Financing for universal health coverage in small island states: Evidence from the Fiji Islands

Asante, AD; Irava, W; Limwattananon, S; Hayen, A; Martins, J; Guinness, L; Ataguba, JE; Price, J; Jan, S; Mills, A; Wiseman, V

Financing for universal health coverage in small island states: Evidence from the Fiji Islands

Asante, AD

Irava, W

Limwattananon, S Hayen, A

Martins, J Guinness, L

Ataguba, JE Price, J Jan, S

Mills, A Wiseman, V

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Publication Type:: Journal Article
Citation:: BMJ Global Health, 2017, 2 (2)
Issue Date:: 2017-01-01

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Field	Value	Language
dc.contributor.author	Asante, AD https://orcid.org/0000-0003-3894-3437	en_US
dc.contributor.author	Irava, W https://orcid.org/0000-0002-4897-4117	en_US
dc.contributor.author	Limwattananon, S	en_US
dc.contributor.author	Hayen, A https://orcid.org/0000-0003-4046-8030	en_US
dc.contributor.author	Martins, J	en_US
dc.contributor.author	Guinness, L https://orcid.org/0000-0002-1013-4200	en_US
dc.contributor.author	Ataguba, JE	en_US
dc.contributor.author	Price, J	en_US
dc.contributor.author	Jan, S https://orcid.org/0000-0003-2839-1405	en_US
dc.contributor.author	Mills, A	en_US
dc.contributor.author	Wiseman, V https://orcid.org/0000-0002-7911-0741	en_US
dc.date.available	2017-02-16	en_US
dc.date.issued	2017-01-01	en_US
dc.identifier.citation	BMJ Global Health, 2017, 2 (2)	en_US
dc.identifier.uri	http://hdl.handle.net/10453/115005
dc.description.abstract	© Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. Background: Universal health coverage (UHC) is critical to global poverty alleviation and equity of health systems. Many low-income and middle-income countries, including small island states in the Pacific, have committed to UHC and reforming their health financing systems to better align with UHC goals. This study provides the first comprehensive evidence on equity of the health financing system in Fiji, a small Pacific island state. The health systems of such states are poorly covered in the international literature. Methods: The study employs benefit and financing incidence analyses to evaluate the distribution of health financing benefits and burden across the public and private sectors. Primary data from a cross-sectional survey of 2000 households were used to assess healthcare benefits and secondary data from the 2008–2009 Fiji Household Income and Expenditure Survey to assess health financing contributions. These were analysed by socioeconomic groups to determine the relative benefit and financing incidence across these groups. Findings: The distribution of healthcare benefits in Fiji slightly favours the poor—around 61% of public spending for nursing stations and 26% of spending for government hospital inpatient care were directed to services provided to the poorest 20% of the population. The financing system is significantly progressive with wealthier groups bearing a higher share of the health financing burden. Conclusions: The healthcare system in Fiji achieves a degree of vertical equity in financing, with the poor receiving a higher share of benefits from government health spending and bearing a lower share of the financing burden than wealthier groups.	en_US
dc.relation.ispartof	BMJ Global Health	en_US
dc.relation.isbasedon	10.1136/bmjgh-2016-000200	en_US
dc.title	Financing for universal health coverage in small island states: Evidence from the Fiji Islands	en_US
dc.type	Journal Article
utslib.citation.volume	2	en_US
utslib.for	1117 Public Health and Health Services	en_US
pubs.embargo.period	Not known	en_US
pubs.organisational-group	/University of Technology Sydney
pubs.organisational-group	/University of Technology Sydney/Faculty of Health
pubs.organisational-group	/University of Technology Sydney/Faculty of Health/Public Health
utslib.copyright.status	open_access
pubs.issue	2	en_US
pubs.publication-status	Published	en_US
pubs.volume	2	en_US

Abstract:

© Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. Background: Universal health coverage (UHC) is critical to global poverty alleviation and equity of health systems. Many low-income and middle-income countries, including small island states in the Pacific, have committed to UHC and reforming their health financing systems to better align with UHC goals. This study provides the first comprehensive evidence on equity of the health financing system in Fiji, a small Pacific island state. The health systems of such states are poorly covered in the international literature. Methods: The study employs benefit and financing incidence analyses to evaluate the distribution of health financing benefits and burden across the public and private sectors. Primary data from a cross-sectional survey of 2000 households were used to assess healthcare benefits and secondary data from the 2008–2009 Fiji Household Income and Expenditure Survey to assess health financing contributions. These were analysed by socioeconomic groups to determine the relative benefit and financing incidence across these groups. Findings: The distribution of healthcare benefits in Fiji slightly favours the poor—around 61% of public spending for nursing stations and 26% of spending for government hospital inpatient care were directed to services provided to the poorest 20% of the population. The financing system is significantly progressive with wealthier groups bearing a higher share of the health financing burden. Conclusions: The healthcare system in Fiji achieves a degree of vertical equity in financing, with the poor receiving a higher share of benefits from government health spending and bearing a lower share of the financing burden than wealthier groups.

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http://hdl.handle.net/10453/115005