An Assessment of Provider Payment Mechanisms (PPMs) in Ethiopia: Implications for Redesign of PPMs and Progress Toward Universal Health Coverage

References

• UNPF. World population dashboard. 2023 [Accessed 2024 Feb 26]. https://www.unfpa.org/data/world-population/ET.
   Google Scholar
• Assefa Y, Gelaw YA, Hill PS, Taye BW, Van Damme W. Community health extension program of Ethiopia, 2003–2018: successes and challenges toward universal coverage for primary healthcare services. Global Health. 2019;15(1):24. doi:10.1186/s12992-019-0470-1.
   PubMed Web of Science ®Google Scholar
• Assefa Y, Van Damme W, Williams OD, Hill PS. Successes and challenges of the millennium development goals in Ethiopia: lessons for the sustainable development goals. BMJ Global Health. 2017;2(2):e000318. doi:10.1136/bmjgh-2017-000318.
   PubMed Web of Science ®Google Scholar
• Accorsi S. Special session “countdown to 2015 in Ethiopia” countdown to 2015: challenges and perspectives in achieving the millennium development goals in Ethiopia. Articles from the 13th World Congress on Public Health; Addis Ababa. 2013;7–15.
   Google Scholar
• Okwaraji YB, Hill Z, Defar A, Berhanu D, Wolassa D, Persson LÃ, Gonfa G, Schellenberg JA. Implementation of the ‘optimising the health extension program’ intervention in Ethiopia: a process evaluation using mixed methods. Int J Environ Res Public Health. 2020;17(16):5803. doi:10.3390/ijerph17165803.
   PubMedGoogle Scholar
• Zerfu TA, Tareke AA, Biadgilign S. Challenges and experience of the Ethiopian rural health extension program: implications for reform and revitalization. BMC Health Serv Res. 2023 Nov 27. 23(1):1309. doi:10.1186/s12913-023-10253-9. PMID: 38012613; PMCID: PMC10683286.
   PubMedGoogle Scholar
• Ministry of Health. Ethiopia demographic health survey 2016. Addis Ababa, Ethiopia: Ministry of Health; 2016.
   Google Scholar
• Ministry of Health. Ethiopia demographic health survey 2019. Addis Ababa, Ethiopia: Ministry of Health; 2019.
   Google Scholar
• Alebachew A, Yusuf Y, Mann C, Berman P. Ethiopia’s progress in health financing and the contribution of the 1998 health care and financing strategy in Ethiopia. MA, Addis Ababa: Harvard TH Chan School of Public Health and Breakthrough International Consultancy, PLC; 2015.
   Google Scholar
• Alebachew A, Mitiku W. Financing exempted health services in Ethiopia: analysis of potential policy options. 2019; doi:10.15585/mmwr.mm6821a2.
   Google Scholar
• Ministry of Health. Ethiopia national heath accounts report, 2019/20. Addis Ababa, Ethiopia: Ministry of Health, Partnership and Cooperation Directorate; 2022.
   Google Scholar
• Alebachew A, Mann C, Mitiku W, Berman P. Resource mobilization for health in devolved context: the Ethiopian experience. Chapter 4 in tracking resources for primary healthcare. World Scientific Publishing; 2020 [Accessed 2024 Feb 26]. doi:10.1142/9789811212413_0004.
   Google Scholar
• Ethiopia Health Sector Financing Reform/Health Financing and Governance Project. Ethiopia Health Sector Financing Reform/Health Finance and Governance (HSFR/HFG) project: end of term project report. Rockville: M.D. Health Financing and Governance Project. Abt Associates: 2018 [Accessed 2024 Feb 26]. https://www.hfgproject.org/ethiopia-health-sector-financing-reform-hfg-end-of-project-report/.
   Google Scholar
• Debie A, Khatri RB, Assefa Y. Contributions and challenges of healthcare financing towards universal health coverage in Ethiopia: a narrative evidence synthesis. BMC Health Serv Res. 2022;22(1):866. doi:10.1186/s12913-022-08151-7.
   PubMed Web of Science ®Google Scholar
• Tefera BB, Tafere C, Yehualaw A, Mebratu E, Chanie Y, Ayele S, Adane S. Availability and stock-out duration of essential medicines in Shegaw Motta general hospital and Motta Health Centre, Northwest Ethiopia. PLOS ONE. 2022;17(9):e0274776. doi:10.1371/journal.pone.0274776.
   PubMedGoogle Scholar
• Gietaneh W, Alle A, Alene M, Assemie MA, Simieneh MM, Birhanu MY. Quality disparity in terms of clients’ satisfaction with selected exempted health care services provided in Ethiopia: meta-analysis. Health Policy Open. 2022;3:100068. https://www.sciencedirect.com/science/article/pii/S259022962200003X.
   PubMedGoogle Scholar
• Ethiopia Health Insurance Service. Strategic health purchasing in Ethiopia: an assessment and strategic actions to improve purchasing. Ethiopia Health Insurance Service. 2022.
   Google Scholar
• Langenbrunner J, Cashin C, O’Dougherty S. Designing and implementing health care provider payment systems: how-to manuals. Washington (DC): The World Bank; 2009. doi:10.1596/978-0-8213-7815-1.
   Google Scholar
• Cashin C, Bloom D, Sparkes S, Barroy H, Kutzin J, O’Dougherty S. Aligning public financial management and health financing: sustaining progress toward universal health coverage. Geneva: World Health Organization; 2017. (Health Financing Working Paper No. 17.4). Licence: CC BY-NC-SA 3.0 IGO. http://apps.who.int/iris/bitstream/10665/254680/1/9789241512039-eng.pdf.
   Google Scholar
• Lagarde M, Powell-Jackson T, Blaauw D. Managing incentives for health providers and patients in the move towards universal coverage. Background paper for the global symposium on health systems research 16-19 November 2010 - Montreux, Switzerland. 2010 [accessed 2023 Dec 15]. https://healthsystemsresearch.org/hsr2010/images/stories/1managing_incentives.pdf.
   Google Scholar
• Kutzin J. A descriptive framework for country-level analysis of health care financing arrangements. Health Policy (New York). 2001;56(3):171–204. doi:10.1016/S0168-8510(00)00149-4.
   PubMed Web of Science ®Google Scholar
• World Health Organization. The world health report 2010. Health systems financing: the path to universal coverage. Geneva (Switzerland): World Health Organization; 2010 [accessed 2021 Sep 29]. https://www.who.int/publications/i/item/9789241564021.
   Google Scholar
• Kutzin J. Health financing for universal coverage and health system performance: concepts and implications for policy. Bull World Health Organ. 2013;91(8):602–11. doi:10.2471/BLT.12.113985.
   PubMed Web of Science ®Google Scholar
• Mathauer I, Dale E, Jowett M, Kutzin J. Purchasing health services for universal health coverage: how to make it more strategic? Geneva (Switzerland): World Health Organization; 2019 [accessed 2022 Feb 1]. https://apps.who.int/iris/handle/10665/311387.
   Google Scholar
• Hanson K, Barasa E, Honda A, Panichkriangkrai W, Patcharanarumol W. Strategic purchasing: the neglected health financing function for pursuing universal health coverage in lowand middle-income countries comment on “what’s needed to develop strategic purchasing in healthcare? policy lessons from a realist review”. Int J Health Policy Manag. 2019;8(8):501–04. doi:10.15171/ijhpm.2019.34.
   PubMed Web of Science ®Google Scholar
• Cashin C, Gatome-Munyua A. The strategic health purchasing progress tracking framework: a practical approach to describing, assessing, and improving strategic purchasing for universal health coverage. Health Syst & Reform. 2022;8(2):e2051794. doi:10.1080/23288604.2022.2051794.
   PubMedGoogle Scholar
• John L, Cashin C, O’Dougherty S. Designing and implementing health care provider payment systems: how-to manuals. (WA) (DC): World Bank; 2009. https://openknowledge.worldbank.org/handle/10986/13806.
   Google Scholar
• Jowett M, Kutzin J, Kwon S, Hsu J, Sallaku J, Solano JG. Assessing country health financing systems: the health financing progress matrix. Geneva (Switzerland): World Health Organization; 2020. Report No: Health financing guidance, no. 8. https://www.euro.who.int/__data/assets/pdf_file/0004/98428/E86300.pdf.
   Google Scholar
• Joint Learning Network (JLN). Provider payment mechanisms diagnostic and assessment guide. Washington (DC): JLN for Universal Health Coverage; 2012.
   Google Scholar
• Cashin C, Ankhbayar B, Tsilaajav T, Nanzad O, Jamsran G, Somanathan A. Assessment of systems for paying health care providers in Mongolia: implications for equity, efficiency and universal health coverage. Report No. 98790-MN. Mongolia: Ministry of Health and Sports; 2018.
   Google Scholar
• Phuong NK, Oanh TTM, Phuong HT, Tien TV, Cashin C. Assessment of systems for paying health care providers in Vietnam: Implications for equity, efficiency and expanding effective health coverage, Global Public Health. An Int J For Res, Policy And Pract. 2015;10(sup1):S80–94. doi:10.1080/17441692.2014.986154.
   Google Scholar
• MOFED. Ministry of finance and economic development. 2024. https://www.mofed.gov.et/ministry-en/directorates/channel-one-program-coordinating-unitcopcu/.
   Google Scholar
• WHO. Provider payment methods and UHC technical brief strategic purchasing for UHC. Erişim adresi; 2017. https://apps.who.int/iris/handle/10665/258894(Erişim…;2017).
   Google Scholar
• Mwase T, Lohmann J, Hamadou S, Brenner S, Somda SM, Hien H, Hillebrecht M, De Allegri M. Can combining performance-based financing with equity measures result in greater equity in utilization of maternal care services? Evidence from Burkina Faso. Int J Health Policy Manag. 2022;11(3):308. doi:10.34172/ijhpm.2020.121.
   PubMedGoogle Scholar
• Nkangu M, Little J, Asahngwa C, Deonandan R, Pongou R, Adams O, Yaya S. Examining the implementation of the performance-based financing equity strategy in improving access and utilization of maternal health services in Cameroon: a qualitative study. Int J Environ Res And Public Health. 2022;19(21):14132. doi:10.3390/ijerph192114132.
   PubMedGoogle Scholar
• Gottret PE, Schieber G. Health financing revisited: a practitioner’s guide. Washington DC: World Bank Publications; 2006.
   Google Scholar
• Cashin C, Ankhbayar B, Phuong H, Jamsran G, Nanzad O, Phuong N. Assessing health provider payment systems. A practical guide for countries working toward universal health coverage. Washington (DC): Joint Learning Network for Universal Health Coverage; 2015.
   Google Scholar
• Cromwell J, Mitchell JB. Physician-induced demand for surgery. J Health Econ. 1986;5(4):293–313. doi:10.1016/0167-6296(86)90006-8.
   PubMed Web of Science ®Google Scholar
• Seyedin H, Afshari M, Isfahani P, Hasanzadeh E, Radinmanesh M, Bahador RC. The main factors of supplier-induced demand in health care: a qualitative study. J Edu Health Promot. 2021;10(1):49. doi:10.4103/jehp.jehp_68_20.
   PubMedGoogle Scholar
• Feldhaus I, Mathauer I. Effects of mixed provider payment systems and aligned cost sharing practices on expenditure growth management, efficiency, and equity: a structured review of the literature. BMC Health Serv Res. 2018;18(1):996. doi:10.1186/s12913-018-3779-1.
   PubMedGoogle Scholar
• Wang H, Otoo N, Dsane-Selby L. Ghana national health insurance scheme: improving financial sustainability based on expenditure review. (WA) (DC): International Bank for Reconstruction and Development/The Word Bank; 2017 [accessed 2022 Feb 14]. https://openknowledge.worldbank.org/bitstream/handle/10986/27658/9781464811173.pdf?.
   Google Scholar
• Amporfu E, Baffour PA, Edusei A, Novignon J, Arthur E. Strategic health purchasing progress mapping: a spotlight on Ghana’s national health insurance scheme. Health Syst & Reform. 2022;8(2):2. doi:10.1080/23288604.2022.2058337.
   Google Scholar
• Dzampe AK, Takahashi S. Competition and physician-induced demand in a healthcare market with regulated price: evidence from Ghana. Int J Health Econ Manag. 2021 Dec 17;22(3):295–313. doi:10.1007/s10754-021-09320-7.
   PubMedGoogle Scholar
• Umuhoza SM, Musange SF, Nyandwi A, Gatome-Munyua A, Mumararungu A, Hitimana R, Rulisa A, Uwaliraye P. Strengths and weaknesses of strategic health purchasing for universal health coverage in Rwanda. Health Syst & Reform. 2022;8(2):2. doi:10.1080/23288604.2022.2061891.
   Google Scholar
• Ezenduka C, Obikeze E, Uzochukwu B, Onwujekwe O. Examining healthcare purchasing arrangements for strategic purchasing in Nigeria: a case study of the Imo state healthcare system. Health Res Policy Sys. 2022;20(1):1–16. doi:10.1186/s12961-022-00844-z.
   PubMedGoogle Scholar
• Honda A, McIntyre D. Strategic purchasing for universal health coverage: a critical assessment. Medical schemes in South Africa. London (UK): Resilient and Responsive Health Systems (RESYST); 2016.
   Google Scholar
• Phuong NK, Oanh TTM, Phuong HT, Tien TV, Cashin C. Assessment of systems for paying health care providers in Vietnam: implications for equity, efficiency and expanding effective health coverage. Global Public Health. 2015;10(sup1):S80–94. doi:10.1080/17441692.2014.986154.
   PubMed Web of Science ®Google Scholar
• Hanson K, Brikci N, Erlangga D, Alebachew A, De Allegri M, Balabanova D, Blecher M, Cashin C, Esperato A, Hipgrave D, et al. The Lancet Global Health Commission on financing primary health care: putting people at the centre. The Lancet Global Health. 2022;10(5):e715–72. doi:10.1016/S2214-109X(22)00005-5.
   PubMed Web of Science ®Google Scholar
• Crampton P, Sutton F, Foley J. Capitation funding of primary care services: principles and prospects. New Zealand Med J (Online). 2002;115(1155):271–4.
   PubMedGoogle Scholar
• Antony M, Bertone MP, Barthes O. Exploring implementation practices in results-based financing: the case of the verification in Benin. BMC Health Serv Res. 2017;17(1):204. doi:10.1186/s12913-017-2148-9.
   PubMedGoogle Scholar
• Waithaka D, Cashin C, Barasa E. Is performance-based financing a pathway to strategic purchasing in Sub-Saharan Africa? A synthesis of the evidence. Health Syst & Reform. 2022 Mar 1. 8(2):e2068231. doi:10.1080/23288604.2022.2068231. PMID: 35666240; PMCID: PMC7613548.
   PubMedGoogle Scholar
• Salehi AS, Borghi J, Blanchet K, Vassall A. The cost-effectiveness of using performance-based financing to deliver the basic package of health services in Afghanistan. BMJ Glob Health. 2020 Sep. 5(9):e002381. doi:10.1136/bmjgh-2020-002381. PMID: 32958537; PMCID: PMC7507335.
   PubMedGoogle Scholar
• Paul E, Albert L, Bisala BN, Bodson O, Bonnet E, Bossyns P, Colombo S, De Brouwere V, Dumont A, Eclou DS. et al. Performance-based financing in low-income and middle-income countries: isn’t it time for a rethink?BMJ. BMJ Glob Health. 2018;3(1):e000664. doi:10.1136/bmjgh-2017-000664.
   PubMedGoogle Scholar
• Witter S, Arhinful DK, Kusi A, Zakariah-Akoto S. The experience of Ghana in implementing a user fee exemption policy to provide free delivery care. Reprod Health Matters. 2007;15(30):61–71. doi:10.1016/S0968-8080(07)30325-X.
   PubMed Web of Science ®Google Scholar
• Pearson L, Gandhi M, Admasu K, Keyes EB. User fees and maternity services in Ethiopia. Int J Gynaecol Obstet. 2011;115(3):310–15. doi:10.1016/j.ijgo.2011.09.007.
   PubMed Web of Science ®Google Scholar
• Nimpagaritse M, Bertone MP. The sudden removal of user fees: the perspective of a frontline manager in Burundi. Health Policy Plan. 2011;26(Suppl 2):ii63–71. doi:10.1093/heapol/czr061.
   PubMedGoogle Scholar
• Galadanci HS, Idris SA, Sadauki HM, Yakasai IA. Programs and policies for reducing maternal mortality in Kano State, Nigeria: a review. (Special issue: reducing maternal mortality in Nigeria: an approach through policy research and capacity building). Afr J Reprod Health. 2010;14:31–36.
   Google Scholar
• Hatt LE, Makinen M, Madhavan S, Conlon CM. Effects of user fee exemptions on the provision and use of maternal health services: a review of literature. J Health Popul Nutr. 2013 Dec. 31(4 Suppl 2):S67–80. PMCID: PMC4021702.
   PubMed Web of Science ®Google Scholar
• Ponsar F, Van Herp M, Zachariah R, Gerard S, Philips M, Jouquet G. Abolishing user fees for children and pregnant women trebled uptake of malaria-related interventions in Kangaba, Mali. Health Policy Plan. 2011;26(Suppl 2):ii72–83. doi:10.1093/heapol/czr068.
   PubMedGoogle Scholar
• Ridde V, Diarra A. A process evaluation of user fees abolition for pregnant women and children under five years in two districts in Niger (West Africa). BMC Health Serv Res. 2009;9(1):89. doi:10.1186/1472-6963-9-89.
   PubMedGoogle Scholar
• Barroy H, Kutzin J, Coulibaly S, Bigeard A, Yaméogo SP, Caremel JF, Korachais C. Public financial management as an enabler for health financing reform: evidence from free health care policies implemented in Burkina Faso, Burundi, and Niger. Health Syst & Reform. 2022;8(1). doi:10.1080/23288604.2022.2064731.
   PubMedGoogle Scholar
• Meessen B, Soucat A, Sekabaraga C. Performance-based financing: just a donor fad or a catalyst towards comprehensive health-care reform? Bull World Health Organ. 2011;89(2):153–56. doi:10.2471/BLT.10.077339.
   PubMed Web of Science ®Google Scholar
• Chukwuma A, Meessen B, Lylozian H, Gong E, Ghazaryan E. Strategic purchasing for better health in Armenia. 2020.
   Google Scholar
• Gatome-Munyua A, Sieleunou I, Barasa E, Ssengooba F, Issa K, Musange S, Osoro O, Makawia S, Boyi-Hounsou C, Amporfu E, et al. Applying the strategic health purchasing progress tracking framework: lessons from nine African countries. Health Syst & Reform. 2022;8(2):e2051796. doi:10.1080/23288604.2022.2051796.
   PubMedGoogle Scholar