Title
Health Care Coverage Decision Making in Low- and Middle-Income Countries: Experiences from 25 Coverage Schemes
Date Issued
01 August 2015
Access level
metadata only access
Resource Type
journal article
Author(s)
Gutierrez H.
Shewade A.
Dai M.
Gómez-Dantés O.
Jain N.
Khonelidze I.
Nabyonga-Orem J.
Saleh K.
Teerawattananon Y.
Nishtar S.
Hornberger J.
Publisher(s)
Mary Ann Liebert Inc.
Abstract
Lessons learned by countries that have successfully implemented coverage schemes for health services may be valuable for other countries, especially low- and middle-income countries (LMICs), which likewise are seeking to provide/expand coverage. The research team surveyed experts in population health management from LMICs for information on characteristics of health care coverage schemes and factors that influenced decision-making processes. The level of coverage provided by the different schemes varied. Nearly all the health care coverage schemes involved various representatives and stakeholders in their decision-making processes. Maternal and child health, cardiovascular diseases, cancer, and HIV were among the highest priorities guiding coverage development decisions. Evidence used to inform coverage decisions included medical literature, regional and global epidemiology, and coverage policies of other coverage schemes. Funding was the most commonly reported reason for restricting coverage. This exploratory study provides an overview of health care coverage schemes from participating LMICs and contributes to the scarce evidence base on coverage decision making. Sharing knowledge and experiences among LMICs can support efforts to establish systems for accessible, affordable, and equitable health care. (Population Health Management 2015;18:265-271)
Start page
265
End page
271
Volume
18
Issue
4
Language
English
OCDE Knowledge area
Epidemiología Bioinformática Ciencias del cuidado de la salud y servicios (administración de hospitales, financiamiento)
Scopus EID
2-s2.0-84938944046
PubMed ID
Source
Population Health Management
ISSN of the container
19427891
Sources of information: Directorio de Producción Científica Scopus