Yogesh Rajkotia, ThinkWell’s Founder and CEO, spoke at the 2014 Africa Forum on Universal Health Coverage (UHC) in December in Addis Ababa. The event was hosted by the Korean International Cooperation Agency.
Over 90 countries have endorsed the United Nations resolution on UHC. Dr. Rajkotia’s presentation discussed health financing trends that have emerged from countries’ drive toward UHC. Over 55 countries have implemented or plan to implement health insurance programs. Over 50 countries have implemented or plan to implement results-based financing. Dr. Rajkotia explained the steep increases in such programs, “Countries are seeking more effective ways to use available funding. Increasingly, health financing mechanisms are being used to drive the efficiency of programs, thus financing is serving to reshape the health sector.” His advice to countries? “Think big and plan ahead.”
Dr. Rajkotia went on to describe the importance of developing specific solutions that work for each country’s context. Traditional, standard models no longer apply. Increasingly, experienced experts are emerging from low and middle income countries, thus making south-to-south information exchange and collaboration an effective way to access advice on adapting customized solutions.
Dr. Rajkotia acknowledged that “Power and politics remain critical factors in developing local solutions. Politics drives progress.” Health financing mechanisms, like providing health cards to each citizen, have increased awareness among citizens, and brought on calls for increased information and involvement. Another way in which health financing has influenced the dynamic is by the defining and strengthening of the purchaser’s role in health services. Purchasing agents — which in a sound design are independent entities, separate from a Ministry of Health — are gaining more purchasing power and more autonomy from Ministries of Health, and are also invested in the benefits offered and the quality of the health services delivered. Dr. Rajkotia points to positive examples of health financing reforms driving improvements to health access and quality, such as Ghana’s successful national health insurance scheme, and the opportunity created for Morocco by its Arab Spring neighbors.
Dr. Rajkotia’s presentation is available on www.thinkwell.global/publications/.