Country Y is a middle-income country with a per capita GDP of USD 9,000 per annum. The country has a life expectancy at birth of 78 years. Ten percent of the population are over the age of 60 years. At present public healthcare services are delivered via central government-managed public hospitals that are financed by general revenues. public health services in Country Y are known to be inefficient and of poor quality. Private healthcare facilities offer services primarily based on user fees. Voluntary health insurance is offered by private insurance companies. Penetration and growth of voluntary insurance has been low due to risk selection-based competition. Country Y does not have a functioning mandatory insurance mechanism.
Province A is an urban area in Country Y. Province A’s health outcomes are low by national standards. In particular the prevalence of NCDs and NCD risk factors is high. The Provincial Health Directorate has set-up a steering committee to design health financing and provision strategies to increase health finances and improve cost-effectiveness of healthcare delivery in Province A. Assume that you have been hired as an advisor to the steering committee. Explain the process you will follow and techniques you will use in designing the healthcare services package as well as health financing mechanisms for Province A. Justify your answer with theory and evidence where appropriate.