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Towards a national health insurance system in ... - Detlef Schwefel

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<strong>Towards</strong> a <strong>national</strong> <strong>health</strong> <strong><strong>in</strong>surance</strong> <strong>system</strong> <strong>in</strong> Yemen – Part 1: Background and assessments 1<br />

<strong>Towards</strong> a <strong>national</strong> <strong>health</strong> <strong><strong>in</strong>surance</strong> <strong>system</strong> <strong>in</strong> Yemen<br />

Part 1: Background and assessments<br />

Table of Content<br />

Chapters<br />

Page<br />

Table of content 1<br />

Abbreviations 3<br />

Preamble 6<br />

Executive summaries 7<br />

1. Background 9<br />

1.1 Introduction 9<br />

1.2 Health <strong><strong>in</strong>surance</strong> 10<br />

1.3 Policy options 12<br />

1.4 Terms of reference 14<br />

1.5 Résumé 14<br />

2. Methodology 15<br />

2.1 Literature review 15<br />

2.2 Interviews 15<br />

2.3 Questionnaires 16<br />

2.4 Workshops 18<br />

2.5 Other methods 19<br />

2.6 Comparative assessment 19<br />

3. Basel<strong>in</strong>e assessment of context 19<br />

3.1 Society and economy 19<br />

3.1.1 Basic features 19<br />

3.1.2 Cultural issues 20<br />

3.1.3 Socio-economics, <strong>in</strong>cl. employment structure 23<br />

3.1.4 Poverty 25<br />

3.1.5 Macroeconomics 26<br />

3.1.6 Development policies 28<br />

3.2 Health Sector 29<br />

3.2.1 Health status 29<br />

3.2.2 Health care utilisation and access 31<br />

3.2.3 Health care delivery and payment 33<br />

3.2.3.1 Public <strong>health</strong> 33<br />

3.2.3.2 Outpatient care 35<br />

3.2.3.3 Inpatient care 37<br />

3.2.3.4 Long-term care 38<br />

3.2.4 Health care f<strong>in</strong>anc<strong>in</strong>g 39<br />

3.2.5 Health care benefits 45<br />

3.2.6 Quality management 47<br />

3.2.7 Satisfaction of clients 48<br />

3.2.8 Reform agenda 48<br />

3.2.9 Rema<strong>in</strong><strong>in</strong>g problems and summary 51<br />

3.3 Social security and protection 52<br />

3.3.1 Private risk management 52<br />

3.3.2 Public risk management 53<br />

3.3.3 Pension/disability/death schemes 54<br />

3.3.4 Accidents and work <strong>in</strong>juries protection 57

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