Health & Medical Sciences - ސިއްޙަތާއި ބޭސްވެރިކަން
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Item From Double Shock To Double Recovery - Implications And Options For Health Financing In The Time Of Covid-19(World Bank Group, 2021-03) Kurowski, Christoph; Evans, David B.; Tandon, Ajay; Eozenou, Patrick Hoang-Vu; Schmidt, Martin; Irwin, Alec; Cain, Jewelwayne Salcedo; Pambudi, Eko Setyo; Postolovska, IrynaThe COVID-19 pandemic has resulted in a double shock - health and economic. As of March 1, 2021, COVID-19 has cost more than 2.5 million lives and triggered an economic recession surpassing any economic downturn since World War II. Almost all countries responded with rapid increases in government spending during 2020 to control the pandemic and protect people, jobs, and businesses. Despite an expected return to economic growth, the International Monetary Fund (IMF) projects government per capita spending to fall across all country income groups in 2021 and 2022. This drop primarily reflects a reduction in the capacity of many governments to further accumulate and service public debt. Part I of this paper explores the impact of this current macro-fiscal outlook on the three primary sources of health spending. Drawing on experiences from previous economic crises, scenario analyses suggest a fall in government per capita spending on health in 2021 and 2022 unless governments make bold choices to increase the share of health in general government spending. The projected drop in per capita government spending on health is expected to coincide with lower levels of household out-of-pocket spending on health and a possible decline in development assistance for health (DAH). The projected decline in government per capita health spending will threaten a recovery from the health and economic shocks. An end to the pandemic can only come through enhanced disease surveillance, strengthened delivery platforms, and the roll out of COVID-19 vaccines. Reclaiming losses in progress toward universal health coverage (UHC) due to disruptions in the supply and demand for essential non-COVID-19 health services during the pandemic is vital for a sustainable and inclusive longer-term economic recovery. Part II of the paper discusses policy options to meet the spending needs in health. These options encompass strategies to make fiscal adjustments work and channel funds where they are most needed, as well as policies to stabilize the balance sheets of social health insurance (SHI) schemes. The paper explains how the health sector can play an active role in expanding fiscal space, contributing to tax reforms, most importantly pro-health taxes, and mobilizing and absorbing external financing, including debt relief. Recognizing that the quality of spending has implications for its quantity, Part II also discusses the challenges and opportunities of the crisis to increase the equity and efficiency of health spending. These include which expenditures to cut and which to protect, which emergency measure to roll back and which to roll out, as well as some of the most controversial trade-offs in health financing underscored by the crisis. Countries did not choose COVID-19, but their leaders have policy choices to make in health financing that will impact the response to the pandemic, the capacity to get back on the path to UHC, and ultimately the strength of the recovery.Item Health SDG profile 2017(Ministry of Health, Maldives, 2017) Ministry of Health; މިނިސްޓްރީ އޮފް ހެލްތްThe year 2015 saw the establishment of the Sustainable Development Goals (SDGs) by the United Nations (UN), to lead the global development agenda up till the year 2030. The SDGs are comprised of 17 global goals, with a total of 169 targets. Of all the 17 SDGs, the health goal, ensuring healthy lives and promoting wellbeing for all ages, i.e. SDG 3 has the largest number of indicators. With the emergence of SDGs, every member country has embarked on aligning country developmental goals and plans with that of the SDGs. Similarly, in the Maldives, as with other agencies and stakeholders within the government, the Ministry of Health (MoH) is working towards meeting the targets of the global agenda in the process of improving the health services provided to citizens scattered geographically across swathes of ocean, which in itself poses challenges. This report duly focuses on the work that is being undertaken at the island, atoll, and country level in terms of meeting the targets of SDGs, the progress that has been made, the milestones achieved, and the challenges that remain as MoH forges ahead with its plans and policies to translate these goals into reality on the ground. As there exists interdependence and inter-linkages between the goals, this report also looks into SDG 2 which deals with ending hunger and achieving food security for improved nutrition, which in a large way translates into healthy lives and promoting wellbeing. The main focus of the report however, is made on the goals within the goal of SDG 3. It takes an in-depth look into areas such as the work that is currently being done to put an end to preventable deaths of new-borns and children under five years of age, to ending the epidemics of AIDS, tuberculosis etc. to ensuring healthy lifestyles to prevent the rise of non-communicable diseases (NCDs) that have become prevalent and are in a large way the leading cause of deaths in modern societies. Amidst all this, due attention is given to challenges faced in terms of hiring and retaining adequately trained local human capital in the sector, the geographical challenges owing to the fact that Maldives is a small island state, the lack of robust Ministry of Health, Republic of Maldives mechanisms in handling data that can be relied on to drive policies to forge ahead, and the need for increased stakeholder engagements when achieving milestones as SDGs themselves are multi-dimensional in nature. The future lies in finding ways to overcome the barriers to progress identified, and using a whole-of-government (WOG) approach in some cases, if not all, to achieve the SDGs in question. Reports in the future will look into broadening the scope, by including other health related SDGs not specifically grouped under SDG 3, but yet contribute in a large way towards bridging the gaps and bringing the health-related goals full circle.