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The Royal Government of Cambodia recently launched its National Social Protection Policy framework to strengthen and expand social security and assistance. To inform social health protection policy, we examine socio‐economic survey data and administrative coverage data to assess the coverage potential of existing coverage mechanisms and current gaps; and compare equitable contribution rates. Over 53 per cent of the population currently has no social health protection coverage mechanism, and about 16 per cent of the population who do have access to a mechanism are not yet enrolled. Current expansion efforts focus on the formal employee scheme, primarily benefiting individuals from higher income households. In addition, recent coverage expansion to some informal workers leaves significant gaps, particularly among the informal sector. We find out‐of‐pocket health care expenditure to be an excessive share of income among lower wealth quintile individuals and conclude they are financially vulnerable. Finally, we illustrate that an equitable approach to individual, monthly health care contributions among the lower three quintiles has a severely limited potential for revenue generation, and collection costs could exceed the amount collected. Therefore, we recommend that vulnerable groups should be exempted from contribution payments as social health protection is expanded. [ABSTRACT FROM AUTHOR]

Abstract: Processes of public policy formation and implementation in the Middle East and North Africa are underexplored. This article presents a case study in public policy reform, focusing on efforts to expand health insurance coverage in Egypt. The account draws on a thematic analysis of peer and non‐peer reviewed literature and print media between 2005 and 2015, with a particular focus on the period to 2011. This analysis shows that reform initiatives failed for much of this period because of fundamental disagreements between key actors over the goals, proposals and the political process for change. The success of planned reforms in Egypt may well depend on the extent to which account is taken of the varied agendas and evolving power relations of these actors, especially given the profound political, social and economic challenges the Egyptian health system now faces. [ABSTRACT FROM AUTHOR]

As part of international efforts framed by the Sustainable Development Goals (SDGs) to extend sustainable and adequate social security coverage, social security systems are increasingly looking to deliver holistic policy responses that meet the different needs of people across the life course. To achieve these objectives globally, not only must the design and goals of social security programmes be recalibrated but significant investments in the health workforce are required. Yet, a fundamental challenge is the current and projected mismatch between the global supply, demand, and need for health workers. A number of critical issues require attention: the need for more and better investments in the health workforce; recognition that the health workforce is not gender neutral and that policies that appropriately recognize, value, and reward women's work in health are of utmost importance; and that political will at the highest level and action across sectors is necessary to allow the required changes [ABSTRACT FROM AUTHOR]

This article analyses the health care system reform process in Europe based on the concept of privatization. This notion is understood from two perspectives. First, privatization may concern the health care financing or the provision of health services. Second, privatization can be 'imposed' on individuals or be 'internalized' and then introduced by individuals (patients and doctors). So we emphasize the diversity that privatization can assume. We classify privatization mechanisms used by different countries and identify which of the perspectives presented are more common in 14 European Union countries since the 1980s. The article shows that even if privatization processes are widespread, they assume different patterns in each country. [ABSTRACT FROM AUTHOR]

Mongolia achieved high population coverage under mandatory health insurance relatively quickly. This fact was viewed by policy- and decision-makers as a central issue for health financing reform in Mongolia. Health insurance brought many new features for health service planning, provision, funding and resource management. Based on initial achievements, health insurance came to be strategically considered as the vehicle for achieving universal coverage. The article analyses developments in Mongolia's health insurance over the last decade along with the core policy dimensions of Universal Health Coverage. It examines various reform approaches and the numerous amendments to laws that have been implemented during this period and discusses new opportunities as well as challenges. The analytical review and findings discussed suggest that Mongolia has a need for evidence-based policy decisions and informed political support, with health insurance backed by robust institutional and administrative capacities. More generally, it also emphasizes that health policy goals and objectives can be attained by strengthening and making transparent and publicly-accountable all health system financing functions and arrangements. The policy analysis, experiences, lessons and proposed strategies presented with regard to Mongolia intend to stimulate wider discussions on health insurance development as well as promote continuing focused research on specific aspects of health insurance and public financing reform. [ABSTRACT FROM AUTHOR]

Résumé Malgré les progrès réalisés en matière d'extension de la couverture des soins de santé, la plupart des pays à faible revenu sont encore loin d'atteindre la couverture médicale universelle et, par conséquent, les améliorations dans le domaine, telles que celles établies par les objectifs du Millénaire pour le développement, ne seront très probablement pas réalisées d'ici à 2015. Les premiers touchés par ce retard sont les plus vulnérables: les pauvres des zones urbaines et rurales, ainsi que les travailleurs de l'économie informelle et leur famille. La situation est réellement préoccupante dans la mesure où non seulement le progrès risque d'être limité, mais on pourrait même connaître un recul si les politiques continuent de ne pas traiter les causes profondes des brèches et des lacunes de la couverture sanitaire. Nous montrons dans cet article que les causes sont à la fois internes et externes au secteur de la santé, et qu'elles sont intimement liées à la pauvreté et à d'autres formes de vulnérabilité. Nous expliquons que les progrès durables vers la couverture médicale universelle ne pourront être réalisés dans un laps de temps raisonnable que si l'on concentre les efforts à la fois sur a) l'extension de la couverture médicale et l'amélioration de l'accès aux soins de santé nécessaires; b) la garantie d'une sécurité des revenus grâce à une aide au revenu accordée aux personnes dans le besoin; c) l'élimination des limites à générer des revenus par le travail ou l'incapacité à le faire; et d) la mise en œuvre de politiques cohérentes autant au sein de chacun des secteurs qui a pour priorité la réduction de la pauvreté, comme les secteurs économique et sanitaire, qu'entre eux. La meilleure façon de mettre en œuvre ces politiques est de le faire dans le cadre de socles nationaux de protection sociale qui portent sur l'accès au moins aux soins de santé essentiels et sur la garantie d'une sécurité des revenus de base au cours du cycle de vie des personnes dans le besoin. La mise en place des socles de protection sociale permettra peut-être de rompre les liens entre la mauvaise santé, la pauvreté et d'autres vulnérabilités, et de réaliser des progrès durables dans le sens d'une couverture universelle des soins de santé et d'autres objectifs de protection sociale. [ABSTRACT FROM AUTHOR]

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