Macquarie University
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Health accounts to formulate health financing policy for the poor: Middle East and North Africa & East Asia and Pacific

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posted on 2022-03-29, 03:10 authored by Osmat Azzam
The way a health system is financed is a key determinant of population health and well-being. This is particularly true in the poorest countries where the level of spending is still insufficient to ensure equitable access to needed health services and interventions. In many countries the price of health care services still pushes many people into poverty. Governments in the richer countries also constantly struggle with the question of how to raise sufficient funds to meet the ever increasing demands of their populations for quality health services. All countries must make decisions about how best to raise sufficient funds for health, how to pool them together to spread the financial risks of ill health, and how to ensure they are used effectively, efficiently, and equitably. Countries make different decisions in each of these areas, so the resulting financing systems vary in areas such as the mix between taxes and insurance, out of pocket contributions, and between public and private funding and provision. Health accounts system could be the tool for measurement. While World Health Organization member countries embraced the concept of universal coverage as early as 2005, few low and middle income countries have yet achieved the objective as well as the international health-related Millennium Development Goals. This is mainly due to numerous barriers that hamper access to needed health services. This PHD research provides an overview of the various Health Accounts methodologies and policies implemented and in low and middle income countries that tackle the dimensions of access to health care; and outlines existing interventions designed to overcome barriers. It will highlight, as an example, variance in financing practices the Middle East and North Africa (MENA) and East Asia and Pacific (EAP) countries. This will be explored using an analytical framework to illustrate the use of Health Accounts and help enhance its usefulness as a policy tool. This will help place benchmarks in the assessment and monitoring of health systems, and the analysis of the importance of health expenditures from a consumption perspective in the economy as a whole. Thus, choosing reliable health financing option to cover the poor and vulnerable group is a major issue which is not an easy process and several assessments have taken here leading to universal free essential health care, along with proposed reimbursement of health care providers for services rendered to the poor. The novelty resulted and addressed here: First, creating an enabling environment supporting: governance, policy development and sensitization to vulnerability in low income countries; Second, proposing direct and indirect strategies which needed to better understand the factors that delay care seeking by vulnerable group. The findings suggest that using Health Account tools is required to tackle specific access barriers and link it to provide monitoring and evaluation of strategic and operational objectives of health planning and policy making in low and middle income countries.


Table of Contents

Chapter I. Introduction -- Chapter II. Literature review -- Chapter III. Methods -- Chapter IV. Results -- Chapter V. Discussion -- Chapter VI. Conclusion.


Bibliography: pages 137-146 Theoretical thesis.

Awarding Institution

Macquarie University

Degree Type

Thesis PhD


PhD, Macquarie University, Faculty of Business and Economics, Department of Economics

Department, Centre or School

Department of Economics

Year of Award


Principal Supervisor

Pundarik Mukhopadhaya

Additional Supervisor 1

Chris Patel


Copyright Osmat Azzam 2016. Copyright disclaimer:




1 online resource (vii, 147 pages) graphs, tables

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