Health-financing reforms in southeast Asia: Challenges in achieving universal coverage

Viroj Tangcharoensathien, Walaiporn Patcharanarumol, Por Ir, Syed Mohamed Al-Junid Syed Junid, Ali Ghufron Mukti, Kongsap Akkhavong, Eduardo Banzon, Dang Boi Huong, Hasbullah Thabrany, Anne Mills

Research output: Contribution to journalArticle

133 Citations (Scopus)

Abstract

In this sixth paper of the Series, we review health-financing reforms in seven countries in southeast Asia that have sought to reduce dependence on out-of-pocket payments, increase pooled health finance, and expand service use as steps towards universal coverage. Laos and Cambodia, both resource-poor countries, have mostly relied on donor-supported health equity funds to reach the poor, and reliable funding and appropriate identification of the eligible poor are two major challenges for nationwide expansion. For Thailand, the Philippines, Indonesia, and Vietnam, social health insurance financed by payroll tax is commonly used for formal sector employees (excluding Malaysia), with varying outcomes in terms of financial protection. Alternative payment methods have different implications for provider behaviour and financial protection. Two alternative approaches for financial protection of the non-poor outside the formal sector have emerged - contributory arrangements and tax-financed schemes - with different abilities to achieve high population coverage rapidly. Fiscal space and mobilisation of payroll contributions are both important in accelerating financial protection. Expanding coverage of good-quality services and ensuring adequate human resources are also important to achieve universal coverage. As health-financing reform is complex, institutional capacity to generate evidence and inform policy is essential and should be strengthened.

Original languageEnglish
Pages (from-to)863-873
Number of pages11
JournalThe Lancet
Volume377
Issue number9768
DOIs
Publication statusPublished - 5 Mar 2011
Externally publishedYes

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Universal Coverage
Healthcare Financing
Southeastern Asia
Laos
Cambodia
Aptitude
Philippines
Indonesia
Vietnam
Social Security
Malaysia
Financial Management
Thailand
Health Insurance
Health Expenditures
Health
Population
Health Equity

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Tangcharoensathien, V., Patcharanarumol, W., Ir, P., Syed Junid, S. M. A-J., Mukti, A. G., Akkhavong, K., ... Mills, A. (2011). Health-financing reforms in southeast Asia: Challenges in achieving universal coverage. The Lancet, 377(9768), 863-873. https://doi.org/10.1016/S0140-6736(10)61890-9

Health-financing reforms in southeast Asia : Challenges in achieving universal coverage. / Tangcharoensathien, Viroj; Patcharanarumol, Walaiporn; Ir, Por; Syed Junid, Syed Mohamed Al-Junid; Mukti, Ali Ghufron; Akkhavong, Kongsap; Banzon, Eduardo; Huong, Dang Boi; Thabrany, Hasbullah; Mills, Anne.

In: The Lancet, Vol. 377, No. 9768, 05.03.2011, p. 863-873.

Research output: Contribution to journalArticle

Tangcharoensathien, V, Patcharanarumol, W, Ir, P, Syed Junid, SMA-J, Mukti, AG, Akkhavong, K, Banzon, E, Huong, DB, Thabrany, H & Mills, A 2011, 'Health-financing reforms in southeast Asia: Challenges in achieving universal coverage', The Lancet, vol. 377, no. 9768, pp. 863-873. https://doi.org/10.1016/S0140-6736(10)61890-9
Tangcharoensathien V, Patcharanarumol W, Ir P, Syed Junid SMA-J, Mukti AG, Akkhavong K et al. Health-financing reforms in southeast Asia: Challenges in achieving universal coverage. The Lancet. 2011 Mar 5;377(9768):863-873. https://doi.org/10.1016/S0140-6736(10)61890-9
Tangcharoensathien, Viroj ; Patcharanarumol, Walaiporn ; Ir, Por ; Syed Junid, Syed Mohamed Al-Junid ; Mukti, Ali Ghufron ; Akkhavong, Kongsap ; Banzon, Eduardo ; Huong, Dang Boi ; Thabrany, Hasbullah ; Mills, Anne. / Health-financing reforms in southeast Asia : Challenges in achieving universal coverage. In: The Lancet. 2011 ; Vol. 377, No. 9768. pp. 863-873.
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