Health Financing Functions and Key Issues Discussion
Explore health financing functions, resource mobilization, pooling, purchasing, benefit packages, community financing, and governance. Learn from key insights on achieving universal health coverage and dynamic systems.
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Health financing functions and key related issues Dr Robert Basaza Health Financing Reforms Imperial Royale Hotel Kampala 7/3/2013 1
Contents Contents Definitions and group discussion points Health financing functions and reforms: resource mobilization, pooling, purchasing and benefit package Other related issues: Community financing and Governance Facilitator and a secretary Health Financing Reforms Imperial Royale Hotel Kampala 7/3/2013 2
Key inspirations (I) Money is the babies milk of health care Prof Bill Hsiao, Harvard. Two African countries have moved closer universal coverage (Rwanda 97% coverage and Ghana 65% in less than 10 Years). Over 60% coverage in Bwindi CHI Scheme (with over 120,000 enrollees in less than 5 years). Health Financing Reforms Imperial Royale Hotel Kampala 7/3/2013 3
Key inspirations (II) Voucher schemes and provider behaviour of accepting less than 50% of market prices for interventions Therefore Yes We can . When you are talking to the educated you to do not aim at completing it all : Basoga, Uganda. Health Financing Reforms Imperial Royale Hotel Kampala 7/3/2013 4
Be suspicious of anyone telling you that they have found the Holy Grail; no single instrument or scheme can be the answer . What are key questions and issues to help countries move towards dynamic, learning, adaptive systems?
Resource mobilization Resource mobilization Raising additional funds for health -/+ diversify funding sources Health Financing Reforms Imperial Royale Hotel Kampala 7/3/2013 6
Resource mobilization Resource mobilization Based on NHA data what are the resource mobilizations implications? How should the National Minimum Health Care Package be financed? What reforms do you propose? How do we ensure a fair and equitable way of mobilizing resources based on ability to pay? In your perspective, is mandatory premium contribution feasible for Uganda? Health Financing Reforms Imperial Royale Hotel Kampala 7/3/2013 7
Strategic purchasing I Strategic purchasing means ensuring a coherent set of incentives for providers, whether public or private, to encourage them to offer priority interventions efficiently. Health Financing Reforms Imperial Royale Hotel Kampala 7/3/2013 8
Strategic purchasing II Strategic purchasing II How does the current system allocate resources for health and pay providers for services delivered? Which reforms do you propose? In your perspective, what are possible strategies to improve the efficiency of use of resources? What type of mechanisms/strategies/incentives should be implemented to improve quality of health care delivery? Health Financing Reforms Imperial Royale Hotel Kampala 7/3/2013 9
Pooling (I) Pooling (I) Bringing together of health financing sources. Pooling of funds is a pre-condition for redistributing them to persons with the greatest health needs. Involves pooling of out of pocket payments and also limiting fragmentation of pools Health Financing Reforms Imperial Royale Hotel Kampala 7/3/2013 10
Pooling (II) Pooling (II) Why do we need pooling and pre-payment to achieve Universal Health Coverage? What is the current pooling arrangement in Uganda? What are the challenges and opportunities for improving pooling and pre-payment? What are possible new ways of shaping pooling in the health financing system for better outcomes? What reforms do you propose? Health Financing Reforms Imperial Royale Hotel Kampala 7/3/2013 11
Benefits package Benefits package A specified list of services or interventions available for every citizen and specified in law or insurance pact. It includes portability and quality dimensions Health Financing Reforms Imperial Royale Hotel Kampala 7/3/2013 12
Benefit package II What benefits are currently included in the package delivered by the government? What do you think should be included in the package,which reforms are required on benefits package and rationing? N.B. Hint in mind the UNMHCP ..?????? Are you aware of the benefits you are entitled to? What can be done to improve transparency and awareness of population to improve utilization of benefits? In what ways can we improve individual and community responsibility towards improvement of their own health? Health Financing Reforms Imperial Royale Hotel Kampala 7/3/2013 13
Community health financing I Peoples participation in financial contributions, choice of service, control and management of health services What are the existing community health financing practices; what should be the role of the community in financing of services? ii. What are the community voices in provision and financing of health services; i. Health Financing Reforms Imperial Royale Hotel Kampala 7/3/2013 14
Community health financing II iv. what are the accountability mechanisms to the community with a target at Parish, sub-County and District levels? v. What are the current roles and envisaged roles of SACOS and other cooperative bodies in Health Financing Reforms? vi. Any other issues of health financing reforms at the community level? Health Financing Reforms Imperial Royale Hotel Kampala 7/3/2013 15
Governance (stewardship) I Strong institutions can make any system work with focused interventions and proper management. Careful management citizens wellbeing; good government. Establishing the best and fairest health system possible. Stewardship encompasses the tasks of defining the vision direction of health policy, Health Financing Reforms Imperial Royale Hotel Kampala 7/3/2013 16
Governance (stewardship) II Stewardship encompasses the tasks of defining the vision and direction of health policy, Exerting influence through regulation and advocacy, Collecting and using information; issues of research Governance of the private sector Ministries of health must take on a large part of the stewardship of health systems. Health Financing Reforms Imperial Royale Hotel Kampala 7/3/2013 17
