Bart Jacobs

Bart Jacobs
Deutsche Gesellschaft für Internationale Zusammenarbeit | GIZ · social health protection project, Cambodia

MSc (Econ.), MSc (Mgmt.), PhD

About

65
Publications
26,074
Reads
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1,860
Citations
Citations since 2016
26 Research Items
1123 Citations
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2016201720182019202020212022050100150200
2016201720182019202020212022050100150200
2016201720182019202020212022050100150200
Additional affiliations
April 2013 - August 2018
Deutsche Gesellschaft für Internationale Zusammenarbeit
Position
  • Consultant
October 2009 - March 2013
Luxembourg Development
Position
  • Health Financing Advisor
November 2007 - October 2009
World Health Organization
Position
  • Technical Officer Social Health Protection and Health Financing

Publications

Publications (65)
Article
The measurement of health-expenditure related impoverishment as a proxy of financial risk protection is regularly used as an indicator of progress towards universal health coverage. However, the use of this indicator is greatly sensitive to analysts’ choices and data sources, making comparisons across time and countries challenging. We report the r...
Article
Full-text available
Knowing the cost of health care services is a prerequisite for evidence-based management and decision making. However, only limited costing data is available in many low-and middle-income countries. With a substantially increasing number of facility-based births in Cambodia, costing data for efficient and fair resource allocation is required. This...
Article
In low- and middle-income countries, patients may travel abroad to seek better health services or treatments that are not available at home, especially in regions where great disparities exist between the standard of care in neighbouring countries. While awareness of South–South medical travels has increased, only a few studies investigated this ph...
Technical Report
Full-text available
Assessment of the possibility for the National Social Security Fund to concurrently manage social health insurance schemes and the health equity fund for strategic purchasing of health services
Article
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Cambodia aims to expand social health protection to move towards Universal Health Coverage. We developed a modeling tool to facilitate the simple, interactive estimation of cost and coverage for three policy alternatives, enabling decision-makers to simultaneously adjust for scenario options currently under consideration. Assuming the adoption of a...
Technical Report
Full-text available
Assessment to determine possible arrangements for the 4Gs (Global Fund, GAVI, Global Financing Facility and World Bank Group) to work together for health financing in Cambodia, eventually assisted by the Social Health Protection Network P4H
Article
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Within the context of universal health coverage, community participation has been identified as instrumental to facilitate access to health services. Social accountability whereby citizens hold providers and policymakers accountable is one popular approach. This article describes one example, that of Community-Managed Health Equity Funds (CMHEFs),...
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en The Royal Government of Cambodia recently launched its National Social Protection Policy framework to strengthen and expand social security and assistance. To inform social health protection policy, we examine socio‐economic survey data and administrative coverage data to assess the coverage potential of existing coverage mechanisms and current...
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To inform efforts to improve Cambodia's social health protection system and advance universal health coverage, health care-seeking and out-of-pocket expenditure (OOPE) were assessed using the 2016 Cambodia Socioeconomic Survey data. This study focuses on the poorest wealth quintile who reside in rural areas-the primary target population of Cambodia...
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Background: Knowledge of the costs of health services improves health facility management and aids in health financing for universal health coverage. Because of resource requirements that are often not present in low- and middle-income countries, costing exercises are rare and infrequent. Here we report findings from the initial phase of establish...
Article
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Cambodia's healthcare system has seen significant improvements in the last two decades. Despite this, access to quality care remains problematic, particularly for poor rural Cambodians. The government has committed to universal health coverage (UHC) and is reforming the health financing system to align with this goal. The extent to which the reform...
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Though Lao People's Democratic Republic (Lao PDR) has made considerable progress in improving maternal and child health (MCH), significant disparities exist nationwide, with the poor and geographically isolated ethnic groups having limited access to services. In its pursuit of universal health coverage , the government introduced a Free MCH initiat...
Article
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Though Lao People's Democratic Republic (Lao PDR) has made considerable progress in improving maternal and child health (MCH), significant disparities exist nationwide, with the poor and geographically isolated ethnic groups having limited access to services. In its pursuit of universal health coverage , the government introduced a Free MCH initiat...
Technical Report
Full-text available
The Government of Cambodia recently launched its National Social Protection Policy Framework to strengthen and expand its social protection system. To inform the future direction of social health protection policy in Cambodia we examine the 2016 Cambodia Socio-economic survey to assess the current coverage potential of existing health insurance sch...
Article
Since the end of its internal conflict in 1998, Cambodia has experienced tremendous developments in the social, economic and health sectors, with the government embarking on substantial reforms in health financing. Health equity funds that have improved access to public health services for poor people have gradually been extended to the entire coun...
Article
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Background: Following the introduction of user fees in Cambodia, Health Equity Funds (HEF) were developed to enable poor people access to public health services by paying public health providers on their behalf, including non-medical costs for hospitalised beneficiaries (HEFB). The national scheme covers 3.1 million pre-identified HEFB. Uptake of...
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Introduction Health system responses to the emergence of non-communicable diseases (NCDs) in many Southeast Asian nations, Cambodia included, have been insufficient. Little is known about how people suffering from such conditions behave in constrained contexts. We examined the experience of patients with NCDs as they seek care for their conditions...
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Background To assess progress towards universal health coverage, countries like Cambodia require evidence on equity in the financing and distribution of healthcare benefits. This evidence must be based on a system-wide perspective that recognises the complex roles played by the public and private sectors in many contemporary healthcare systems. Ob...
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Background: Older people make up an increasing proportion of the population in low- and middle-income countries. This brings a number of challenges, as their health needs are greater than, and different from, those of younger people. In general, these health systems are not geared to address their needs, and traditional support systems tend to erod...
Article
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Background: Non-communicable diseases (NCD) pose challenges to Cambodia's health system. Medicines for NCD are on the National Essential Medicines List but no clinical guidelines support their utilization. Two social health protection schemes aimed at the informal sector population exist (Health Equity Funds and Insurance) together with two diseas...
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Background Cambodia developed its public health system along the principles of the district model and geared its services towards managing communicable diseases and maternal and child health issues. In line with other countries in the region, non-communicable diseases have emerged as a leading cause of adult mortality. We assessed the current capac...
Research
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Universal health coverage is high on the international policy agenda, and appears set to become the post-2015 overarching sustainable development goal. Achieving universal coverage is by no means an easy undertaking that can be attained in a relatively short time period, and as such requires a roadmap. Despite its relevance, surprisingly little has...
Article
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Emergency referral care is considered an essential component of the district health system. Nevertheless, the establishment of effective and durable transport arrangements of such referral care by use of an ambulance is considered controversial in low-income countries. We aim to assess the extent to which an ambulance service as part of the distric...
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The Government of Lao Peoples' Democratic Republic (Lao PDR) has embarked on a path to achieve universal health coverage (UHC) through implementation of four risk-protection schemes. One of these schemes is community-based health insurance (CBHI) - a voluntary scheme that targets roughly half the population. However, after 12 years of implementatio...
Article
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There is now widespread acceptance of the universal coverage approach, presented in the 2010 World Health Report. There are more and more voices for the benefit of creating a single national risk pool. Now, a body of literature is emerging on institutional design and organizational practice for universal coverage, related to management of the three...
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Outreach services for vaccination present a useful vehicle to deliver maternal and child health (MCH) care to hard-to-reach women and children. In Laos, uptake of MCH services inversely correlates with distance from a health facility; hence, the concurrent delivery of MCH services during community vaccination outreach has been promoted. Here we ass...
Article
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Most health system strengthening interventions ignore interconnections between systems components. In particular, complex relationships between medicines and health financing, human resources, health information and service delivery are not given sufficient consideration. As a consequence, populations' access to medicines (ATM) is addressed mainly...
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Background Borrowing money is a common strategy to cope with health care costs. The impact of borrowing on households can be severe, leading to indebtedness and further impoverishment. However, the available literature on borrowing practices for health is limited. We explore borrowing practices for paying for health care by the poor in Cambodia and...
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The objective of this study was to estimate household costs (direct medical, direct non-medical and opportunity costs) associated with outpatient consultations and inpatient admissions at three tertiary hospitals in Lao PDR (national, university and regional hospitals). Revolving drug funds are the main sources of revenue for the facilities. We use...
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While World Health Organization member countries embraced the concept of universal coverage as early as 2005, few low-income countries have yet achieved the objective. This is mainly due to numerous barriers that hamper access to needed health services. In this paper we provide an overview of the various dimensions of barriers to access to health c...
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To assess the impact on equity and effectiveness of introducing targeted subsidies for the poor into existing voluntary health insurance schemes in Low Income Countries with special reference to cross-subsidisation. A functional model was constructed using routine collected financial data to analyse changes in financial flows and resulting shifts i...
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Contracting non-governmental organizations (NGOs) has been shown to increase health service delivery output considerably over relatively short time frames in low-income countries, especially when applying performance-related pay as a stimulus. A key concern is how to manage the transition back to government-operated systems while maintaining health...
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keywords health care, community-based health insurance, social protection, universal coverageAccess to affordable and effective health care is a majorproblem in low and middle income countries (LMIC) andout-of-pocket expenditure for health care a major cause ofimpoverishment (Meessen et al. 2003; Frenk et al. 2006;McIntyre et al. 2006; Van Doorslae...
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Cambodia is developing cutting-edge initiatives needed to break the links between poverty and ill-health. The most effective of these are the Health Equity Funds, fee-waiver schemes that aim to provide increased access to health services and greater community involvement for the poor. Recent research indicates that HEFs successfully reach the poor,...
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To assess the effects of a user fee scheme, and related fee exemption system, on the health care seeking behaviour, the out-of-pocket expenditure and the coping mechanisms of fee-exempted patients (FEP) at Kirivong Referral Hospital in Cambodia. A pre-coded structured questionnaire administered to pre-identified FEP and fee-paying patients (PP) of...
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There is a large body of evidence that user fees in the health sector create exclusion. Health equity funds attempt to improve access to health care services for the poorest by paying the provider on their behalf. This paper reviews four hospital-based health equity funds in Cambodia and draws lessons for future operations. It investigates the prac...
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All but one of the health equity funds (HEFs) currently operating in Cambodia, introduced to address the adverse effects of low user fee exemption rates, rely heavily on external funding and have high administrative overheads. This article reports on a study of one type of HEF, based in Kirivong Operational Health District (KOD) and operated throug...
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This article presents research findings into the effectiveness of an innovative equity fund approach to improving access to public sector health services for the poor in Kirivong Operational Health District in Cambodia. The operational health district is the lowest organizational level in the Cambodian health system, providing services through heal...
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The objective of this study was to investigate the management of sexually transmitted diseases (STDs) in the Ugandan private sector clinics and drug shops. Men with urethral discharge who had consulted clinics (264) or drug shops (141) for treatment in 5 districts were interviewed using a precoded questionnaire 1 to 3 weeks after initiation of trea...
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The objective of this study was to formulate appropriate responses by the public-health sector to reduce acute malnutrition among children in Cambodia. A cross-sectional survey to identify wasting together with a simple wealth-ranking exercise was conducted. Thereafter, separate focus-group discussions were also conducted with mothers of malnourish...
Article
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This article provides lessons learned on establishing effective community participation in two externally funded, NGO-implemented health projects working at district level in Cambodia. The first project was implemented in accordance with the Cambodian national guidelines on community participation. The second - using lessons and experiences gained...
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A resurgence of tuberculosis (TB) occurred in Russia in the 1990s, in a period of general health crisis following the break-up of the Soviet Union. Inter-related increases in poverty, unemployment and unhealthy lifestyle probably contributed to increased incidence and mortality from TB among the civilian population. The number of prisoners increase...