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Assessment of equity in healthcare financing in Fiji and Timor-Leste: a study protocol
  1. Augustine D Asante1,
  2. Jennifer Price1,
  3. Andrew Hayen1,
  4. Wayne Irava2,
  5. Joao Martins3,
  6. Lorna Guinness4,
  7. John E Ataguba5,
  8. Supon Limwattananon6,
  9. Anne Mills7,
  10. Stephen Jan8,
  11. Virginia Wiseman1,9
  1. 1School of Public Health and Community Medicine, University of New South Wales, Sydney, Australia
  2. 2Centre for Health Information, Policy and Systems Research, Fiji National University, Suva, Fiji
  3. 3Faculty of Medicine and Health Sciences, National University of Timor-Leste (UNTL), Dili, Timor-Leste
  4. 4Faculty of Public Health & Policy, London School of Hygiene and Tropical Medicine, London, UK
  5. 5Health Economics Unit, School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa
  6. 6Faculty of Pharmaceutical Sciences, Department of Social and Administrative Pharmacy, Khon Kaen University, Khon Kaen, Thailand
  7. 7London School of Hygiene and Tropical Medicine, London, UK
  8. 8The George Institute, Sydney, Australia
  9. 9Department of Global Health and Development, London School of Hygiene and Tropical Medicine, London, UK
  1. Correspondence to Dr Augustine D Asante; a.asante{at}unsw.edu.au

Abstract

Introduction Equitable health financing remains a key health policy objective worldwide. In low and middle-income countries (LMICs), there is evidence that many people are unable to access the health services they need due to financial and other barriers. There are growing calls for fairer health financing systems that will protect people from catastrophic and impoverishing health payments in times of illness. This study aims to assess equity in healthcare financing in Fiji and Timor-Leste in order to support government efforts to improve access to healthcare and move towards universal health coverage in the two countries.

Methods and analysis The study employs two standard measures of equity in health financing increasingly being applied in LMICs—benefit incidence analysis (BIA) and financing incidence analysis (FIA). In Fiji, we will use a combination of secondary and primary data including a Household Income and Expenditure Survey, National Health Accounts, and data from a cross-sectional household survey on healthcare utilisation. In Timor-Leste, the World Bank recently completed a health equity and financial protection analysis that incorporates BIA and FIA, and found that the distribution of benefits from healthcare financing is pro-rich. Building on this work, we will explore the factors that influence the pro-rich distribution.

Ethics and dissemination The study is approved by the Human Research Ethics Committee of University of New South Wales, Australia (Approval number: HC13269); the Fiji National Health Research Committee (Approval # 201371); and the Timor-Leste Ministry of Health (Ref MS/UNSW/VI/218).

Results Study outcomes will be disseminated through stakeholder meetings, targeted multidisciplinary seminars, peer-reviewed journal publications, policy briefs and the use of other web-based technologies including social media. A user-friendly toolkit on how to analyse healthcare financing equity will be developed for use by policymakers and development partners in the region.

This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/

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