Does the distribution of health care benefits in Kenya meet the principles of universal coverage?

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dc.contributor.authorChuma, Janeen_ZA
dc.contributor.authorMaina, Thomasen_ZA
dc.contributor.authorAtaguba, Johnen_ZA
dc.date.accessioned2015-11-04T11:49:43Z
dc.date.available2015-11-04T11:49:43Z
dc.date.issued2012en_ZA
dc.description.abstractBACKGROUND:The 58th World Health Assembly called for all health systems to move towards universal coverage where everyone has access to key promotive, preventive, curative and rehabilitative health interventions at an affordable cost. Universal coverage involves ensuring that health care benefits are distributed on the basis of need for care and not on ability to pay. The distribution of health care benefits is therefore an important policy question, which health systems should address. The aim of this study is to assess the distribution of health care benefits in the Kenyan health system, compare changes over two time periods and demonstrate the extent to which the distribution meets the principles of universal coverage. METHODS: Two nationally representative cross-sectional households surveys conducted in 2003 and 2007 were the main sources of data. A comprehensive analysis of the entire health system is conducted including the public sector, private-not-for-profit and private-for-profit sectors. Standard benefit incidence analysis techniques were applied and adopted to allow application to private sector services. RESULTS: The three sectors recorded similar levels of pro-rich distribution in 2003, but in 2007, the private-not-for-profit sector was pro-poor, public sector benefits showed an equal distribution, while the private-for-profit sector remained pro-rich. Larger pro-rich disparities were recorded for inpatient compared to outpatient benefits at the hospital level, but primary health care services were pro-poor. Benefits were distributed on the basis of ability to pay and not on need for care. CONCLUSIONS: The principles of universal coverage require that all should benefit from health care according to need. The Kenyan health sector is clearly inequitable and benefits are not distributed on the basis of need. Deliberate efforts should be directed to restructuring the Kenyan health system to address access barriers and ensure that all Kenyans benefit from health care when they need it.en_ZA
dc.identifier.apacitationChuma, J., Maina, T., & Ataguba, J. (2012). Does the distribution of health care benefits in Kenya meet the principles of universal coverage?. <i>BMC Public Health</i>, http://hdl.handle.net/11427/14670en_ZA
dc.identifier.chicagocitationChuma, Jane, Thomas Maina, and John Ataguba "Does the distribution of health care benefits in Kenya meet the principles of universal coverage?." <i>BMC Public Health</i> (2012) http://hdl.handle.net/11427/14670en_ZA
dc.identifier.citationChuma, J., Maina, T., & Ataguba, J. (2012). Does the distribution of health care benefits in Kenya meet the principles of universal coverage?. BMC public health, 12(1), 20.en_ZA
dc.identifier.ris TY - Journal Article AU - Chuma, Jane AU - Maina, Thomas AU - Ataguba, John AB - BACKGROUND:The 58th World Health Assembly called for all health systems to move towards universal coverage where everyone has access to key promotive, preventive, curative and rehabilitative health interventions at an affordable cost. Universal coverage involves ensuring that health care benefits are distributed on the basis of need for care and not on ability to pay. The distribution of health care benefits is therefore an important policy question, which health systems should address. The aim of this study is to assess the distribution of health care benefits in the Kenyan health system, compare changes over two time periods and demonstrate the extent to which the distribution meets the principles of universal coverage. METHODS: Two nationally representative cross-sectional households surveys conducted in 2003 and 2007 were the main sources of data. A comprehensive analysis of the entire health system is conducted including the public sector, private-not-for-profit and private-for-profit sectors. Standard benefit incidence analysis techniques were applied and adopted to allow application to private sector services. RESULTS: The three sectors recorded similar levels of pro-rich distribution in 2003, but in 2007, the private-not-for-profit sector was pro-poor, public sector benefits showed an equal distribution, while the private-for-profit sector remained pro-rich. Larger pro-rich disparities were recorded for inpatient compared to outpatient benefits at the hospital level, but primary health care services were pro-poor. Benefits were distributed on the basis of ability to pay and not on need for care. CONCLUSIONS: The principles of universal coverage require that all should benefit from health care according to need. The Kenyan health sector is clearly inequitable and benefits are not distributed on the basis of need. Deliberate efforts should be directed to restructuring the Kenyan health system to address access barriers and ensure that all Kenyans benefit from health care when they need it. DA - 2012 DB - OpenUCT DO - 10.1186/1471-2458-12-20 DP - University of Cape Town J1 - BMC Public Health LK - https://open.uct.ac.za PB - University of Cape Town PY - 2012 T1 - Does the distribution of health care benefits in Kenya meet the principles of universal coverage? TI - Does the distribution of health care benefits in Kenya meet the principles of universal coverage? UR - http://hdl.handle.net/11427/14670 ER - en_ZA
dc.identifier.urihttp://hdl.handle.net/11427/14670
dc.identifier.urihttp://dx.doi.org/10.1186/1471-2458-12-20
dc.identifier.vancouvercitationChuma J, Maina T, Ataguba J. Does the distribution of health care benefits in Kenya meet the principles of universal coverage?. BMC Public Health. 2012; http://hdl.handle.net/11427/14670.en_ZA
dc.language.isoengen_ZA
dc.publisherBioMed Central Ltden_ZA
dc.publisher.departmentHealth Economics Uniten_ZA
dc.publisher.facultyFaculty of Health Sciencesen_ZA
dc.publisher.institutionUniversity of Cape Town
dc.rightsThis is an Open Access article distributed under the terms of the Creative Commons Attribution Licenseen_ZA
dc.rights.holder2011 Chuma et al; licensee BioMed Central Ltden_ZA
dc.rights.urihttp://creativecommons.org/licenses/by/2.0en_ZA
dc.sourceBMC Public Healthen_ZA
dc.source.urihttp://www.biomedcentral.com/bmcpublichealth/en_ZA
dc.subject.otherHealth Careen_ZA
dc.subject.otherBenefitsen_ZA
dc.subject.otherdistributionen_ZA
dc.subject.otherHealth interventionsen_ZA
dc.titleDoes the distribution of health care benefits in Kenya meet the principles of universal coverage?en_ZA
dc.typeJournal Articleen_ZA
uct.type.filetypeText
uct.type.filetypeImage
uct.type.publicationResearchen_ZA
uct.type.resourceArticleen_ZA
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