Wednesday, March 3, 2010

[EQ] The Joint Learning Workshop on Universal Health Coverage

The Joint Learning Workshop on Universal Health Coverage

Workshop planned in consultation with:
Delegation leads from each participating country, and with technical and/or financial support from a number of partners, including the ACCESS Health Initiative, Atlantic Philanthropies, the Bill & Melinda Gates Foundation, GTZ, the International Labour Organization, the Providing for Health (P4H) Initiative, the Results for Development Institute, the Rockefeller Foundation, and the World Bank.

Website www.jointlearningworkshop.org

The Joint Learning Workshop on Universal Health Coverage, held in Gurgaon, India on February 3-5, 2010, convened 120 representatives from six countries – Ghana, India, Indonesia, Philippines, Thailand and Vietnam – and several international organizations to share experiences in carrying out health coverage reform domestically, as well as to learn from the experiences and challenges of reform processes in other countries

Joint Learning Workshop brings together six countries to discuss universal health coverage reform

 

Over the past decade, a number of national or state-level reforms have been implemented by governments that are committed to expanding health coverage through "demand-side" (third-party) financing models, to reach the poorest and informal sectors of their populations.  These reforms are ambitious in their goals, but challenging to implement successfully.  Many organizations and initiatives currently provide helpful policy assistance for and generate valuable information on these new and innovative reforms.  To complement these existing activities, there is increasing demand for cross-learning and joint problem-solving among countries pursuing similar reforms.  Cross-learning activities are specifically desired by implementing practitioners who feel they can work with peer countries to identify strategies and tactics to overcome the many challenges to successful implementation. 

To meet this demand for cross-learning, a group of initiating countries, in collaboration with several development partners, is developing a plan to establish a multi-country cross-learning platform for countries implementing demand-side financing reforms.  This effort would result in a network of country-level implementers, ongoing activities designed for cross-country learning and problem-solving, a repository of existing and new tools that could be used by implementers, better documentation and dissemination of existing reform efforts and a practical research agenda around core implementation questions.

As a first step toward the development of an ongoing, multi-country cross-learning platform, representatives from six countries
Ghana, India, Indonesia, Philippines, Thailand and Vietnam – and their development partners convened a joint learning workshop in Delhi, India on February 3 – 5, 2010.

·          The first day opened with three country-led panel discussions reviewing health coverage schemes of representative delegations, specifically covering the following themes: scope of coverage, financing, and institutional structure.

·          The second day allowed participants to focus on particular technical issues related to quality, provider management, coverage and technology. These technical sessions allowed representatives to tackle the topics expressed as most relevant on a very granular level, through joint learning and problem solving among country delegations.

·          On the third day, members convened to report back from the four technical breakout sessions and discuss potential opportunities for future joint learning activities.

One day prior to the start of the workshop, participants also had the opportunity to participate in site visits to learn more about the RSBY smart card, an innovative electronic enrollment and record keeping mechanism widely implemented within the 23 Indian states currently served by the RSBY scheme.

The workshop served as the pilot initiative in a series of joint learning activities. Beyond sharing ideas and experiences, participants also laid the foundations for the creation of Joint Learning Network. Specific follow-up activities are expected to take place later in the year. [From Brian Latko Results for Development Institute]

Technical tracks

While the first day was designed to give participants a general overview of each country's health insurance reform efforts and discuss broadly the typical design issues and choices facing health insurance schemes, the technical track sessions allowed participants to hone in on one of four key implementation issues in a smaller group setting. The sessions were intended to serve as a platform for joint learning and problemsolving across country delegations.

Technology technical track

Moderator: Gina Lagomarsino (Results for Development Institute)
Presenters: Dr. Sun
Hau Chen (Taiwan) – Information Management Division, Bureau of National Health Insurance, Government of Taiwan; Dr. Kannika Pruksachat (Thailand) – Social Security Office, Government of Thailand

This session explored the various ways that countries can utilize information technology to improve the functioning of national health insurance systems. Presenters shared the success stories of Taiwan and Thailand in implementing sophisticated smart card or identity card technologies, and the ways in which these technologies contributed to health system reform in these countries. Participants identified and discussed a number of common issues around information technologies, including their technological needs, how new technologies can enable systems reform, and the challenges that they face in developing and adopting new technology. While many "lessons learned" emerged from the day-long discussion, the country delegates recognized that further collaboration and learning across countries is necessary.

Coverage technical track

Moderator: Dr. Peter Berman – The World Bank
Presenters: Dr. MariaLuisa Escobar (Colombia) – The World Bank (Formerly with the Government of Colombia); Mr. Anil Swarup (India/RSBY) – Ministry of Labor and Employment, Government of India; Mr. Prasad Rao Pasam (India/Aarogyasri) – General Manager of Human Resources, Star Health; Dr. Eduardo Banzon (the Philippines) – The World Bank

Participants in this technical track discussed effective strategies for increasing awareness and coverage levels among the populations targeted by their countries' health insurance schemes. Topics covered included mechanisms for identifying and targeting members of the formal and informal sectors, and challenges associated with expanding coverage.

Provider management technical track

Moderators: Dr. Somil Nagpal – The World Bank (Formerly with Indian Insurance Regulatory and Development Authority); Dr. Jack Langenbrunner – The World Bank
Presenter: Dr. Jadej Thammatacharee (Thailand) – National Health Security Office, Government of Thailand

Participants in this technical track discussed their schemes' approaches to provider contracting and payment, as well as the associated tradeoffs and challenges. They were able to learn from the experiences of Thailand and other schemes which have employed innovative approaches to provider payment and jointly

Quality technical track

Moderator: Dr. Jerry La Forgia – The World Bank
Presenters: Dr. Robert Janett (US/Massachusetts) – Senior Medical Director of Network Health, Cambridge Health Alliance; Dr. Paulo Borem (Brazil) – Commercial Director, UNIMED, Belo Horizonte

Participants in this technical track focused on the various options available for health insurers and purchasers for incentivizing quality of care improvements in a demand side health financing environment. Major issues discussed included how to handle underuse, overuse and misuse of services, lack of data on quality and subsequent challenges in monitoring, accreditation mechanisms and congestion of facilities, among others.

 

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