Session: Reforming Health Sector Organization
4214.0: Tuesday, November 18, 2003: 2:30 PM-4:00 PM
Reforming Health Sector Organization
Three economists from Chile (Ricardo Bitran), Sénégal (François Diop), and the United States (Marty Makinen) who have more than 50 years of combined experience working with developing country health systems will assess where health sector organization stands and propose how they think it should change to improve performance. Traditionally, Ministries of Health in developing countries owned a network of health facilities, employed the staff, allocated government resources for health, and offered services at no charge. This achieved improving health indicators in many countries over the last 40 years, but many believe that this form of organization has hindered greater achievement. Problems remain in terms of equity, efficiency, quality, responsiveness, and long-term sustainability A number of countries have made changes in this basic organization by instituting one or more of the following reforms, many suggested or supported by economists: (1) charging users for a share of the cost of services, (2) organizing social health insurance for formal sector workers, (3) separating provision from payment, (4) granting some management autonomy to government-owned providers, (5) establishing contractual relationships with government and private providers, (6) facilitating the development of community-based health insurance, (7) decentralizing resource allocation, (8) using payment methods to try to increase responsiveness and efficiency, (9) instituting systems like accreditation to try to improve quality, and (10) changing the status of government health workers from civil servants to contract employees. The speakers will assess the changes in organization and make their suggestions concerning ways forward.
Learning Objectives: 1. Assess changes in health sector organization 2. Identify how health sector organization could be changed further in developing countries to improve performance 3. Discuss economists' perspectives on health system organization and performance
See individual abstracts for presenting author's disclosure statement and author's information.
Moderator(s):Marty Makinen, PhD
2:30 PMReforming Health Sector Organization in Sub-Saharan Africa
Francois Diop, PhD
2:50 PMMissing pieces in health system performance
Marty Makinen, PhD
Organized by:International Health
Endorsed by:Asian Pacific Islander Caucus of APHA; Latino Caucus
CE Credits:CME, Health Education (CHES), Nursing, Pharmacy

The 131st Annual Meeting (November 15-19, 2003) of APHA