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Healthcare Services and Health Financing Mechanisms

Country Y is a middle-income country with a per capita GDP of USD 9,000 per annum. The country has a life expectancy at birth of 78 years. Ten percent of the population are over the age of 60 years. At present public healthcare services are delivered via central government-managed public hospitals that are financed by general revenues. Public health services in Country Y are known to be inefficient and of poor quality. Private healthcare facilities offer services primarily based on user fees. Voluntary health insurance is offered by private insurance companies. Penetration and growth of voluntary insurance has been low due to risk selection-based competition. Country Y does not have a functioning mandatory insurance mechanism.

Province A is an urban area in Country Y. Province A's health outcomes are low by national standards. In particular the prevalence of NCDs and NCD risk factors is high. The Provincial Health Directorate has set-up a steering committee to design health financing and provision strategies to increase health finances and improve cost-effectiveness of healthcare delivery in Province A. Assume that you have been hired as an advisor to the steering committee. Explain the process you will follow and techniques you will use in designing the healthcare services package as well as health financing mechanisms for Province A. Justify your answer with theory and evidence where appropriate.

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Province A of Country Y is experiencing poor health outcomes compared to the national
standards. Non-communicable diseases such as Type II Diabetes, Heart Disease, and others related to
lifestyle choices are prevalent among members of this community. Though prevention is key in
improving health outcomes, GDP is relatively low, which means many citizens cannot afford voluntary
health insurance premiums. In an urban area, providing healthcare on a large scale can be a daunting
endeavor. Reaching the various segments of the population with education efforts requires flexibility,
knowledge of the various segments of the population, and building relationships between patients and
Funding for healthcare in Country Y comes from government funding for hospitals, but public
health services do not reach all who are in need of health care. Private facilities are available but are
likely to be widely underutilized, due to low GDP and little in the way of financial resources to pay for
care in such facilities. The plan to improve healthcare funding and cost effectiveness must consider how
and where those who cannot afford care will receive services. Physician and nurse salaries are costly
and government revenues may not entirely cover them. Then there is the issue of where to locate
healthcare facilities, so they may be easily accessed and utilized by everyone who needs care.
The goals of improving healthcare in Province A are twofold: Improving accessibility
to quality care and improving efficiency. The objectives of financing such efforts are to minimize costs
as much as possible and make good use of each dollar spent on providing healthcare. Therefore, the
plan should focus on obtaining resources at a lower cost, so that more resources, such as care providers,
can be utilized to serve the large urban population. Improving health outcomes of citizens in Province A
is another goal, which ultimately will help control costs, by reducing the number of hospitalizations and
possibly by reducing the high level of care required. This means the incidence of Type II Diabetes, Heart
Disease, and other related disorders must include prevention efforts, education, and programs that
effectively bring about lifestyle changes. Ways to facilitate lifestyle changes should be incorporated into
the healthcare plan. They should be at little to no cost to citizens in the urban area, if they are to be
sustainable over a longer period of time. "It has been shown in both developed and developing
countries that a comprehensive long term approach has the potential to reduce risk factors in the
population and in turn, disease, disability and death" (World Health Organization, 2013). Though the
health problems facing citizens is known, the exact numbers are not well known, due to varied
utilization of healthcare throughout the urban area and throughout the country. Therefore, before
planning for the appropriate numbers of healthcare providers, facilities, and other resources, more
data is required on the population to be served.
Healthcare Planning in Provide A
Gathering Data
The plan begins with research to collect data on the health of the population in Province A.
A breakdown of population by age is already known. Therefore, a random sample health survey of
each age group, using the appropriate ratios proportionate to the current population will provide
the planning committee with greater insight. Though health problems such as NCDs generally affect
older adults more, lifestyle habits begin in childhood. In addition, the incidence of Diabetes and Obesity
is increasing in child populations globally. "Worldwide, it is estimated that more than 22 million children
under five years old are obese or overweight, and more than 17 million of them ...

Solution Summary

Healthcare services and health financing mechanisms are determined.