title: Assessment of equity in healthcare financing in Fiji and Timor-Leste: a study protocol.
abstract: BACKGROUND
  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
  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.
  
  
  BACKGROUND
  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.
authors.affiliation: School of Public Health and Community Medicine, University of New South Wales, Sydney, Australia.
authors.forename: Augustine D
authors.initials: AD
authors.lastname: Asante
authors.affiliation: School of Public Health and Community Medicine, University of New South Wales, Sydney, Australia.
authors.forename: Jennifer
authors.initials: J
authors.lastname: Price
authors.affiliation: School of Public Health and Community Medicine, University of New South Wales, Sydney, Australia.
authors.forename: Andrew
authors.initials: A
authors.lastname: Hayen
authors.affiliation: Centre for Health Information, Policy and Systems Research, Fiji National University, Suva, Fiji.
authors.forename: Wayne
authors.initials: W
authors.lastname: Irava
authors.affiliation: Faculty of Medicine and Health Sciences, National University of Timor-Leste (UNTL), Dili, Timor-Leste.
authors.forename: Joao
authors.initials: J
authors.lastname: Martins
authors.affiliation: Faculty of Public Health & Policy, London School of Hygiene and Tropical Medicine, London, UK.
authors.forename: Lorna
authors.initials: L
authors.lastname: Guinness
authors.affiliation: Health Economics Unit, School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa.
authors.forename: John E
authors.initials: JE
authors.lastname: Ataguba
authors.affiliation: Faculty of Pharmaceutical Sciences, Department of Social and Administrative Pharmacy, Khon Kaen University, Khon Kaen, Thailand.
authors.forename: Supon
authors.initials: S
authors.lastname: Limwattananon
authors.affiliation: London School of Hygiene and Tropical Medicine, London, UK.
authors.forename: Anne
authors.initials: A
authors.lastname: Mills
authors.affiliation: The George Institute, Sydney, Australia.
authors.forename: Stephen
authors.initials: S
authors.lastname: Jan
authors.affiliation: School of Public Health and Community Medicine, University of New South Wales, Sydney, Australia Department of Global Health and Development, London School of Hygiene and Tropical Medicine, London, UK.
authors.forename: Virginia
authors.initials: V
authors.lastname: Wiseman
mesh_terms: D003430:Cross-Sectional Studies; D003695:Delivery of Health Care / Q000191:economics*; D005367:Fiji; D006297:Health Services Accessibility / Q000191:economics*; D054625:Healthcare Disparities; D061889:Healthcare Financing; D006801:Humans; D007214:Indonesia; D007348:Insurance, Health / Q000191:economics*; D012189:Retrospective Studies; D012959:Socioeconomic Factors; D019472:Universal Health Insurance / Q000191:economics*