Comparative Analysis on Communicable and Non-Communicable Diseases on Catastrophic Spending and Impoverishment in Tanzania

Does National Health Protection Cover the Vulnerable Groups in Indonesia? A Case Study of Waste Pickers in Surabaya

The National Health Protection (NHP) of Indonesia is a pro-poor social health insurance as the government pays the monthly premium for the poor. A waste picker is classified as an urban poor group needing affordable or free access to health care. This study explores the extent to which the NHP protects the health of waste pickers and provides them with quality health care. For this mixed-method study, 342 waste pickers completed the survey, 40 engaged in interviews, and 15 participated in Natural Group Discussions. The study found that 20% of waste pickers were not enrolled in NHP due to issues such as incorrect validation of poverty, discrimination, illegal fees, nepotism, unaffordable premiums, and lack of interest in purchasing the health plan. Among those who were enrolled, waste pickers expressed satisfaction with the health care they received and the behavior of the staff. However, they did criticize certain aspects such as waiting times, service gaps between full-paying and subsidized patients, suspicion of the quality of medicines, complicated medical administration procedures, and inflexibility of the capitation system. The study concludes that despite the NHP, poor groups remain vulnerable to accessing free health care.

An Ayurvedic Medication (Chyawanprash) as a Prophylaxis for Non-Communicable Disease and Communicable Disease: A Protocol for Systematic Review and Meta-Analysis

Globally, non-communicable diseases (NCDs) and communicable diseases (CDs) are on the rise, posing a significant public health threat. A holistic ayurvedic preparation called chyawanprash (CP) has shown positive outcomes in NCDs and CDs. Hence, we aimed to report the outcomes in a systematic manner. To determine the safety, efficacy, healthcare utilization, and quality of life of CP as an optional therapy for NCD and CD management. This systematic review will adhere to PRISMA-P and Cochrane guidelines for methodological considerations. It will evaluate CP efficacy in diverse populations, considering Ayurvedic and non-Ayurvedic comparators. The study design will encompass randomized controlled trials (RCTs) published from 2010 to 2023 in healthcare settings, controlled environments, and communities. We will also analyze primary outcomes related to immunity biomarkers, vital signs, and secondary outcomes such as quality of life. Data sources and search strategy will involve systematic searches in databases such as Cochrane, PubMed, Google Scholar, Web of Science, and Scopus using MeSH terms and Boolean operators. Screening and data extraction will follow a standardized form with four independent reviewers. Quality assessment will use the Cochrane risk of bias tool. The systematic review will provide an exhaustive summary of the effectiveness and safety of CP to address the growing burden of NCDs and CDs. Registration: CRD42023418994.

Does health insurance solve health care utilization puzzle in Tanzania?

OBJECTIVES

The global target of achieving universal health coverage by 2030 is a nightmare in most developing countries. To seek in-depth reasons, this study examines the effects of health insurance on healthcare utilization in Tanzania.

STUDY DESIGN

This study used a non-experimental research design.

METHODS

Probit model, negative binomial regression, and instrumental variable Poisson with generalized method of moments were used to solve the healthcare utilization puzzle by the use of Andersen Health Care Utilization Model by using the Tanzania Panel Survey data of 2020/21.

RESULTS

The findings showed that education level, income, age, residence, household size, insurance, and distance from homestead to health facilities are significant policy intervention factors for improving households' healthcare utilization behavior among households in Tanzania.

CONCLUSION

Prioritize should be made on interventions that ensure the affordability of health services without compromising the quality of services offered and expanding the share of the government budget on health sector.

Analysis on the equity differential on household healthcare financing in developing countries: empirical evidence from Tanzania, East Africa

BACKGROUND

Achieving equity in healthcare services has been a global priority. According to the literature, a slew of initiatives aimed at increasing household equity in healthcare financing have exacerbated the problem, making it hard for most developing countries to understand the real cause of the problem.

METHOD

The non-experimental research design has been used to explore the Tanzania Panel Survey (NPS) data 2019/2020, to investigate equity differential in household healthcare financing in Tanzania by the use of conventional instrumental variable methods of Two-stage and Three-stage least square methods RESULTS: Despite the global agenda of universal health coverage, this paper reveals that 86 percent of Tanzania lacks health insurance with a high degree of inequitable distribution of health facilities as 71.54 percent of the population is in rural areas, yet these areas have poor health systems compared to urban ones. These disparities increase pressure on household healthcare financing and widen the inequity and equality gaps simultaneously. Additionally, a household's income, education, health care waivers, out-of-pocket expenditure, and user fees have been found to have a significant impact on household equity in healthcare financing.

CONCLUSION

To reverse the situation and increase equity in household healthcare financing in most developing countries, this paper suggests that an adequate pooling system should be used to allow more people to be covered by medical prepayment programs, and the donor-funded programs in developing countries should focus on health sector infrastructure development and not the capacity building.