Abstract
To successfully develop, run and sustain an eye care programme, several resources are required, finance being among the essential ones. The source of such financing varies somewhat based on who the provider is – the government, non-profit hospital or private sector. Equally the sources vary depending on whether such financing is for capital investment or operating expenses. For a given programme, financing is driven by design, execution, efficiency and a host of other factors. In all areas of the world, financing of eye care is undergoing rapid change. In many low- and middle-income countries (LMIC), the government is promoting health insurance to the poor and marginalized in an effort to make healthcare services inclusive. While such efforts are aimed at achieving universal coverage by removing financial barriers, it is possible that these efforts will compromise the market dynamics as the key stakeholders become less concerned about costs. Since patients with insurance don’t need to pay, they are not cost-conscious. Neither are the hospitals since they get reimbursed for the procedures at negotiated rates, which, at present, tends to be on the high side. As eye care services and financing needs continue to grow, newer modalities like social impact funding or eye care-specific debt financing are emerging. This chapter covers all these facets of financing eye care services with case studies and articulation of ground realities in Asia, Africa and Latin America.
Money isn’t the most important thing in life, but it’s reasonably close to oxygen on the ‘gotta have it’ scale– Zig Ziglar
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Out-of-pocket expenditure (OOPS) as % of total health expenditure (THE); Viet Nam; 2014. Source: WHO Health Accounts. Available from http://www.who.int/health-accounts/en/.
References
Binagwaho A, Scott K, Rosewall T, et al. Improving eye care in Rwanda. Bull World Health Organ. 2015;93:429–34.
Blanchet K, James P. Can international health programmes be sustained after the end of international funding: the case of eye care interventions in Ghana. BMC Health Serv Res. 2014;14:77.
Bozzani FM, Griffiths UK, Blanchet K, Schmidt E. Health systems analysis of eye care services in Zambia: evaluating progress towards VISION 2020 goals. BMC Health Serv Res. 2014;14:94.
Economist Intelligence Unit. Latin America: healthcare outlook. http://www.eiu.com/industry/article/1840711968/latin-america-healthcare-outlook/2013-08-05. Accessed 26 Jan 2016.
Eliah E, Shayo A, Gendo C, Courtright P, Theraney M, Lewallen S. Can VISION 2020 be implemented in rural government settings? Findings from two programmes in Tanzania. Tropical Med Int Health. 2008;13:1284–7.
Evans CT, Lenhart PD, Lin D, et al. A cost analysis of pediatric cataract surgery at two child eye health tertiary facilities in Africa. J AAPOS. 2014;18:559–62.
Geneau R, Massae P, Courtright P, Lewallen S. Using qualitative methods to understand the determinants of patients’ willingness to pay for cataract surgery: a study in Tanzania. Soc Sci Med. 2008;66:558–68.
Ibrahim N, Pozo-Martin F, Gilbert C. Direct non-medical costs double the total direct costs to patients undergoing cataract surgery in Zamfara state, Northern Nigeria: a case series. BMC Health Serv Res. 2015;15:163.
Laviers HR, Omar F, Jecha H, Kassim G, Gilbert C. Presbyopic spectacle coverage, willingness to pay for near correction, and the impact of correcting uncorrected presbyopia in adults in Zanzibar, East Africa. Invest Ophthalmol Vis Sci. 2010;51:1234–41.
Lewallen S, Robert H, Hal A, et al. Increasing cataract surgery to meet vision 2020 targets; experience from two rural programmes in east Africa. Br J Ophthalmol. 2005;89:1237–40.
Maeda A, et al. Universal health coverage for inclusive and sustainable development a synthesis of 11 country case studies. Washington, DC: World Bank; 2014. p. 12. UHC_for_InclusiveSustainableDevelopment_11CountryCaseStudies.pdf. Accessed 25 Jan 2016.
Melese M, Alemayehu W, Friedlander E, Courtright P. Indirect costs associated with accessing eye care services as a barrier to service use in Ethiopia. Tropical Med Int Health. 2004;9:426–31.
Palmer JJ, Chinanayi F, Gilbert A, et al. Mapping human resources for eye health in 21 countries of sub-Saharan Africa: current progress towards VISION 2020. Hum Resour Health. 2014;12:44.
Palmer JJ, Chinanayi F, Gilbert A, et al. Trends and implications for achieving VISION 2020 human resources for eye health targets in 16 countries of sub-Saharan Africa by the year 2020. Hum Resour Health. 2014;12:45.
PhilHealth Circular No. 018-2015. Guidelines on the diagnosis and management of uncomplicated cataract in adults. http://www.philhealth.gov.ph/circulars/2015/circ018-2015.pdf. Accessed 26 Jan 2016.
Razafinimpanana N, Nkumbe H, Courtright P, Lewallen S. Uptake of cataract surgery in Sava Region, Madagascar: role of cataract case finders in acceptance of cataract surgery. Int Ophthalmol. 2012;32:107–11.
Tran HTP, Mathauer I, Nguyen TKP. A health financing review of Viet Nam with a focus on social health insurance. World Health Organisation; 2011. p. 21. http://www.who.int/health_financing/documents/cov-oasis_e_11-vietnam/en/. Accessed 26 Jan 2016.
UNICEF. Is PhilHealth’s sponsored program reaching the poorest of the poor? 2010. www.unicef.org/philippines/brief02_fnl.pdf. Accessed 26 Jan 2016.
World Bank. Health expenditure, total (% of GDP). http://data.worldbank.org/indicator/sh.xpd.totl.zs. Accessed 26 Jan 2016.
Foster A, Thulasiraj RD. Planning, management and evaluation of eye-care services. In: Johnson GJ, Minassian DC, Weale R, editors. The epidemiology of eye disease. London: Chapman & Hall; 1998. p. 350–7. isbn 0 412 64310 3.
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Ravilla, T., Courtright, P., Melgar, J.F.Y., Green, D. (2019). Affordability and Financing for Eye Care. In: Khanna, R., Rao, G., Marmamula, S. (eds) Innovative Approaches in the Delivery of Primary and Secondary Eye Care. Essentials in Ophthalmology. Springer, Cham. https://doi.org/10.1007/978-3-319-98014-0_6
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