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Is your
‘Universal Healthcare Coverage’ system
a learning system?
Prof Bruno Meessen (ITM, Antwerp) &
El Houcine Akhnif (M...
Content of the presentation
1. Illustration of our joint project
2. Definition of ‘Universal Healthcare Coverage’ (UHC)?
3...
1. Background on the
project
Meetings with CoPs, their objectives and participating
countries - 8 slides
The Project
• Donor: French Muskoka Fund
• Objective: help country clients elaborate their strategy
to achieve UHC
• Imple...
The communities of practice(CoPs)
• Definition: a group of people who interact on a
regular basis to foster their knowledg...
The CoP Philosophy
• All of us have a certain knowledge.
• We should design new mechanisms to exploit this
knowledge and t...
The Project – 3 Phases
Analysis of
Fragmentation 2014
Learning System
Analysis 2015
Support for Action
2016
The project is...
Key Results of Phase 1
• Summary and Report: here.
• Two findings:
• Francophone African countries are characterized by
hi...
Launch of Phase 2
• We launched a call for participation.
• 11 countries were invited to the conference in
Rabat (December...
Country Participants in Rabat
• Mali
• Rwanda
• Ivory Coast
• Cameroon
• Senegal
• Morocco
• Togo
• DRC
• Benin
• Burkina ...
Countries currently collecting data
• Mali
• Rwanda
• Ivory Coast
• Cameroon
• Senegal
• Morocco
• Togo
• DRC
• Benin
• Bu...
2. What is the “UHC
System” ?
The objective of our project ( and competition of ideas for
drawings) – 3 slides
The UHC System: it is more than
just the Ministry of Health!
Financial and
Technical
Partners
Min Social Affaires
Provider...
Multiple stakeholders =
fragmentation
Source of challenges !
Conclusion of Phase 1
• Progress towards UHC: there is no unique solution as
every country starts from its own situation!
...
3. What is a learning
organisation?
Concept with examples (5 slides)…
Definition
« It is an organization capable to adapt in a context
characterized by continuous change and
interdependence »
...
The 3 key steps of a learning
culture
Gather new
information
Combine the new
information with your
existing knowledge
base...
Organizational Learning
Learning takes place at different stages, levels and in
different ways.
A Learning Organization is...
Illustration
In a learning organization:
• The leader recognizes that he/she doesn’t have full knowledge.
So Leadership va...
Illustration
In a learning UHC system…
• Acquire:
• One launches a pilot to test a new idea
• There is information about t...
PHASE 2 of the study
Are you curious and would you like to learn more about this
cross-country study? Some slides to prese...
Contribution
• Analyze: No country can progress towards UHC without
having an independent learning capacity
• Ambition: Co...
Research Question
• To what extent is the UHC system in your country a
« learning system »?
→ Data collection is focused o...
Analytical Framework
Be well positioned/
build the capability
to access/ collect
new information
Combine new
information w...
Examples (block 1)Type Evaluation Issues Level Score
5 Policy makers are aware that different power interests and stakes a...
Examples (block 2)
Technical knowledge in favor of UHC
45 In our organization we established a strong scientific culture –...
Examples (block 3)Experimentation
1 In our UHC system, experimenting and piloting is commonly accepted and
adopted by many...
Survey Data Collection
• A team of 2-3 national experts.
• Between 30-40 other experts directly involved in
the UHC agenda...
Expected Output
The research will allow each country:
1. compare itself with other participating countries
2. identify mor...
Any interest?
• Additional information: bmeessen@itg.be
• To join our CoPs (see slide 4)
• To simply remain informed, simp...
Forthcoming…
Upcoming SlideShare
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Is your "Universal Health Coverage" system a learning system ?

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By prof. Bruno Meessen (ITM Antwerp) & El Houcine Akhnif (MOH, Morocco)

In the context of Muskoka II project

Published in: Leadership & Management

Is your "Universal Health Coverage" system a learning system ?

  1. 1. Is your ‘Universal Healthcare Coverage’ system a learning system? Prof Bruno Meessen (ITM, Antwerp) & El Houcine Akhnif (MoH, Morocco)
  2. 2. Content of the presentation 1. Illustration of our joint project 2. Definition of ‘Universal Healthcare Coverage’ (UHC)? 3. What do we mean by a ‘learning system’? 4. Ongoing research Precondition: that you have some basic knowledge of UHC The presentation includes hyperlinks on which you can simply click to access additional information.
  3. 3. 1. Background on the project Meetings with CoPs, their objectives and participating countries - 8 slides
  4. 4. The Project • Donor: French Muskoka Fund • Objective: help country clients elaborate their strategy to achieve UHC • Implementation: experts from the communities of practice “Performance Based Financing ” (CoP PBF) and “Financial Access to Health Services” (CoP FAHS) under the coordination of Prof Bruno Meessen.
  5. 5. The communities of practice(CoPs) • Definition: a group of people who interact on a regular basis to foster their knowledge on a specific theme. • Members: CoP PBF and CoP FAHS currently include more than 2.500 experts. • Activities: share scientific knowledge & knowledge based on experience (workshops, blogs, online discussions…).
  6. 6. The CoP Philosophy • All of us have a certain knowledge. • We should design new mechanisms to exploit this knowledge and transform it into action. • It is about collective and personal transformation transformation.
  7. 7. The Project – 3 Phases Analysis of Fragmentation 2014 Learning System Analysis 2015 Support for Action 2016 The project is driven by national experts- it includes data collection and evaluation of the current state in one country, as well as cross-country comparisons.
  8. 8. Key Results of Phase 1 • Summary and Report: here. • Two findings: • Francophone African countries are characterized by highly fragmented healthcare financing systems • Access to data and information was the major problem → Direction for Phase 2
  9. 9. Launch of Phase 2 • We launched a call for participation. • 11 countries were invited to the conference in Rabat (December 2014) • Objective: develop a joint approach and analytical instrument that allows countries to assess and learn their healthcare system capacity in order to progress towards UHC
  10. 10. Country Participants in Rabat • Mali • Rwanda • Ivory Coast • Cameroon • Senegal • Morocco • Togo • DRC • Benin • Burkina Faso • Burundi
  11. 11. Countries currently collecting data • Mali • Rwanda • Ivory Coast • Cameroon • Senegal • Morocco • Togo • DRC • Benin • Burkina Faso • Burundi • If you are interested to contact the representatives of your country please write to El Houcine Akhnif
  12. 12. 2. What is the “UHC System” ? The objective of our project ( and competition of ideas for drawings) – 3 slides
  13. 13. The UHC System: it is more than just the Ministry of Health! Financial and Technical Partners Min Social Affaires Providers Researchers Government Community mutual funds Min of Health Social Security Fund of Civil Servants
  14. 14. Multiple stakeholders = fragmentation Source of challenges !
  15. 15. Conclusion of Phase 1 • Progress towards UHC: there is no unique solution as every country starts from its own situation! • However one element is common: we should be capable of collecting information, interpreting it and take decisions accordingly– i.e. the 3 key characteristics of a learning organization.
  16. 16. 3. What is a learning organisation? Concept with examples (5 slides)…
  17. 17. Definition « It is an organization capable to adapt in a context characterized by continuous change and interdependence » Peter Senge. The fifth discipline 1990 « A learning organization is an organization able to create, acquire, interpret, and transfer knowledge, and to modify its behavior taking into account new knowledge and insights » David A Garvin Learning in Action 2000
  18. 18. The 3 key steps of a learning culture Gather new information Combine the new information with your existing knowledge base to come to a new understanding of reality Adjust decisions and actions accordingly. Acquire Analyse Act
  19. 19. Organizational Learning Learning takes place at different stages, levels and in different ways. A Learning Organization is one that manages to create and take advantage of its own learning process.
  20. 20. Illustration In a learning organization: • The leader recognizes that he/she doesn’t have full knowledge. So Leadership values experts. • The leader encourages intellectual curiosity, risk-taking and initiatives. He/she is also open to criticism. • Innovate, experiment and document. • Failure is allowed but lessons should be drawn from it. • Knowledge of good ideas and solutions is shared. • Know how of the experienced is transferred to newcomers. • …
  21. 21. Illustration In a learning UHC system… • Acquire: • One launches a pilot to test a new idea • There is information about the experience of other countries • Data and reports are distributed through departments, there is an efficient collaboration between ministries, feedback from external offices is collected.. • One masters relevant concepts, methodologies… • Future needs are anticipated. • Analyze: • National researchers inform policy makers on evidence from their study • Routine data are used to evaluate progress towards UHC • Performance is compared with equivalent units from other countries. • Action: • Decisions are taken based on preceding analysis • The identified “best practices” are then put in place.
  22. 22. PHASE 2 of the study Are you curious and would you like to learn more about this cross-country study? Some slides to present it to you...and convince you to join us!
  23. 23. Contribution • Analyze: No country can progress towards UHC without having an independent learning capacity • Ambition: Conduct research to enhance awareness of this • Contributions: • Develop an evaluation tool adapted to the UHC system • Test it in the respective countries • Share results
  24. 24. Research Question • To what extent is the UHC system in your country a « learning system »? → Data collection is focused on this topic. We compiled a matrix of 92 questions; it will then allow us to produce a score; the latter will be quantified through sub-dimensions, as well as compared with the scores of other participating countries (benchmarking). • Our analytical framework comprises three big blocks.
  25. 25. Analytical Framework Be well positioned/ build the capability to access/ collect new information Combine new information with pre-existing stock , interprete, synthesize and build new understanding Shape action accordingly through decisionmaking and action Block 1: Leadership that develops a vision, launches the mission and its objectives towards a learning culture (obstacles, schedule…) BlocK 2: Environmental & organizational culture that values learning BlocK 3: Learning practices and procedures
  26. 26. Examples (block 1)Type Evaluation Issues Level Score 5 Policy makers are aware that different power interests and stakes are involved in UHC-once the decision is made they assure its implementation system | 1 | 2 | 3 | 4 | 5 | 6 | 7 | / | | No opinion (0) 6 There is a common understanding of UHC and its objectives in ministries and among different stake holders - possible misunderstandings were successfully resolved system | 1 | 2 | 3 | 4 | 5 | 6 | 7 | / | | No opinion (0) 7 In our UHC system, there is consultation and agreement on the content delivered to the media so as to avoid misunderstandings or confusions (coordinated external communication) system | 1 | 2 | 3 | 4 | 5 | 6 | 7 | / | | No opinion (0) 8 Policy makers have put I place a monitoring procedure to make sure that ministries and concerned agencies are made accountable for progress achieved on UHC related actions and decisions (periodic review, activity report, dashboard with key indicators..) system | 1 | 2 | 3 | 4 | 5 | 6 | 7 | / | | No opinion (0)
  27. 27. Examples (block 2) Technical knowledge in favor of UHC 45 In our organization we established a strong scientific culture – our decisions are based on evidences (disease burden, cost-effectiveness of intervention, equity in access…) organization | 1 | 2 | 3 | 4 | 5 | 6 | 7 | / | | No opinion (0) 46 In our organization, we accelerate the UHC agenda with a pro-active attitude with respect to incorporating technological innovation ( ex. internet, mobile technology, data). organization | 1 | 2 | 3 | 4 | 5 | 6 | 7 | / | | No opinion (0) 47 In our organization, we accelerate the UHC agenda through quantitative evaluation s (routine administrative data, household surveys, national health accounts…) organization | 1 | 2 | 3 | 4 | 5 | 6 | 7 | / | | No opinion (0) 48 Our organization's culture is sufficiently strong to avoid and/or resist bad practices that hinder the learning process for UHC ( ex. corruption, political sabotage, private conflicts) organization | 1 | 2 | 3 | 4 | 5 | 6 | 7 | / | | No opinion (0) 49 National stakeholders in charge of UHC are sufficiently strong to align financial and technical actors from abroad with the national agenda. organization | 1 | 2 | 3 | 4 | 5 | 6 | 7 | / | | No opinion (0)
  28. 28. Examples (block 3)Experimentation 1 In our UHC system, experimenting and piloting is commonly accepted and adopted by many actors, particularly before an ambitious policy is introduced ( ex. free healthcare, performance based financing, health insurance in the informal sector) system | 1 | 2 | 3 | 4 | 5 | 6 | 7 | / | | No opinion (0) 2 In our UHC system, there is ample collaboration at national level between decision makers, professionals, implementing actors, scientists, technical and financial partners to conduct rigorous impact evaluations of pilot projects. system | 1 | 2 | 3 | 4 | 5 | 6 | 7 | / | | No opinion (0) 3 Through different procedures ( ex. policy brief, onsite visits, workshops) and platforms (pilot committee), lessons learned from pilot experiences are integrated in UHC policies and strategies. system | 1 | 2 | 3 | 4 | 5 | 6 | 7 | / | | No opinion (0) 4 Our teams are encouraged to innovate and test ideas that are likely to improve daily performance. Team | 1 | 2 | 3 | 4 | 5 | 6 | 7 | / | | No opinion (0) 5 In our organization, it ‘s common practice to set up a pilot before scaling up an ambitious strategy related to UHC (ex. free healthcare, performance based financing) Organization | 1 | 2 | 3 | 4 | 5 | 6 | 7 | / | | No opinion (0)
  29. 29. Survey Data Collection • A team of 2-3 national experts. • Between 30-40 other experts directly involved in the UHC agenda in your country (officials from the Health Ministry, Ministry of Social Affairs, researchers, technical assistants...)
  30. 30. Expected Output The research will allow each country: 1. compare itself with other participating countries 2. identify more advanced countries which would allow an opportunity to learn (phase 3 of the project).
  31. 31. Any interest? • Additional information: bmeessen@itg.be • To join our CoPs (see slide 4) • To simply remain informed, simply like the CoP's page on
  32. 32. Forthcoming…

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