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cover page image What do policy makers think about health system and health inequalities in Asia?

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Bhatia, Mirgesh, Viroj Tangcharoensathien,Ravi P. Rannan-Eliya, Aparnaa Somanathan et al.
1 Jun 2005 | 23 pages

Abstract: In recent years, a number of Asian countries have witnessed significant changes to their health care system both in terms of financing and delivery of health care. To some extent health sector reforms and its impact on equity and efficiency have been addressed, the views of the policy makers has not been studied. Policy makers are important actors in both formulation and implementation of health policies and hence assessing their views on health systems and health inequalities is crucial. This paper presents the comparative results of a survey conducted using a standardised questionnaire among 184 policy makers of 10 Asian countries namely: Hong Kong, Taiwan, Sri Lanka, China, Mongolia, Thailand, Bangladesh, India, Indonesia, Nepal. Flexibility was built-in the design of the questionnaire to allow collecting data using approaches (mail questionnaire, face-to face interviews, convenient sampling) suitable to individual countries. The design of the questionnaire was aimed at capturing both policy makerís knowledge on health inequalities and their opinion on specific health system issues including eliciting equity efficiency trade-offs. The results show that policymakers have a positive attitude towards equity, and a good understanding on health determinants outside health sector, especially socio-economic development, income distribution in favour the rich than the poor, etc. which could have a large impact on health inequities. With respect to equity-efficiency trade offs, up to a cut off point, policymakers have preference for programs benefiting the poor than the rich, given equivalent cost and effectiveness. To ensure comparability the results of these studies are presented for groups of countries and to some extent results vary among the groups depending upon the level of democratization and bureaucratic systems of each countries and how policy agenda was formulated. Policy implications of the study findings are discussed.