Health system development2


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Health system development2

  1. 1. Health System Development Programme 2006-2011
  2. 2. Objectives 1. To promote utilization of health systems research to improve health systems performance by enhancing research culture among decision makers at all level 2. To explore and develop an appropriate and sustainable financing mechanism for fair financing of health and equitable delivery of services 3. To expand and strengthen international cooperation in line with the 30 year long term health plan by collaborative activities
  3. 3. Project 1. Health Systems Research and Development Project 2. Developing Alternative Financing Mechanisms for Health Project 3. International Health Cooperation Project
  4. 4. Health System Research and Development Project
  5. 5. Developing Alternative Financing Mechanism for Health Project
  6. 6. International Health Cooperation Project
  7. 7. Strength Health System Research • Able to disseminate knowledge and skills on heath systems concepts and health systems research (HSR) methodology to health managers who provide services to the community. • Able to develop user friendly HSR tools for health system strengthening, assessments and quality improvements • HSR studies can provide technical know-how for health systems strengthening, assessment and quality improvements.
  8. 8. Strength Health Financing • Health financing assessment and development of new scheme was initiated in collaboration with WHO Consultants • Interest of all stake holders and donors after implementing awareness raising workshops at township level • Attention of the international donors based on publication of National Health Accounts and health financing studies • Appropriate health manpower (Health Economists) posted in the planning division but still limited number
  9. 9. Weakness Health System Research 1. There has no financial support for HSR studies conducted by mid-level health managers. 2. There has weaknesses in dissemination of information to the higher level health authority to take action based on HSR findings.
  10. 10. Weakness Health Financing 1. Poor advocacy to high level policy making body on health financing situation 2. Lack of interest of decision maker on health financing situation 3. Limited number of skilled health manpower especially health economists 4. Lack of skilled staff on financing and budgeting in the township health system 5. No or limited community awareness on health financing issues 6. Current health financing and costing research is not covered all the area and need more research on alternative health financing and efficient utilization of limited resources 7. Need more partners on implementing new financing scheme
  11. 11. Requirements to be fulfilled for achieving targets Health System Research 1. Dedication by project personnel, knowledge, experiences and skills on research management obtained by actual implementation of the project contribute achievements of the targets. 2. Political supports and guidance from Departmental Head, sharing and discussion of experiences on project implementation among technical colleagues were contributions for the achievements 3. Close collaboration and coordination with health and health related departments such as Department of Health, Department of Medical Sciences, General Administration Department , Central Statistical Organization, national and international NGOs were the contributors for achievement
  12. 12. Requirements to be fulfilled for achieving targets Health Financing 1. High level advocacy meeting on current health financing situation and options for protecting the poor achieving Universal Coverage 2. Capacity building in the area of health economics to mid level officers 3. Feasibility studies on development of new health financing methods should be explored 4. Financial management and mobilization of funds in township health system should be extended to more townships 5. Connecting with more partners on solving the problem of waiving the poor and vulnerable (technical as well as financial) 6. Awareness raising of community through implementing new financing scheme in the pilot area (knowing by doing) 7. More research on costing, cost effectiveness for assisting the decision making (improving efficiency)
  13. 13. Other comments Health Financing • Providing more knowledge on advantage of health insurance especially in the area of fund pooling and risk pooling among the solidarity group to all levels • Awareness raising of other countries’ experiences on health financing situation among different regions of WHO
  14. 14. 1. Identify key barriers / bottlenecks to increase sustained coverage which are beyond the control of the service delivery system HRH shortages, Distribution, Quality, motivation etc. Transport to reach the ‘hard to reach’ (especially for outreach) Affordability and fund flow issues especially to district level Infrastructure at periphery, Logistics Management monitoring & supervision Coordination with and between partners 2. Identify what causes lead to these problems problem analysis 3. Identify how to overcome them formulate your objectives identify interventions
  15. 15. At what level are the performance constraints & bottlenecks? SYSTEM LEVEL Policy & sector analysis: PHC, PRSP, MDGS PROGRAM LEVEL Strategy analysis: RED, MPA, demand vs. supply driven OPERATIONAL LEVEL Needs analysis HR: skills, skills mix, retention Capital: stores, equipment, vehicles Capacity building
  16. 16. Strengthening interventions UNICEF CCM ISS GF Drug Supply & Quality Logistics Service delivery 3DF INGOs Surveillance Advocacy & Communication WHO NHSC UNFPA
  17. 17. Strengthening Systems MoF, World Bank, UNICEF GAVI HSS Gov’T, UNDP, MNPED Drug Supply & Quality Logistics HSS Service delivery HSS UNICEF PRSP Surveillance Advocacy & Communication SWAp
  18. 18. Policy space ACCESS EQUITY Drug Supply & Quality Logistics Service delivery Surveillance STEWARDSHIP Advocacy & Communication PRO-POOR
  19. 19. Strategic Framework: An example from DPRK NATIONAL DEVELOPMENT PRIORITIES, LAW AND INTERNATIONAL AGREEMENTS MEDIUM TERM DEVELOPMENT PLAN FOR THE HEALTH SECTOR IN DPRK S Y S T E M STRATEGIC AREA 1 STRATEGIC AREA 2 STRATEGIC AREA 3 STRATEGIC AREA 4 Health System Non Communicable Disease Communicable Disease Women’s and Children Health (1)Policy, Planning & Coordination (2) Health Information (3) Human Resources (4) Drug Supply & Logistics Systems (5) Financing & Financial management (6) Service Delivery Systems (7) Science & technology (8) Community participation (1) Chronic Diseases (2) Injury (3) Mental health (4) Aged care & Disability (5) Tobacco Control (1) Immunization (2) Malaria (3) TB, (4) HIV, (5) Hepatitis B treatment (6) Pandemic Planning and emerging diseases (1) Maternal Health (2) Neo natal Health (3) Reproductive Health (4) Child Health (5) Nutrition (6) Adolescent Health STRATEGIC AREA 5 The Social and Environmental Determinants of Health (1) Food Safety (2) Health & Hygiene promotion (3) Climate Change (4) Safe water & Sanitation (5) Health Life Conditions (6) Emergency preparedness MULTI SECTOR AND SOCIETY Health Outcomes and MDG Goals P R O G R A M S
  20. 20. Links Between Objectives and Actions STRATEGIC AREA 1 HEALTH SYSTEM OBJECTIVE Planning Sub Objective Strategic Approach HR Sub Objective Strategic Approach Finance Sub Objective Strategic Approach Essential Medicine Sub Objective Strategic Approach 5 priority actions for each sub objective Service Delivery Sub Objective Strategic Approach Community Participation Sub Objective Strategic Approach