Priorities and Strategies for Health Financing in the Caribbean

Subregional Dialogue on Health Financing in the Caribbean Conclusions and next steps

Universal Access to Health and Universal Health Coverage Imply that all people and communities have access, without any kind of discrimination, to comprehensive, qualityhealth services, without exposing users to financial difficulties. Require implementing policies and actions with a multisectoral approach to address the social determinants of health and promote a society-wide commitment to fostering health and well-being. Values Right to Health Equity Solidarity 2

The key questions when discussing health financing For what? Access and coverage for all equity, efficiency and sustainability. How? Pre-payment, pooling, increased fiscal space (including efficiency gains) How long it takes? It depends, but it is not a short road requires permanent monitoring and accountability What does it take? Political will, people buy in, community engagement. 3

Financial arrangements: It can t be out of pocket again elimination of direct payment It can t be private health insurance leaving the most in need out It has to be a combination of people who are working together, employers and government, it has to be that combination Social Compact - 4

FINANCING ARRANGEMENTS Key Priorities (Strategies and Requirements) Tier 1 Tier 2 Establish Proper Costing Models and Clear Progressive or Equity-based Funding Determine best political approaches Strengthen Overall Economic Position Create Strong Legislation and Regulation Improve Information Systems Align System Capacity and Benefits Deliver Regional Solidarity and Collaboration Obtain Stakeholder Buy-in Improve Overseas Care and Purchasing Options Note that country specific needs, experience and situations must be accounted for in planning and execution. There is no one-size-fits-all approach.

FISCAL SPACE Key Priorities (Strategies and Requirements) Tier 1 Tier 2 There is a need for evidence-based policy options to ensure by- partisan discussions to increase spending on health. More efficient use of resources for example expanding the role of primary care facilities. Diversifying revenue sources with a view to securing additional funding for health. More effective advocacy for health funding starting at the highest levels eg Prime Ministerial meetings. Exploring Umbrella legislation for pooling across the region. NIH in various countries can be used as a framework for increasing economies of scale for procuring pharmaceuticals for example .

Next steps Meeting report and preparation of a briefing paper for advocacy with high-level national authorities and Regional Institutions. Capacity building for countries to generate evidence for advocacy and to address implementation challenges (i.e. fiscal space studies, national health accounts). Continue support to countries for the improvement of health financing arrangements according to each country reality and improve efficiency in health systems and services. Establish a network on Health Financing in the Caribbean, in collaboration with Regional institutions and partners. Strengthen PAHO-UWI-HEU partnership develop action plan for joint collaboration for 2018-2019, including recognition UWI-HEU becoming a PAHO/WHO collaborating center. 7

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