Financing for universal health coverage in small island states: Evidence from the Fiji Islands

© Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. Background: Universal health coverage (UHC) is critical to global poverty alleviation and equity of health systems. Many low-income and middle-income countries, including small island states in the Pacific, have committed to UHC and reforming their health financing systems to better align with UHC goals. This study provides the first comprehensive evidence on equity of the health financing system in Fiji, a small Pacific island state. The health systems of such states are poorly covered in the international literature. Methods: The study employs benefit and financing incidence analyses to evaluate the distribution of health financing benefits and burden across the public and private sectors. Primary data from a cross-sectional survey of 2000 households were used to assess healthcare benefits and secondary data from the 2008–2009 Fiji Household Income and Expenditure Survey to assess health financing contributions. These were analysed by socioeconomic groups to determine the relative benefit and financing incidence across these groups. Findings: The distribution of healthcare benefits in Fiji slightly favours the poor—around 61% of public spending for nursing stations and 26% of spending for government hospital inpatient care were directed to services provided to the poorest 20% of the population. The financing system is significantly progressive with wealthier groups bearing a higher share of the health financing burden. Conclusions: The healthcare system in Fiji achieves a degree of vertical equity in financing, with the poor receiving a higher share of benefits from government health spending and bearing a lower share of the financing burden than wealthier groups

Comparisons of health expenditure in 3 Pacific Island Countries using National Health Accounts.

National Health Accounts (NHA) is an important monitoring tool for health policy and health systems strengthening. A pilot project amongst three Pacific Island Countries (PICs) to assist in developing their NHAs, allowed these countries to identify their sources of health funds, the health providers on which these funds are spent, and the types of health goods and services provided. In this paper we report some of the findings from the NHA exercises in FSM, Fiji and Vanuatu. The development of these NHA country reports have allowed these countries to better understand the flow of financial resources from financing agents, to health providers, and to health functions. The NHA findings across the three countries enabled a comparative analysis of health expenditures between the three countries as well as with countries in the Asia Pacific Region.link_to_OA_fulltex

Comparisons of Health Expenditure in the Pacific Island Countries using National Health Accounts

National Health Accounts (NHA) is an important monitoring tool for health policy and health systems strengthening. A pilot project amongst three Pacific Island Countries {PICs) to assist in developing their NHAs, allowed these countries to identify their sources of health funds, the health providers on which these funds are spent, and the types of health goods and services provided. In this paper we report same of the findings from the NHA exercises in FSM, Fiji and Vanuatu. The development of these NHA country re parts have allowed these countries to better understand the flow of financial resources from financing agents, to health providers, and to health functions. The NHA findings across the three countries enabled a comparative analysis of health expenditures between the three countries as well as with countries in the Asia Pacific Region

Impact of out-of-pocket expenditures on families and barriers to use of maternal and child health services in Papua New Guinea : evidence from the Papua New Guinea household survey 1996 and household income and expenditure survey 2009–2010; country brief

Overall maternal and child health indicators are among the worst in the Asia-Pacific region, and the HIV/AIDS epidemic is one of the most serious. Two surveys allow for an exploration of how healthcare utilization has changed over a 13-year period. The poor should be in greater need of medical care, but in practice they make less use and suffer from greater barriers to access. Building community health posts with inpatient facilities for childbirth in rural areas would help to reduce physical access barriers to healthcare