household subsistence income on health care.1 In this blog, I discuss the origins and impacts of these OOP payments, potential policy solutions and their likely impacts, and the challenges that Mongolia is likely to face in tackling OOP expenses in the future. How Mongolia’s health system has evolved since 1990 Since the early 1990s, when Mongolia transitioned to a market economy, the Mongolian health system has undergone a number of healthcare financing reforms, gradually moving away from the centralized, state-controlled “Semashko-style” model. In 1993, Social Health Insurance (SHI)…
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Indonesia’s pursuit of universal health coverage: challenges in selecting high-value healthcare and preventing waste

Policy Blog
This was an invited guest blog written by colleagues in Thailand’s Health Intervention and Technology Assessment Program. Health care technologies, including medicines, vaccines, and devices, contribute towards improved health outcomes but are also drivers of the rising costs of healthcare. Therefore, in the interest of sustainability it is essential to assess the value of these technologies on a regular basis. Indonesia, the fourth most populous country in the world, has a prime example of an evolving health system that is facing rising health care costs. This challenge, along with Indonesia’s transition from official development assistance for health and a budget deficit facing the country’s social insurance administration organization (called BPJS), which administers the national health insurance program, have made health technology assessment (HTA) a critically important tool. HTA can help…
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