Strategies to Develope an Essential Healthcare Package: Definition, Package and Criteria_Chinese Journal of Evidence-Based Medicine

Authors：

YANG Li ¹ , WANG Jin ¹ , CAO Zhihui ¹ , SUN Jia ¹ , GAO Jun ² , XU Wenying ¹ ,  WU Ming ¹

1. Department of Health Policy and Management, School of Public Health, Peking University, Beijing 100191, China;2. Center for Health Statistics and Information, Ministry of Health, Beijing 100044, China;

Corresponding author：

WU Ming, Email: w_ming@126.com

Keywords：

Essential health care; Package; Criteria; Systematic review

DOI：

10.7507/1672-2531.20090108

Video：

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Abstract Full text Figures/Tables Video References Cited by

Objective 　To describe the criteria and procedure for defining an essential healthcare package in the developed and developing countries.
Method 　Search words were chosen by both health policy experts and search coordinators after discussion and pilot. We searched electronic databases, websites of health institutions and governments and search engine Google. Any reports of implemented strategy to develope an essential healthcare package were included. Pre-designed data extraction form was used for collecting strategies and study method of included studies. Then the extracted information was analyzed and described.
Result 　One hundred and sixty-six studies covering 72 countries were included, most of which were studies in the middle and low Countries. In terms of study objective,160 articles aimed to describe strategies, 6 articles aimed to evaluate effectiveness of strategies.Five studies evaluating effectiveness were cross-sectionnary data, and one study was time series.
Conclusion 　An appropriate package should be defined according to both technique criteria and social welfare criteria, considering each country’s healthcare system and market structure, characteristics of the demander and provider, capacity of government’s regulation. The experience in transition countries gives us more high lights.

Citation： YANG Li,WANG Jin,CAO Zhihui,SUN Jia,GAO Jun,XU Wenying,WU Ming. Strategies to Develope an Essential Healthcare Package: Definition, Package and Criteria. Chinese Journal of Evidence-Based Medicine, 2009, 09(6): 599-609. doi: 10.7507/1672-2531.20090108 Copy

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10.	Asian Development Bank Regional and Sustainable Development Department. Scaling up health sector potential for poverty reduction: lessons from Papua new guinea with selective references to Cambodia and Sri Lanka. Paper prepared for the Conference on Up-scaling Poverty Reduction Shanghai, 25-27 May, 2004.
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42.	Knowles J. Strengthening Community Based Kenya Essential Care Package for Health (CB-KEPH) at the community level. The Ministry of Health, March 2006.
43.	Mahfouz AA, Abdelmoneim I, Khan MY. Primary health care emergency services in Abha district of southwestern Saudi Arabia. Eastern Mediterranean Health Journal, 2007, 13(1): 103.
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59.	Hotchkiss D, Piccinino L. Primary health care reform in Albania: findings from an impact assessment of a pilot project. Abt Associates Inc. June 2005.
60.	Chukwuani CM. A baseline survey of the Primary Healthcare System in South Eastern Nigeria. Health Policy, 2006, 77: 182-201.
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1. Winslow CE. Man and epidemics, Princeton, New Jersey, 1952.
2. WHO. Primary health care: report of the International Conference on Primary Health Care, Alma-Ata 1978. Geneva, WHO, 1978.
3. World Bank. Investing in health: world development report 2003: New York, Oxford University Press.
4. WHO. Sustainable health financing, universal coverage and social health insurance. WHA 58.33. WHO, Geneva, 2005.
5. 汤胜蓝. 初级卫生保健发展与保障机制的国际经验. 初级卫生保健工作的快速政策咨询任务报告. 卫生部人才交流中心 2007. 4.
6. Tarimo E. Essential health service packages: uses, abuse and future directions. WHO, 1997.
7. Söderlund N. Possible Objectives and Resulting Entitlements of Essential Health Care Packages. Health Policy, 1998, 45(3): 195-208.
8. Ensor T, Ali L, Hossain A, et al. Projecting the cost of essential services in Bangladesh. Nt J Health Plann Mgmt, 2003, 18: 137-149.
9. Cumming J. Core services and priority-setting: the New Zealand experience. Health Policy, 1994, 29(1-2): 41-60.
10. Asian Development Bank Regional and Sustainable Development Department. Scaling up health sector potential for poverty reduction: lessons from Papua new guinea with selective references to Cambodia and Sri Lanka. Paper prepared for the Conference on Up-scaling Poverty Reduction Shanghai, 25-27 May, 2004.
11. Rutten F. How to define a basic package of health services for a tax funded or social insurance based health care system? HEPAC, 2001, 2: 45-46.
12. Pan American Health Organization, Organization and management of health systems and services division of health systems and services development. Health systems and services profile of Suriname. 1st Edition, June 2002.
13. Torbica A, Fattore G. The “Essential Levels of Care” in Italy: When being explicit serves the devolution of powers. Eur J Health Econ, 2005, 6(Suppl 1): 46-52.
14. Samvel G. health care system in transition Armenia. European Observatory on Health Care Systems, 2001, 3(11): 1020-1077.
15. Vargas-Barón E. Formative evaluation of parenting programmes in four countries of the CEE/CIS region: Belarus, Bosnia & Herzegovina, Georgia and Kazakhstan. UNICEF Regional Office for Central and Eastern Europe and the Common Wealth of Independent States, Geneva 2006.
16. Hlavacka S, Wágner R, Riesberg A. Health Care Systems in Transition: Slovakia. WHO Regional Office for Europe on behalf of the European Observatory on Health Systems and Policies, 2004, 6(10):.
17. New B. The Rationing Debate: Defining a package of healthcare services the NHS is responsible for the case for. BMJ, 1997, 314: 498.
18. Bellanger MM. Cherilova V. The health benefit basket in France. Eur J Health Econ, 2005, 6(Suppl 1): 24-29.
19. Charles C. Medical necessity in Canadian health policy: four meanings and a funeral? The Milbank Quarterly, 1997, 75(3): 365-394.
20. Bernfort L. Decisions on inclusion in the Swedish basic health care package—roles of cost-effectiveness and need. Health Care Analysis, 2003, 11(4): 301-308.
21. Busse R. Health care systems in eight countries: trends and challenges. European Observatory on Health Care Systems, London, 2002.
22. Knippenberg R. Implementation of the Bamako initiative: strategies in Benin and guinea. International Journal of Health Planning and Management, 1997, 12: S11-19.
23. Kapiriria L. Using burden of disease information for health planning in developing countries: the experience from Uganda. Social Science & Medicine, 2003, 56: 2433-2441.
24. Tragakes E, Lessof S. Health care systems in transition: Russian federation. Copenhagen, European Observatory on Health Systems and Policies, 2003, 5(3): 1-197.
25. Figueras J. Health care systems in transition Belarus. World Health Organization Regional Office for Europe, 1997.
26. Chukwuani CM. A baseline survey of the Primary Healthcare System in South Eastern Nigeria. Health Policy, 2006, 77: 182-201.
27. Norheim OF. Adoption of new health care services in Norway (1993–1997): specialists’ self-assessment according to national criteria for priority setting. Health Policy, 2001, 56: 65-79.
28. Russel M. Applying DALY to assessing national health insurance performance: the relationship between the national health insurance expenditures and the burden of disease measures in Iran. Int J Health Plann Mgmt, 2005, 20: 89-98.
29. Ahlam A, Muneera H, AI-Osimy RN. A study of satisfaction among primary health care patients in Saudi Arabia. Journal of Community Health, 1993, 18(3): 163-173.
30. Gonza MA. Beyond health gain: the range of health system benefits expressed by social groups in Mexico and Central America. Social Science & Medicine, 2001, 52: 1537-1550.
31. Gross R, Brammli-Greenberg S. Evaluating the effect of regulatory prohibitions against risk selection by health status on supplemental insurance ownership in Israel. Social Science & Medicine, 2004, 58(9): 1609-1622.
32. Afghanistan Research and Evaluation Unit. A guide to government functioning outside of Kabul: early observations based on missions to Herat and Faryab. World Bank, Working Draft, March 13, 2003.
33. Kulzhanov M, Healy J. Health care systems in Transition. European Observatory On Health Care Systems, 1999.
34. WHO. Health care systems in transition republic of Moldova. World Health Organization Regional Office for Europe Copenhagen, 1996.
35. The Uganda National Health Research Organisation (UNHRO). Essential national health research in Uganda: a case study of progress and challenges in implementing the ENHR strategy. Cohred Document, 2000.6.
36. CCS Team. WHO country cooperation strategy. Republic Of Mozambique, 2004-2008.WHO, 2003.
37. Mwabu G, Noumba I, Gesami R, et al. Health service provision and health status in Africa: the case of Kenya and Cameroon. Revised version of a paper presented at the Global Development Network (GDN) Conference, Prague, Czech Republic, April 2002.
38. Almeida C, Chagastele P, Barbosa S. A priority-setting methodology for an institutional programme of research for health service technology development and innovation. Global Forum for Health Research Forum 8, Mexico, November 2004.
39. Mayhew SH. Sexual and reproductive health: challenges for priority-setting in Ghana’s health reforms. Health Policy and Planning, 2004, 19(Suppl 1): i50-i61.
40. Dlamini, QQ, Lush L, Auton M, et al. Impact of public-private partnerships addressing access to pharmaceuticals in low and middle income countries. Published by the initiative on public-private partnerships for health, Global Forum for Health Research, September 2004.
41. Ministry Of Health, Human Services, Family Affairs and Gender Relations. Quality services for life. 6th March 2000.
42. Knowles J. Strengthening Community Based Kenya Essential Care Package for Health (CB-KEPH) at the community level. The Ministry of Health, March 2006.
43. Mahfouz AA, Abdelmoneim I, Khan MY. Primary health care emergency services in Abha district of southwestern Saudi Arabia. Eastern Mediterranean Health Journal, 2007, 13(1): 103.
44. Ensor T, Ali L, Hossain A, et al. Projecting the cost of essential services in Bangladesh. Nt J Health Plann Mgmt, 2003, 18: 137-149.
45. Department of State for Finance and Economic Affairs. PRSP/SPA II Annual Progress Report. January-December 2004.
46. Söderlund N. An essential hospital package for South Africa--selection criteria, costs and affordability. S Afr Med J, 1999, 89(7): 757-765.
47. Somanje H, Phoya A. Malawi essential health package. 2002/3 FY Plan of action. Reaching an EHP implementation plan. European Observatory on Health Care Systems, 1999.
48. Feilden R. Assessment of the health system in Nepal with a special focus on immunization. 2001. www.uncief.com.
49. Lekhan V, Rudiy O, Nolt E. Health Care Systems in Transtion: Ukraine. Copenhagen, WHO Regional Office for Europe on behalf of the European Observatory on Health Systems and Policies, 2004, 6(7): 1-123.
50. Division of Health Planning and Information. National Health Policy. Ministry of Health, October, 2003.
51. Orgil B. Costing the Mongolian essential health care package. Ministry of Health, Mongolia Asian Development Bank, Nov, 2005.
52. Pan American Health Organization. Health in the Americas, 1998 Edition. Washington, D.C.: Paho.
53. Anne Maryse Pierre-Louis. Public health in the Middle East and North Africa. Meeting the challenges of the twenty-first century. World Bank, 2004.
54. Ministry of Health of Italy. The Italian National Health Service. 1999.
55. Department for International Development Health Systems Resource Centre. Peru Country Health Briefing Paper. Dfid, 1999.
56. Busse R, Stargardt T, Schreyoog J. Determining the “Health Benefit Basket” of the statutory health insurance scheme in Germany. Eur J Health Econom, 2005, 6(Suppl 1): 30-36.
57. Corens D. Health system review: Belgium. Health Systems in Transition, 2007, 9(2): 1-172.
58. Russel M. Applying DALY to assessing national health insurance performance: the relationship between the national health insurance expenditures and the burden of disease measures in Iran. Int J Health Plann Mgmt, 2005, 20: 89-98.
59. Hotchkiss D, Piccinino L. Primary health care reform in Albania: findings from an impact assessment of a pilot project. Abt Associates Inc. June 2005.
60. Chukwuani CM. A baseline survey of the Primary Healthcare System in South Eastern Nigeria. Health Policy, 2006, 77: 182-201.
61. Muller M. Establishment of essential primary health care services in the DRC. World Health Organization Project Proposal, July 2005.
62. Henk AM. Have JT. Choosing core health services in the Netherlands. Health Care Analysis, 1993, I: 43-47.
63. Gauld R. Health care rationing policy in New Zealand: development and lessons. Social Policy & Society, 2004, 3: 3, 235-242.
64. USAID. USAID’s health program in Haiti. USAID, 2004.
65. Ministry of Health Government of Ethiopia. Essential Health Service Package for Ethiopia. Jul, 2005.
66. Bilde Lone, Ankjaer-Jen Sen A, Old-Samsøe BD. the health benefit basket in Denmark: a description of entitlements, actors, and decision-making processes in the curative health sector. Eur J Health Econom, 2005, 6(Suppl 1): 11-17.
67. Bernfort L. Decisions on inclusion in the Swedish basic health care package—roles of cost-effectiveness and need. Health Care Analysis, 2003, 11(4): 301-308.
68. Government of Rwanda. Health Sector Policy. Feb, 2005.
69. Kozierkiewicz A, Tr?bka W, Romaszewski A. Definition of the “Health Benefit Basket” in Poland. Eur J Health Econom, 2005, 6(Suppl 1): 58-65.
70. Chernichovsky D, Chinitz D. The political economy of health system reform in Israel. Health Economics, 1995, 4(2): 127-141.
71. Ham C. Priority setting in health care: learning from international experience. Health Policy, 1997, 49-68.
72. United Nations Children’s Fund Executive Board. Revised Country Programme Document. Uncief, 1 November 2004.
73. Somanathan A. Health care in the developing world: Bangladesh and Sri Lanka country studies. Prepared for global development network-merck health care in the developing world. Study final draft dated December 25, 2002.
74. Mason A. Does the English NHS have a ‘Health Benefit Basket’? Eur J Health Econ, 2005, 6(Suppl 1): 18-23.
75. Health Economics Unit. Bangladesh National Health Accounts, 1999-2001. Data International Ltd. December, 2003.
76. Simpson D. Development of administrative and financial management capacity for sector-wide approaches (SWAPS): the experience of the Bangladesh health sector. April, 2001.
77. Ministry of Health Government of Ethiopia. Essential health service package for Ethiopia. Jul, 2005.
78. Regional Office for South-East Asia. Social health insurance report and documentation of the technical discussions held in conjunction with the 40th meeting of CCPDM New Delhi, 4-5 September 2003.
79. Ministry of Economic Planning and Development. Malawi poverty reduction strategy 2003/2004 annual progress report. Feb, 2005.
80. CCS Team, WHO. Country Cooperation Strategy - Nepal. 2001.
81. Mahfouz AA, Abdelmoneim I, Khan MY. Primary health care emergency services in Abha district of southwestern Saudi Arabia. Eastern Mediterranean Health Journal, 2007, 13(1): 103.
82. Patel R. Development of an essential healthcare package (ehp) proposal for medical aid schemes in south Africa’s transition towards SHI. Board of Healthcare Funders of Southern Africa, February 2007.
83. Ministry of Health of Italy. The Italian National Health Service. 1999.
84. Schreyögg J. Defining the “health benefit basket” in nine European countries: evidence from the European union health basket project. Eur J Health Econ, 2005, 6(Suppl 1): 2-10.
85. World Health Organization Regional Office for the Western Pacific. Primary health care review project region specific report. Manila, Philippines, August 2002.
86. Donatini A, Rico A. Health care systems in transition: Italy. European Observatory on Health Care Systems, 2001, 3(4): 1020-1077.
87. Gakidou E. Assessing the effect of the 2001–06 Mexican health reform: an interim report card. Lancet, 2006, 368: 1920-1935.
88. Russel M. Applying DALY to assessing national health insurance performance: the relationship between the national health insurance expenditures and the burden of disease measures in Iran. Int J Health Plann Mgmt, 2005, 20: 89-98.
89. Devadasan N. The landscape of community health insurance in India: an overview based on 10 case studies. Health Policy, 2006, 78: 224-234.
90. Hauck K, Smith Pr C, Goddard M. The economics of priority setting for health care: a literature review. Health, Nutrition and Population (Hnp) Discussion Paper. September 2004.
91. Hrabaè B, Ljubiæ B, Bagariæ I. Basic package of health entitlements and solidarity in the federation of Bosnia and Herzegovina. Croatian Medical Journal, 2000, 41(3): 287-293.
92. World bank. Annex 8 – Health. www.Worldbank.Org.
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Chinese Journal of Evidence-Based Medicine

Strategies to Develope an Essential Healthcare Package: Definition, Package and Criteria

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