Policy Dialogue Makes It Happen!

Policy dialogue makes it happen!

A

n EU-Luxembourg / WHO

collaborative agreement towards UHC

5th _{Anniversary Annual Meeting}

CELEBRATE – SHARE – INNOVATE Brussels, 21-23 March 2017

…Or where are we coming from?

 The UHC-Partnership

country-led identification process

 Comprehensive approach to UHC is key and that

MoHs should take a significant share of the leadership together with WHO

 Better shape partners' interventions at country

level towards effective development cooperation

 Balance between seed money and senior technical

…Or what did we achieve?

Roadmaps (summary table of roadmaps at a glance

Major focus

AREAS of ACTIVITIES LEVELS of ACTIVITIES TYPES of ACTIVITIES

Health System Development Towards UHC : the FIT approach

UHC

PHC and Hospital Reform in Moldova

HRH strategy in Sierra L.

public

accountability

and “citizen’s voice” in Tunisia

HS Ann. reviews

Institutional coherence of the different agencies of the health sector

in Morocco (ANAM,…) Health Fin. Strategy

 Country learning programme

 Global UHC course for francophone countries

 Global Advanced WHO health financing course

(in English),

 Scientific publications: BMC series on policy

dialogue (AFRO), others at regional and country level

 Support to Country Cooperation Strategies

 Collaboration with many departments at HQ,

regional and country level.

 A multitude of global products for HF advocacy and

policy guidance  Fiscal space analysis

 System wide approach to analyse efficiency across health programmes  Health financing country diagnostics (available in English and French)  Series on state budget transfer arrangements in Asia, European countries

and Latin America for extending coverage to people in the informal sector

 Ongoing work on a guide to assess demand-side barriers to health care

for people in the informal economy

 Dozens of missions (HQ and ROs) in countries for

launching the programme and following up on activities

 UHC-P and WHO reform: from country focus 70% of

the resources are at country level G7 – G20

 The role of the country office: better positioned to

fulfill its mandate with MoH and partners

 Collaboration between the 3 WHO levels

 Collaboration with the EU Del. and Lux Represent.

 Evaluation: internal integrated evaluation of HGF

department (WHO), ROM, external evaluation (KIT), and verification mission (June 2017)

 Reorganization of the HGF department in HQ

around @theams

 IHP+ IHP+ for UHC 2030

Programme Country TA Status TA starting d ate TA ro Resp person Liberia In pla ce Apr-14 Mes fin, G Moldova Light mode Light mode Dr Ha ris Sierra Leone Light mode Switched to full mo de Ma r 2016 Ma r-16 Ka da nda le, So wmya Sudan Light mode/Fu ll mode June 2016 Light mode (20 11-2015) June 2016 Dr Na eema El Ga s s er TBA Togo In pla ce Apr-12 Elongo, Ta rcis s e / Dra ve, Ma ma d ou Tunisia In pla ce Sep-12 Guis s et, Ann L is e / Ma thivet, Ben

oît Vietnam In pla ce Ma y-12 Es ca lante, Socorro Chad In pla ce Ma y-14 Zina , Ya couba DR Congo In pla ce Sep-14 (Pedroza , Julio) / To ure ML Guinea In pla ce Jun-14 Adzodo, M Ren é Mozambique Light mode Light mode De Graeve, Hi lde South Sudan In pla ce Dec-13 Ongom, Mos e s Timor-Leste In pla ce 01/01/2013 15 July 2016 Pa nda v, Ra jes h Ca s tello Fra nc es h, Ma ria Dolores Yemen Na tiona l Aug-14 Na s her, Ja mal Burundi In pla ce Nov-16 Nouhou, Ha m a dou Guinea Bissa u Ukraine Full mode Ja n-17 La i, Taa vi Tajikistan Light mode Light mode Poka nevich, Ig or South Africa Zambia Full mode Nov-16 Peris ic, Da rinka Morocco Light mode Light mode Souteyra nd, Y ves Senegal Cabo Verde Mali Laos In pla ce Aug-15 Fong, Monica Burkina Faso Niger Ya o, Théodore In pla ce Jul-14 Ka la mba y, Hyp polite EU Phase 1 EU-P1 EU PHase 2 EU-P2 EU PHase 3 EU-P3 Lux In pla ce Dec-14

From a financial point of view…

On average 400,000 USD per country per year

Pledged Spent Balance

(in US$)

EU Contribution 61,260,426 39,556,301 21,704,125

Luxembourg Contribution 14,149,421 7,239,781 6,909,940

Total 75,409,847 46,796,082 28,614,065

Phase I,II & III (2011-2018)

 UHC Partnership is a strong enabler

 Coordination and alignment between plans at

national, regional and district level is crucial for success

 Countries have recognised increased need in

leveraging legal frameworks

 Civil Society and citizens engagement are

important and need to be fostered

 In order to leave no one behind, we need to

improve on benefit package design

 There is a need to strengthen the governance and

stewardship of health purchasers in respective countries

 UHC Partnership seed funding has aided in

attracting core substantial funding

 Agencies: better harmonization and alignment!

 Flexible funds to add activities according to

MOH interest and priorities

 It is instrumental to ensure the way forward by

enhancing support on the implementation side

…Or how do we show it?

The website Publications Handbook

 Annual meetings

 Annual reports (2012-2016)

 Scientific conferences (Vancouver,…)

 Stories from the field (see website)

 Special events: EDD, WR meetings, Devco days,

 Country specific events to launch the UHC-P (in

most of the countries)

 Country specific material: Moldova, Tunisia,

Vietnam, Togo, Guinea, Ukraine,…

 Twitter, cartoons,

 You Tube

…Or where room for improvement matters

 Rosters

 Realist research

 Community of practice…

 Country learning programme

 Flexibility and adaptation to the

evolving global health landscape

(UHC Partn_ership con_tribu tion) • Cont_racte d 6 m emb ers of NH I wo rk str_eam s to p rovid_{e tec} hnica_{l ana} lysis and i_nput s into the d_iscussi ons • Healt_{h econ} om ist at W CO prov iding _con tinuou s TA t_{o the} proc_ess • Med_{ia m} onito ring o_{n th} e UHC reform He alth fi_nanc ing re_form imp_rovin g acc_ess to qu ality _serv ices to all _Sou th A_frica ns Impro_{ved n} atio_{nal h} ealth finan cing r_eform stra_tegy towa rds U_{HC (} NHI W hite paper) Imp rove_{d tec} hnic_{al in} puts _into the N HI wo rk str_eams and othe_{r NH} I-relat ed activit ies SO UT H AF_RIC A Supp_ortin g the _policy dialo gue amo ng N_atio nal D epartme nt of H_ealth and _Natio nal Treas_ury WHO -led UHC Partn_ersh ip ac_tivity : Supp_ortin g the _tech nical a_nalys is as p art o f the _UHC reform _(wo rk str_eams of N atio_{nal H} ealth _Insu rance_{), ER1} ,3, 4_{, 5} (UHC Partn ership con_trib ution) The process has con tribut ed to _incr eas ed _mutual under standing among na tional and interna tiona l par tner_{s on} the issu es an d cha lleng es Vie t Nam is faci ng on the way _to UHC, an d be tter pr_og ramma tic alignmen t of _don or suppo rt the gov_ernmen t to ach ieve _{UHC g} oal s. National Health Finan cing Str ateg y was comp leted _an d ser ves _{as an} im por_tan t pol_icy gu_idin g docu men t for both na tional an d in_tern ational partn ers _wor kin g in healt h sec tor developm en_t Sever al roun ds of stak_eh older consu ltation s w ere h_eld on the dr aft HCF strateg y to en sur e the pr oce ss was inc lusiv e and consen sus was obt ain ed WHO fac_ilit ated for mulation of tech nical team s, gu ided _by the Vic e Minis ter of Health (in char ge o f healt h finan cing ), to wor_{k on} rele van t bac_kgr oun d stu_dies VIETNAM In conju nction with the MOH, WHO co-con ven ed a kic k-of consult ation wher e k ey finan_cing iss ues wer_{e ide} ntified an d proce ss of the s trateg_y developm en t was defi_ned WHO -led UHC Par tnershi p act_ivit y: De velopm en t of _Vie tnam Health Care F ina ncing (HCF) Str ateg y for _period from 20 17 – 2025 (ER ₄₎ O nc_{e fu} lly _im ple_m en_te d: _th e imp ro_ve me nt wil l b e t_hre e-f_old : • Fir st t_he n atio na_{l le} vel will ha_ve , u p-to -d ate c omp re_he nsiv e mo nit orin g d ata to _ta ke in fo_rme d h_ea lth policy de_cis io ns. • Se co_nd : th e a ccr_ed ita_tio n p ro_ce ss wil l r ely on _th e s_ame a ccu rat_{e, c} omp re_he nsiv e d ata. • Th ird_{: h} os_pit als m an_ag eme nt wil l b e emp owe re d t_{o t} ak_{e o} rga_niz atio na_{l d} ec_isio ns_{, wit} h p os_itiv e e_ffe ct o_{n q} ualit y of c are_{, b} ase d o_{n e} vid en_ce an d in _a n a uto_no mo us _wa y. O n t_he lon ge r ru n a t n ation al l_ev el: _fu ll-blo w n (₂₀ 0+ _fa cil_itie s), _co mp re_he nsive h_os pit_{al p} erf orma nc_e mo nit orin g s_yst em in _p la ce _a t t he D GS SP , u_pd ate d y_ea rly The Dep artmen t o_{f P} ub_lic Hea lth Ser vices (D_GS SP₎ ha s a n u p-to -d_ate , com pre_he nsi ve visi on _o f th_{e p} erf_orm an_ce of en_ro lle d fac ilit_ies , s o d_oes ea_ch fa cili_{ty d} ire_cto r TUN IS IA The projec t o f h_ospi tal pe rfo_rm an_ce dashb oa_rd s w as _lau nc_hed in 20₁₅ , aimin g a t s_tren gthen in g ev iden ce_-b ased dec isio_n ma kin g a_{t ev} er y lev el of th_e hea lth sy_stem W HO -le d U_HC Pa_rtn ersh ip _a ctiv_ity : St re_ng th_en in g o f t_he e xp ert_ise in _m on_ito rin g a_nd ev_alu atio n a_{t n} atio na l, r_egio na_{l a} nd _fa cili ty le ve_l(ER2 ). Fo_llo w -u p a_{t n} ation al l_ev el: sca_le-up from 17 to ₃₇ h_ospi ta_ls be_tw ee_n ph_ase I a_nd II (2₀₁ 6), _als o in clu din_g fac ilitie s o_{f th} e ₁ st w ave of ac_cred ita_tio ns Cre_ati on _o f q ua lity _co lla_bo ra_tiv es_{: a} sp_ac e fo r fa_cilitie s to d isc_us s th is iss_ue, sh are exp er ien ces an d fin_d solu tio ns Some fac ilitie s imp lem en t im pro_ve m en ts m easur es (e. g.: bet_ter in fo_rma tio n o f patie nts an d sta ff a_like, imp ro_ved patie nts path_w ay s etc …₎ Vi sib_le org_an isa tio_na l im pro_ve m en_ts ob_ser ved at fac_ility lev_el , w ith a t_an gib le po_siti ve im pa ct o_{n q} ua_lity of c are Fol low -up a_{t fa} cili_ties lev el_s: w orkin g en vir_onm en_{t a} nd _its co ns_eq ue_nc es on _qu ality id_en tif ied as a m ajo_r ch alle nge

…Or what are the implications for the next 3 days?

 7 working sessions over 3 days

 At least 24 working groups in French and in

English adressing > 15 key areas of our work

 Many opportunities

 to bring country success stories up front,

 discuss challenges and constraints and

 envisage new ways and energies for MoHs,

WCOs and partners to be at the centre of their country's health system agenda