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. Project
1. Health Systems Research and Development
Project
2. Developing Alternative Financing Mechanisms
for Health Project
3. International Health Cooperation Project
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. 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. 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. 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. 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. 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. 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.
15.
16. 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
17. 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
21. 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
22. 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
Editor's Notes
W/s on Health systems Research Methodology for Post -Graduate Students from Medical University
2006-2007 IM (1)Ygn, IM(2) Ygn, IM Mdy (430) Participants
2008-2009 IM (1)Ygn, IM(2) Ygn, IM Mdy (639) Participants
2010-2011 IM (1)Ygn, IM(2) Ygn, IM Mdy (350) Participants
Training in Research Methodology and Research Management for Health Staff working in S/D
2006-2007 Sagaing, Bago(West), Magwe (78) Participants
2008-2009 Mon, Shan (South) (60) Participants
User-friendly HSR tools
Quality Assessment on Care of STI Patients
Collecting Mortality data among the Community by Verbal Autopsy Method
Facility Based Verification of Cause of Death by Hospital Record Examination
Service Availability Mapping(SAM) for a Township
HSR Studies
Community Based Injury Survey
Pilot Implementation of verification of Cause of Death with Verbal Autopsy in Pyinmana Tsp.
Facility Based verification of Cause of Death by Hospital Record Examination
Study on Independent Evaluation of Completeness and Coverage of Mortality Data in Urban Areas of Myanmar
Workshop on Health Financing:
Workshop on Exploring Mechanism for Financing Health in Myanmar, 2006
Workshop on National Health Accounts, 2007
Workshop on Awareness raising and Capacity Building on Measuring Costs and
Effects of Health Intervention and Estimating Economic Consequences of Illness,
2009
Training for financial management:
Training Workshop on Financial Planning and Management in Health, Mandalay, 2007
Training Workshop on Financial Planning and Mobilization of Funds in Township Health System (Le We, Pyawbywe, Tatkone), 2009
Training Workshop on Financial Planning and Mobilization of Funds in Township Health System (Yaetarshae, Wundwin, Myitthar), 2009
Training Workshop on Financial Planning and Mobilization of Funds in Township Health System in Mon State, 2010
Developing National Health Accounts:
Myanmar National Health Accounts (2002-2005)
Myanmar National Health Accounts (2006-2007)
Health Economic and Financing Studies:
Health Care Financing Methods and Access to Health Care in Myanmar, 2007
Health Financing Situation in Myanmar: Improving Access to Health Care by poor in Township Hospitals, 2009
Service delivery: preventive and curative personal health services; primary, secondary services and tertiary services (public/private/voluntary NGOs)
Public health service; services for specific population groups such as children and women, or for specific conditions such as tobacco or alcohol problems
Resources: trained staff, commodities, facilities and knowledge
Financing: sources of funds such as user fees, insurance, tax,
Social dialogue on the policy choices that will set the boundaries for strategic options
