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Health Financing Reform in Thailand : Toward Universal Coverage under Fiscal ConstraintsThailand's model of health financing and its ability to rapidly expand health insurance coverage to its entire population presents an interesting case study. Even though it is still a middle-income country with limited fiscal resources, the country managed to reach universal health insurance coverage through three main public schemes: the Universal Coverage Scheme (UCS), the Social Security Scheme (SSS), and the Civil Servant Medical Benefit Scheme (CSMBS). The UCS, which is the largest and most instrumental scheme in the expansion of coverage to the poor and to those in the informal sector, is the focus of this report. It describes the nuts and bolts of the UCS as a key component of the health financing system in Thailand. It analyzes Thailand's experience in health insurance coverage expansion within limited fiscal constraints through various mechanisms to contain costs. It also explores the two commonly discussed approaches for the universal coverage movement: the expansion model (starting from covering the poor and formal sector to universal coverage) and the comprehensive approach (covering the entire population at the same time).
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The Health Extension Program in EthiopiaEthiopia has made substantial progress in improving health outcomes during the last decade and is on track to achieve some of the health Millennium Development Goals. Innovative strategies to improve household behaviors and coverage of basic health care services contributed to Ethiopia's achievements, and the Health Extension Program (HEP) remains the core of such innovations and provides a model for countries struggling to improve health outcomes in a resource-constrained setting. The program rests on an accelerated expansion of basic health infrastructure and local human resources with required skills to scale-up delivery of high-impact interventions focusing on improving the supply of and enhancing demand for a well-defined package of essential promotive, preventive, and curative health services. The objectives of the case study are to provide a detailed description of (a) the context for the introduction of the program; (b) the scope of the service package delivered under the program; and (c) the institutional arrangements and the links with the rest of the health system. The case study also summarizes and discusses the evidence of the program's achievements and the challenges to achieving universal primary health care coverage. The study also discusses the importance of political will and commitment in introducing such large-scale innovations in improving service delivery and mobilizing the community in a resource-constrained setting.
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Results and Performance of the World Bank Group 2012 : Volume III. Management Action RecordManagement welcomes the Independent Evaluation Group (IEG) report results and performance 2012 of the World Bank group (RAP) and its overall positive assessment of the World Bank group development effectiveness. Management appreciates that the report provides a balanced picture of the World Bank group activities and recognizes that all three institutions have taken important steps to strengthen results, monitoring, and reporting. The report is especially useful to management to prioritize the challenges in the context of the ongoing efforts to strengthen focus on results. Management is concerned that the share of investment lending projects rated moderately satisfactory or better appears to be declining, after a long period of improvements observed since the mid-1990s.This reports includes five chapters: (i) the global development context ;(ii) world bank group operations: findings from evaluation work; (iii) enhancing the bank group's effectiveness;(iv) strengthening institutional results orientation;(v) conclusion: areas for attention