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Health Policy and Financing

WHO Regional Office of the Western Pacific

Ke Xu Coordinator Health Policy and Financing

May 23, 2016. ADB

Disclaimer: The views expressed in this paper/presentation are the views of the author and do not
Disclaimer: The views expressed in this paper/presentation are the views of the author and do not necessarily reflect the views or policies
of the Asian Development Bank (ADB), or its Board of Governors, or the governments they represent. ADB does not guarantee the
accuracy of the data included in this paper and accepts no responsibility for any consequence of their use. Terminology used may not
necessarily be consistent with ADB official terms.

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Health Policy and Financing WHO Regional Office of the Western Pacific Ke Xu Coordinator Health Policy
Health Policy and Financing WHO Regional Office of the Western Pacific Ke Xu Coordinator Health Policy
Health Policy and Financing WHO Regional Office of the Western Pacific Ke Xu Coordinator Health Policy
Structure of the discussion
Structure of the discussion
  • Health system governance and financing in the overall health system development

  • Guiding strategy for country support:

UHC: Moving towards Better Health (Regional Action Framework)

  • Priority technical areas

  • Discussion

Technical areas Priority counties Collaborations

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Structure of the discussion  Health system governance and financing in the overall health system development
Structure of the discussion  Health system governance and financing in the overall health system development

Health Policy and Financing

Mission: Support Member States to progress faster towards UHC

through strengthening of health systems governance and financing

Health Policy and Financing Mission: Support Member States to progress faster towards UHC through strengthening of
Health Policy and Financing Mission: Support Member States to progress faster towards UHC through strengthening of
Health Policy and Financing Mission: Support Member States to progress faster towards UHC through strengthening of

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Action framework UHC: moving towards better health
Action framework
UHC: moving towards better health
EFFICIENCY QUALITY EQUITY SUSTAINABILITY AND RESILIENCE ACCOUNTABILITY Health system attributes
EFFICIENCY
QUALITY
EQUITY
SUSTAINABILITY
AND RESILIENCE
ACCOUNTABILITY
Health system attributes

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Adopted at the 66th RCM in October 2015 (WPR/R66.R2)

Action framework UHC: moving towards better health EFFICIENCY QUALITY EQUITY SUSTAINABILITY AND RESILIENCE ACCOUNTABILITY Health system
Action framework UHC: moving towards better health EFFICIENCY QUALITY EQUITY SUSTAINABILITY AND RESILIENCE ACCOUNTABILITY Health system

What are the main features of the framework?

Purpose: help countries to accelerate progress towards UHC with the focus on actions

Draws on global and regional experiences with input from Member States, experts and development partners.

To be applicable to health systems at various stages of development

Encompasses individual and population level services, and incorporating health system building blocks

 

Takes a comprehensive view and whole-of-system approach

Provides guidance to Member States to diagnose the root cause of the problems and to develop country-specific road maps and choose a group of interconnected actions for UHC

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1. Quality Action Domains
1. Quality Action Domains
  • 1.1 Regulations and regulatory environment

    • a. Enforce workforce regulation

    • b. Strengthen national regulatory authorities for medicines and technologies

    • c. Adopt service standards for health facilities and infrastructure

    • d. Legislate to protect patient rights

  • 1.2 Effective, responsive individual & population-based services

    • a. Build and maintain a competent workforce and multi-disciplinary teams

    • b. Implement evidence-informed protocols & interventions individual & population levels

    • c. Use individual and population-level health information for health improvement

  • 1.3 Individual, family and community engagement

    • a. Improve health literacy and capacity for health decision-making

    • b. Adopt systematic approach to monitor patient experience for service improvement

    • c. Empower patients and families through self-efficacy and peer-support groups

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    1. Quality Action Domains 1.1 Regulations and regulatory environment a. Enforce workforce regulation b. Strengthen national
    1. Quality Action Domains 1.1 Regulations and regulatory environment a. Enforce workforce regulation b. Strengthen national
    2. Efficiency Action Domains
    2. Efficiency Action Domains
    • 2.1 Health system architecture to meet population needs

      • a. Define the core service packages and delineate the roles of health institutions at different levels

      • b. Make more resources available for public health, primary-level services and disadvantaged population groups

      • c. Guide non-state service providers for public health

  • 2.2 Incentives for appropriate provision and use of services

    • a. Use provider payment mechanisms and other incentives to foster appropriate behaviour

    • b. Leverage price and benefit package design to encourage provision of desired services and avoid unnecessary use of services

    • c. Improve management and rational use of medicines and health technologies

  • 2.3 Managerial effectiveness and efficiency

    • a. Encourage all providers to be efficient through managed autonomy

    • b. Improve overall management capacity and skills to meet requirements in the changing environment

    • c. Strengthen information systems and effective use of information and communications technologies (ICT)

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    2. Efficiency Action Domains 2.1 Health system architecture to meet population needs a. Define the core
    2. Efficiency Action Domains 2.1 Health system architecture to meet population needs a. Define the core
    3. Equity Action Domains
    3. Equity Action Domains
    • 3.1 Financial protection

      • a. Reduce financial and non-financial barriers to access

      • b. Strengthen appropriate connections between health financing and other social protection schemes

  • 3.2 Service coverage and access

    • a. Improve equitable access to services

    • b. Catalyse appropriate demand for services

  • 3.3 Non-discrimination

    • a. Foster respectful care

    • b. Provide legal protection

    • c. Create opportunities for vulnerable groups to have a voice

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    3. Equity Action Domains 3.1 Financial protection a. Reduce financial and non-financial barriers to access b.
    3. Equity Action Domains 3.1 Financial protection a. Reduce financial and non-financial barriers to access b.
    4. Accountability Action Domains
    4. Accountability Action Domains
    • 4.1 Government leadership and rule of law for health

      • a. Set the vision for health sector development and ensure sufficient resources for health

      • b. Strengthen the rule of law and regulatory institutions

      • c. Build leadership and management capacities

  • 4.2 Partnerships for public policy

    • a. Secure intersectoral collaboration across government

    • b. Work with non-state partners on shared interests for health

    • c. Empower communities to participate in decisions and actions that affect them

  • 4.3 Transparent monitoring and evaluation

    • a. Develop efficient health information systems and streamline information flows

    • b. Facilitate open access to information

    • c. Strengthen institutional capacity for health policy and systems research and translation of evidence into policy

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    4. Accountability Action Domains 4.1 Government leadership and rule of law for health a. Set the
    4. Accountability Action Domains 4.1 Government leadership and rule of law for health a. Set the
    5. Sustainability and Resilience Action Domains
    5. Sustainability and Resilience
    Action Domains
    • 5.1 Public health preparedness

      • a. Strengthen capability to detect and respond to diseases or conditions with the potential to become a major public health concern or emergency

      • b. Develop cross-sectoral partnerships and plans for disaster risk management

      • c. Devise and test business continuity plans

  • 5.2 Community capacity

    • a. Enhance community capacity for disease management and health promotion

    • b. Promote community participation and readiness for disaster risk management

  • 5.3 Health system adaptability and sustainability

    • a. Develop foresight capabilities

    • b. Leverage resources for health through cross-programme and inter-institutional linkages

    • c. Institutionalize participatory governance

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    5. Sustainability and Resilience Action Domains 5.1 Public health preparedness a. Strengthen capability to detect and
    5. Sustainability and Resilience Action Domains 5.1 Public health preparedness a. Strengthen capability to detect and
    Monitoring progress on UHC
    Monitoring progress on UHC
    • Regional framework for monitoring UHC aligned

    with SDGs and Global Reference List of 100 Core

    Health Indicators

    • National framework based on national priorities, population needs, and contextual factors

    • Monitoring UHC at local, national, regional, and global levels and from different perspectives

    • Taking into consideration of tracking progress and improve performance

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    Monitoring progress on UHC  Regional framework for monitoring UHC aligned with SDGs and Global Reference
    Monitoring progress on UHC  Regional framework for monitoring UHC aligned with SDGs and Global Reference
    Broader context in the region
    Broader context in the region
    • Rapid aging process, changes in disease pattern (NCD), emerging pandemics, and natural disasters

    • Decentralization (deconcentration, delegation, devolution and privatization)

    • Multisector involvement, diverse needs for health services, and risk factors control

    • Globalization and regional cooperation

    International regulations (conventions)

    Health security and public health functions

    Medicines (pharmaceutical issues)

    Health services (non-tradable to tradable) medical tourism and workforce migration

    • Economic growth and high expectation for health services

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    Broader context in the region  Rapid aging process, changes in disease pattern (NCD), emerging pandemics,
    Broader context in the region  Rapid aging process, changes in disease pattern (NCD), emerging pandemics,
    Priority technical areas
    Priority technical areas
    • Health system governance (legislation and regulation, decentralization, accountability)

    • Country specific UHC roadmap and implementation

    • Health financing system design: revenue collection, pooling, resource allocation and purchasing

    • Domestic financing and public financial management

    • Resource tracking and monitoring of UHC

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    Priority technical areas  Health system governance (legislation and regulation, decentralization, accountability)  Country specific UHC
    Priority technical areas  Health system governance (legislation and regulation, decentralization, accountability)  Country specific UHC
    Discussions
    Discussions
    • Commonly interested technical areas

    • Commonly interested in specific countries

    • Collaborations at regional and country levels

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    Discussions  Commonly interested technical areas  Commonly interested in specific countries  Collaborations at regional
    Discussions  Commonly interested technical areas  Commonly interested in specific countries  Collaborations at regional