在坦桑尼亚开发改进的社区卫生基金:这是一个公平的过程吗?
Peter Binyaruka1, Gemini Mtei2, John Maiba1
1Department of Health System, Impact Evaluation and Policy, Ifakara Health Institute, PO Box 78373, Dar es Salaam, Tanzania.
Health policy and planning
|November 14, 2023
概括
坦桑尼亚 坦桑尼亚 坦桑尼亚 坦桑尼亚
科学领域:
- 卫生政策和系统研究 卫生政策和系统研究
- 卫生经济学 卫生经济学
- 公共卫生管理公共卫生管理.
背景情况:
- 坦桑尼亚2016 - 26年卫生融资战略旨在减少不平等和低效.
- 该战略提出强制性国家医疗保险,这是一个长期的立法过程.
- 改进的社区卫生基金 (iCHF) 于2017/18年作为非正式部门的短期措施而推出.
研究的目的:
- 检查坦桑尼亚改善的社区卫生基金 (iCHF) 的决策过程.
- 评估iCHF决策过程在多大程度上符合程序公正的标准.
- 分析iCHF改革中的背景,内容,参与者和流程的作用.
主要方法:
- 使用了定性研究方法.
- 进行了文档审查和关键线人采访 (n=12).
- 政策分析三角框架和程序公平性标准指导了分析.
主要成果:
- 在ICHF改革中,规避了标准的立法程序,不包括公众咨询.
- 一个技术工作组领导了这个过程,但受益人和提供者没有参与.
- 在ICHF过程中缺乏透明度,并没有考虑减少行政成本的证据.
结论:
- 通过扩大风险共享,ICHF改革部分解决了医疗融资的分散性.
- 决策过程强调了在技术改革中需要更高的程序公平性.
- 提高程序公平性可以提高医疗融资改革的响应性,合法性和实施.
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