Health Equity: 12/11/09

Friday, December 11, 2009

[EQ] Public stewardship of private providers in mixed health systems

Public stewardship of private providers in mixed health systems

Synthesis report from the Rockefeller Foundation—sponsored initiative on the role of the private sector in health systems

Lagomarsino Gina, Stefan Nachuk, and Sapna Singh Kundra. 2009.

Washington, DC: Results for Development Institute. ISBN 978-0-9788790-8-2

Available online PDF [74p.] at: http://bit.ly/1gpmsq

“……..This report summarizes the findings from research commissioned in 2008 by the Rockefeller Foundation, in collaboration with the Results for Development Institute and the Thai Ministry of Public Health’s International Health Policy Program. This research—resulting in 14 papers by various institutions, examining the role of the private sector in health systems in developing countries— draws on multiple data sources, including, a global survey of countries’ regulatory models, a scan of innovative private sector financing and delivery models, a survey of attitudes toward the private health sector, and evidence on where people receive health services.

The Foundation sponsored this work as part of broader repositioning of its health strategy to address the emerging challenges of the 21st century. The repositioning led, in late 2008, to adoption of a new Foundation initiative on Transforming Health Systems to achieve high-quality, accessible, and affordable health coverage for all.

One key theme emerging from this analysis is the importance of public stewardship of the nonstate sector (that is, the private sector, broadly defined). Effective government stewardship is crucial for achieving broader health objectives, given the reality that many countries already have large, complex markets for healthcare, presenting major challenges and significant opportunities.

A second key theme is that many governments are not performing that stewardship role particularly well at present. Policy dialogue and decisionmaking—within government and with donors— are often not well informed about the huge scale and diversity of health services that exist beyond government-run facilities. Those in the public sector who should be overseeing the entire health system—state and nonstate—are not monitoring what is happening in the nonstate sector and have imperfect understanding of the forces at work in the health system in its entirety. Nor is there adequate appreciation of the fact that private out-of-pocket payments by households account for a large proportion of total health spending.

Compounding these problems are severe limitations in the data available on the nonstate sector. Basic information on what kinds of services the private sector provides, to whom, and with what results is not readily at hand for policymakers…..”

Table of contents

Executive summary

Chapter 1 The context: Country health systems include much more than government-run services

A varied mix of service providers

Is the private sector growing or shrinking?

Complexity of mixed public-private systems

Why do health markets persist?

Challenges for health markets

Chapter 2 The challenge: Developing effective stewardship

The regulatory mechanism

The financing mechanism

The purchasing mechanism

Limited stewardship of health markets in the developing world

Systemic barriers to stewardship in mixed health systems

Chapter 3 Ideas for accelerating progress toward better stewardship of mixed health systems

Invest in information about health markets

Support innovative models that can serve as “stepping stones” to broader reforms

Develop a roadmap for mixed health system stewardship

In conclusion

Notes

Partner papers and references

Health Sector Governance and Implications for the Private Sector

Innovative Health Service Delivery Models for Low and Middle Income Countries

Innovative Pro-Poor Healthcare Financing and Delivery Models

Making Health Markets Work for the Poor: Improving Provider Performance

Overcoming the Challenges of Scaling Voluntary Risk Pools in Low-Income Settings

Performance Incentives in Provider Purchasing and Contracting Arrangements: Rationale and Experiences

Private Sector Role in Health Supply Chains:
Review of the Role and Potential for Private Sector Engagement in Developing Country Health Supply Chains

Private-public mix in woman and child health in low-income countries: an analysis of demographic and health surveys

Provider Purchasing and Contracting for Health Services: The Case of Zambia

Provider Purchasing and Contracting Mechanisms

Regulation of Health Service Delivery in the Private Sector: Challenges and Opportunities

The role of the private sector in health:
a landscape analysis of global players’ attitudes toward the private sector in health systems and policy levers that influence these attitudes

Toward a New Paradigm for Health Sector Development

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[EQ] Methodological Toolbox on the Right to Food

Methodological Toolbox on the Right to Food

Economic and Social Department
The Food and Agriculture Organization of the United Nations 2009

Website: http://www.fao.org/righttofood/publi_02_en.htm

The purpose of the Methodological Toolbox is to provide a practical aid for the implementation of the Right to Food Guidelines.

It contains a series of analytical, educational and normative tools that offer guidance and hands-on advice on the practical aspects of the right to food. It covers a wide range of topics such as assessment, legislation, education, budgeting and monitoring. It emphasises the operational aspects of the right to food and contributes to strengthening in-country capacity to implement this right.

Download the pdf publications:

1. Guide on legislating for the right to food (4 MB)
2. Methods to monitor the human right to adequate food - Vol I (565 KB)
2. Methods to monitor the human right to adequate food - Vol II (1,2 MB)
3. Guide to conducting a right to food assessment (1.7 MB)
4. Right to food curriculum outline (2.3 MB)
5. Budget work to advance the right to food (3.9 MB)

1. GUIDE ON LEGISLATING - FOR THE RIGHT TO FOOD

Contents

Foreword

Acknowledgements

Acronyms and abbreviations

Introduction and purpose of this guide

PART ONE – Background: the right to food in international law

PART TWO – Constitutional recognition

PART THREE – Framework law

PART FOUR – Sectoral compatibility review

Conclusion

Annex.

Checklist for framework law on the right to food

References

2. METHODS TO MONITOR THE HUMAN RIGHT TO ADEQUATE FOOD - Vol I

Contents

1. Monitoring the human right to food – an overview

2. The meaning and application of rights-focused and rights-based monitoring

3. Putting rights-focused and rights-based monitoring of the right to adequate food into

4. Defining analytical and methodological agendas

5. Legal and institutional settings for monitoring the right to food

6. Getting started

Annex 1. Clarification of relevant and commonly used terms

Annex 2. What can be learned so far from country experiences?

2. METHODS TO MONITOR THE HUMAN RIGHT TO ADEQUATE FOOD - Vol II

Contents

1. Introduction

2. A Monitoring Framework for the Right to Adequate Food

3. Indicators to Measure the Progressive Realization of the Right to Adequate Food

4. Monitoring Implementation Processes through Rights Focused Assessments

5. Monitoring Impacts on the Realization of the Right to Adequate Food

6. Community Level Monitoring of the Right to Adequate Food

7. Assessing Existing Information Systems and Information Needs: Information Gap Analysis

8. Information Gathering Methods to Monitor the Right to Adequate Food

9. Sharing Monitoring Information on the Right to Adequate Food

Annex 1. Clarification of Relevant and Commonly Used Terms

Annex 2. Database Inventories

Annex 3. Dietary Assessment Methods

Annex 4. An Example: Rights-Focused Assessment and Monitoring of School Feeding Programmes

Annex 5. Maps as Presentational Tools in Monitoring the Human Right to Adequate Food

Annex 6. Preparing Monitoring Reports for International Human Rights Bodies

3. GUIDE TO CONDUCTING - A RIGHT TO FOOD ASSESSMENT

Contents

1. Introduction

2. A human rights-based approach to food and nutrition security

3. Assessing trends and causes of food and nutrition insecurity

4. Assessing the environment for the right to adequate food

5. Relevant analytical methods

6. Final remarks

References

Annex 1: sources of assessment information

Annex 2. Indicators for the right to adequate food assessment

Annex 3. Vulnerable group profiling

Annex 4. General data on relevant programmes and other actions

Annex 5. Assessing institutional motivation, capacity and performance

4. RIGHT TO FOOD - CURRICULUM OUTLINE

Contents

PART ONE – PREAMBLE

1. Introduction

2. The role of academic institutions

3. Notes for the users of the curriculum outline

4. Target learner groups

5. The structure of the curriculum outline and how to use the document

PART TWO – Thematic units

Thematic Unit A: Introduction to the Right to Adequate Food

Thematic Unit B: Role s an d Right to Adequate Food Tasks

Thematic Unit C: Assessing The Realization of the Right to Adequate Food

Thematic Unit D: Formulation, Implementation and Monitoring of National Laws, Policies and Programmes

Thematic Unit E: Public Budget Planning, Implementation and Monitoring

Thematic Unit F: Institution Building and Capacity Strengthening

Thematic Unit G: Human Rights Monitoring and International Reporting on Progress

Thematic Unit H: Public Information, Education and Advocacy

Thematic Unit I: Enforceability of, and Access to, Judicial, Quasi-judicial and Administrative Recourse Systems

Thematic Unit J: Policy Assistance and Advice by International Agencies

Thematic Unit K: Respect for and protection of human rights advocates, activists and workers

Thematic Unit L: Multilateral Negotiations on the Right to Adequate Food

PART THREE – Learning Paths

Annex 1. Task and learning content analysis

5. BUDGET WORK TO ADVANCE - THE RIGHT TO FOOD

Contents

Introduction

PART ONE

1. Building a right to food case

2. Analyzing the government’s budget

3. Presenting a claim

PART TWO

4. Approaching a right to food budget

References

Annex 1. Governments’ international human rights obligations and the Right to Food Guidelines

Annex 2. Budget classifications, budget calculations and costing

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