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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 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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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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Health Policy and Financing


Mission: Support Member States to progress faster towards UHC
through strengthening of health systems governance and financing

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Health system attributes

Action framework
UHC: moving towards better health

EFFICIENCY
QUALITY

EQUITY
SUSTAINABILITY
AND RESILIENCE
ACCOUNTABILITY

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


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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


1.1 Regulations and regulatory environment
a.
b.
c.
d.

Enforce workforce regulation


Strengthen national regulatory authorities for medicines and technologies
Adopt service standards for health facilities and infrastructure
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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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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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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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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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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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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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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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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Discussions
Commonly interested technical areas
Commonly interested in specific countries
Collaborations at regional and country levels

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