“Engaging with health markets is going to be critical for governments in the future, especially given the recent UN resolution,” notes Sara Bennett, referring to a UN resolution urging countries to work towards affordable Universal Health Coverage (UHC).
Many country governments will need to purchase services from both public and private providers to achieve UHC. At the same time governments need to guard against arrangements that enable powerful stakeholders to consolidate their position in a health system that provides ineffective services at an unnecessarily high cost.
Policy-makers, entrepreneurs, academics and funders convened in Bellagio, Italy, in December 2012 to explore this tension. The result was the Bellagio Statement on the Future of Health Markets (http://bit.ly/XFrN4X).
To broaden the conversation, participants in the Bellagio meeting are holding a roundtable webinar. The webinar will be chaired by Dr Sara Bennett from Johns Hopkins School of Public Health, who convened the session in Bellagio.
Discussants include: Kelechi Ohiri, Senior Special Adviser to the Honourable Minister of State for Health in Nigeria; Kwasi Boahene, Director Advocacy & Program Development at the Health Insurance Fund; and Sikder Zakir, Founder of the Telemedicine Reference Center Ltd. (TRCL); Guy Stallworthy, Senior Program Officer at the Bill & Melinda Gates Foundation; & Dr Allan Pamba, Director Public Engagement & Access Initiatives at GSK.
An initial presentation will help set the scene, outlining the background to the meeting as well as highlighting key points from the resultant statement. Following the introduction, the discussants will offer their reactions to and commentary on the Bellagio Statement. The webinar will then shift to a ‘fishbowl’ format, where the speakers and other participants at the meeting will have an open discussion on some of the main topics from Bellagio. The webinar will wrap up with a question and answer session for all.
This is the final draft of the discussion document on subsidies for agricultural knowledge and information services.
This document will be used to kick start a series of featured discussions in MaFI.
The document was produced by MaFI's Subsidies Learning Team in 2009 and 2010
Make or buy role of private sector in healthAlaa Hamed
The Role of Private Sector in Health, the economic argument on how to make decision to produce or to buy health services, Based on the book "Public Ends, Private Means", A chapter on the political economy of private sector participation in the health sector by Alex Preker and April Harding
This is the final draft of the discussion document on subsidies for agricultural knowledge and information services.
This document will be used to kick start a series of featured discussions in MaFI.
The document was produced by MaFI's Subsidies Learning Team in 2009 and 2010
Make or buy role of private sector in healthAlaa Hamed
The Role of Private Sector in Health, the economic argument on how to make decision to produce or to buy health services, Based on the book "Public Ends, Private Means", A chapter on the political economy of private sector participation in the health sector by Alex Preker and April Harding
Presented by Jens A. Andersson (CIMMYT), Elias Damtew (ILRI) and Zelalem Lema (ILRI) at the Africa RISING Learning Event, Arusha, Tanzania, 11-12 November 2014
As enthusiasm for universal health coverage grows, discussions spring up about the respective roles of the public and private sector in reaching this goal in developing countries. These exchanges have sometimes pit the two sectors against one another instead of identifying areas of collaboration that build on their respective comparative advantages. As one of several events leading to the Private Sector in Health Symposium in Sydney in July, please join a webinar during which we will identify factors and discuss examples of how the public and private sectors can work together to increase access to health insurance for low-income populations.
he private sector have the potential to be an effective provider of health care products and services for populations at the base of the economic pyramid.
This webinar presents two investment models: a market-based initiative and a challenge fund. The presenters will address the impact of these models with examples from programmes run by the Strengthening Health Outcomes through the Private Sector (SHOPS) project in India and sub-Saharan Africa.
Arunesh Singh will discuss market-based partnerships and Colm Fay will present on a challenge fund recently launched in East Africa.
Arunesh Singh, formerly of Market-based Partnerships in Health India, has over 14 years of development experience in corporate and social enterprises. He oversees market-based partnerships with private sector companies that address family planning, reproductive health, and child health.
Colm Fay, a private sector specialist, focuses on business strategies for the base of the pyramid and impact investing. He manages the HANSHEP Health Enterprise Challenge Fund.
This webinar is sponsored by Strengthening Health Outcomes through the Private Sector (SHOPS) http://www.shopsproject.org/
You can find out more about HANSHEP on their website http://www.hanshep.org/
The past decade has seen a growing appreciation of the importance of private healthcare providers as the first, and often only, source of healthcare in many countries. This has led to a range of interventions aimed at engaging these providers to deliver standardized public health goods and services. One partnership modality, called clinical social franchising, applies commercial principles to achieve this goal.
In 2012, 74 clinical social franchising programs were operational in 40 countries. The programmes included networks of 66,000+ providers that delivered franchised clinical and health services for family planning; maternal, newborn and child health; and to diagnose and treat TB, malaria and/or HIV. Millions of people received services. The scale and overall health impact of these programs is documented in the Clinical Social Franchising Compendium, 2013 (http://bit.ly/10nVT25).
This approach to engaging private purveyors of health and clinical services is gaining traction worldwide. The evidence base for this approach is also increasing, with studies now addressing health impact, quality of care, new usership of formal medical services, cost-effectiveness and equity.
This webinar will explain how clinical social franchising works, how it is being adapted in different countries and the evidence for its relevance as a public health approach.
Artificial intelligence (AI) is everywhere, promising self-driving cars, medical breakthroughs, and new ways of working. But how do you separate hype from reality? How can your company apply AI to solve real business problems?
Here’s what AI learnings your business should keep in mind for 2017.
Study: The Future of VR, AR and Self-Driving CarsLinkedIn
We asked LinkedIn members worldwide about their levels of interest in the latest wave of technology: whether they’re using wearables, and whether they intend to buy self-driving cars and VR headsets as they become available. We asked them too about their attitudes to technology and to the growing role of Artificial Intelligence (AI) in the devices that they use. The answers were fascinating – and in many cases, surprising.
This SlideShare explores the full results of this study, including detailed market-by-market breakdowns of intention levels for each technology – and how attitudes change with age, location and seniority level. If you’re marketing a tech brand – or planning to use VR and wearables to reach a professional audience – then these are insights you won’t want to miss.
Transforming Health Markets in Asia and AfricaJeff Knezovich
Gerry Bloom and David Peters introduce the key concepts from their new book, Transforming Health Markets in Asia and Africa, at a recent launch event hosted by the Results for Development Institute for the DC Health systems Board.
The role of informal providers in health marketsJeff Knezovich
Gina Lagomarsino of Results for Development's Center for Health Market Innovation reflects on findings from a new book, Transforming Health Markets in Asia and Africa and adds information about recent studies in which CHMI has been involved on informal providers in Bangladesh, India and Nigeria.
Successes and failures of institutional innovations for improving access to s...ILRI
Presented by Alex Tatwangire at the Workshop on In-depth smallholder pig value chain assessment and preliminary identification of best-bet interventions, Kampala, 9-11 April 2013
pigs, markets, value chains, crp37, Uganda, east Africa, Ifad, ilri, presentations
Presented by Alex Tatwangire at the Workshop on In-depth smallholder pig value chain assessment and preliminary identification of best-bet interventions, Kampala, 9-11 April 2013
Presented by Dr. Nelson Gitonga, Insight Health Advisor, Kenya during Regional AIDS Training Network (RATN) 12th General Council Meeting held in Mombasa, Kenya from 24th - 29th June 2013
Presented by Jens A. Andersson (CIMMYT), Elias Damtew (ILRI) and Zelalem Lema (ILRI) at the Africa RISING Learning Event, Arusha, Tanzania, 11-12 November 2014
As enthusiasm for universal health coverage grows, discussions spring up about the respective roles of the public and private sector in reaching this goal in developing countries. These exchanges have sometimes pit the two sectors against one another instead of identifying areas of collaboration that build on their respective comparative advantages. As one of several events leading to the Private Sector in Health Symposium in Sydney in July, please join a webinar during which we will identify factors and discuss examples of how the public and private sectors can work together to increase access to health insurance for low-income populations.
he private sector have the potential to be an effective provider of health care products and services for populations at the base of the economic pyramid.
This webinar presents two investment models: a market-based initiative and a challenge fund. The presenters will address the impact of these models with examples from programmes run by the Strengthening Health Outcomes through the Private Sector (SHOPS) project in India and sub-Saharan Africa.
Arunesh Singh will discuss market-based partnerships and Colm Fay will present on a challenge fund recently launched in East Africa.
Arunesh Singh, formerly of Market-based Partnerships in Health India, has over 14 years of development experience in corporate and social enterprises. He oversees market-based partnerships with private sector companies that address family planning, reproductive health, and child health.
Colm Fay, a private sector specialist, focuses on business strategies for the base of the pyramid and impact investing. He manages the HANSHEP Health Enterprise Challenge Fund.
This webinar is sponsored by Strengthening Health Outcomes through the Private Sector (SHOPS) http://www.shopsproject.org/
You can find out more about HANSHEP on their website http://www.hanshep.org/
The past decade has seen a growing appreciation of the importance of private healthcare providers as the first, and often only, source of healthcare in many countries. This has led to a range of interventions aimed at engaging these providers to deliver standardized public health goods and services. One partnership modality, called clinical social franchising, applies commercial principles to achieve this goal.
In 2012, 74 clinical social franchising programs were operational in 40 countries. The programmes included networks of 66,000+ providers that delivered franchised clinical and health services for family planning; maternal, newborn and child health; and to diagnose and treat TB, malaria and/or HIV. Millions of people received services. The scale and overall health impact of these programs is documented in the Clinical Social Franchising Compendium, 2013 (http://bit.ly/10nVT25).
This approach to engaging private purveyors of health and clinical services is gaining traction worldwide. The evidence base for this approach is also increasing, with studies now addressing health impact, quality of care, new usership of formal medical services, cost-effectiveness and equity.
This webinar will explain how clinical social franchising works, how it is being adapted in different countries and the evidence for its relevance as a public health approach.
Artificial intelligence (AI) is everywhere, promising self-driving cars, medical breakthroughs, and new ways of working. But how do you separate hype from reality? How can your company apply AI to solve real business problems?
Here’s what AI learnings your business should keep in mind for 2017.
Study: The Future of VR, AR and Self-Driving CarsLinkedIn
We asked LinkedIn members worldwide about their levels of interest in the latest wave of technology: whether they’re using wearables, and whether they intend to buy self-driving cars and VR headsets as they become available. We asked them too about their attitudes to technology and to the growing role of Artificial Intelligence (AI) in the devices that they use. The answers were fascinating – and in many cases, surprising.
This SlideShare explores the full results of this study, including detailed market-by-market breakdowns of intention levels for each technology – and how attitudes change with age, location and seniority level. If you’re marketing a tech brand – or planning to use VR and wearables to reach a professional audience – then these are insights you won’t want to miss.
Transforming Health Markets in Asia and AfricaJeff Knezovich
Gerry Bloom and David Peters introduce the key concepts from their new book, Transforming Health Markets in Asia and Africa, at a recent launch event hosted by the Results for Development Institute for the DC Health systems Board.
The role of informal providers in health marketsJeff Knezovich
Gina Lagomarsino of Results for Development's Center for Health Market Innovation reflects on findings from a new book, Transforming Health Markets in Asia and Africa and adds information about recent studies in which CHMI has been involved on informal providers in Bangladesh, India and Nigeria.
Successes and failures of institutional innovations for improving access to s...ILRI
Presented by Alex Tatwangire at the Workshop on In-depth smallholder pig value chain assessment and preliminary identification of best-bet interventions, Kampala, 9-11 April 2013
pigs, markets, value chains, crp37, Uganda, east Africa, Ifad, ilri, presentations
Presented by Alex Tatwangire at the Workshop on In-depth smallholder pig value chain assessment and preliminary identification of best-bet interventions, Kampala, 9-11 April 2013
Presented by Dr. Nelson Gitonga, Insight Health Advisor, Kenya during Regional AIDS Training Network (RATN) 12th General Council Meeting held in Mombasa, Kenya from 24th - 29th June 2013
As part of the Global Development Institute Lecture Series Dr Irene Guijt, Head of Research at Oxfam GB, delivered a lecture entitled: Evidence for Influencing: Balancing research integrity and campaign strategy in Oxfam
When using evidence to influence, what compromises have to be made in different contexts due to practical, political and strategic reasons?
Dr Guijt presents on challenges and successes, using examples of Oxfam research and campaign strategies from across the world.
Social Entrepreneurship and its Importance for Successful Nonprofit Practice...AshokaFEC
Can Social Entreprenuers Save the World? See Ashoka FEC's Chief Entrepreneur, Valeria Budinich's Keynote address to the Novartis "Power of Partnering" National Meeting from November 9, 2010. The theme focuses on social entrepreneurship and its importance for successful nonprofit practices in today’s economy and culture. Want more info? Check out fec.ashoka.org
Three challenges for innovators in rural developmentJacqueline Ashby
Innovation Asia Pacific Symposium J Ashby May 4 2009 Presentation. Discusses three challenges for innovators in rural development in relation to shortcomings of innovation systems theory and the need for engagement with policy.power relations and politics.
Placing the Evolution of HTA In Emerging Markets in Context of Health System ...Office of Health Economics
These slides were presented by Professor Adrian Towse at the 9th World Congress of the International Health Economics Association in July 2013. The presentation examined how the development of health care systems affect the evolution of the use of health technology assessment. Three countries provide case studies: Brazil, China and Taiwan.
ARTIFICIAL INTELLIGENCE IN HEALTHCARE.pdfAnujkumaranit
Artificial intelligence (AI) refers to the simulation of human intelligence processes by machines, especially computer systems. It encompasses tasks such as learning, reasoning, problem-solving, perception, and language understanding. AI technologies are revolutionizing various fields, from healthcare to finance, by enabling machines to perform tasks that typically require human intelligence.
These lecture slides, by Dr Sidra Arshad, offer a quick overview of physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar leads (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Ve...kevinkariuki227
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
MANAGEMENT OF ATRIOVENTRICULAR CONDUCTION BLOCK.pdfJim Jacob Roy
Cardiac conduction defects can occur due to various causes.
Atrioventricular conduction blocks ( AV blocks ) are classified into 3 types.
This document describes the acute management of AV block.
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Title: Sense of Taste
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
Anti ulcer drugs and their Advance pharmacology ||
Anti-ulcer drugs are medications used to prevent and treat ulcers in the stomach and upper part of the small intestine (duodenal ulcers). These ulcers are often caused by an imbalance between stomach acid and the mucosal lining, which protects the stomach lining.
||Scope: Overview of various classes of anti-ulcer drugs, their mechanisms of action, indications, side effects, and clinical considerations.
The prostate is an exocrine gland of the male mammalian reproductive system
It is a walnut-sized gland that forms part of the male reproductive system and is located in front of the rectum and just below the urinary bladder
Function is to store and secrete a clear, slightly alkaline fluid that constitutes 10-30% of the volume of the seminal fluid that along with the spermatozoa, constitutes semen
A healthy human prostate measures (4cm-vertical, by 3cm-horizontal, 2cm ant-post ).
It surrounds the urethra just below the urinary bladder. It has anterior, median, posterior and two lateral lobes
It’s work is regulated by androgens which are responsible for male sex characteristics
Generalised disease of the prostate due to hormonal derangement which leads to non malignant enlargement of the gland (increase in the number of epithelial cells and stromal tissue)to cause compression of the urethra leading to symptoms (LUTS
These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
Shaping future health markets: Reflections from Bellagio
1. @psinhealth
www.pshealth.org
#healthmkt
Shaping the future of health markets:
Reflections from Bellagio
An initiative of
the Private Sector in Health Symposium
2. Symposium: Sydney – 6 July 2013
• Since 2009 a group of researchers and policy analysts
working on health markets in low and middle-income
countries have organised a pre-congress symposium
at the biennial conferences of the International Health
Economics Association
• The aim has been to encourage and disseminate high
quality research on the performance of these markets
and on practical strategies for improving access to
safe and effective services by the poor
• The Future Health Systems Consortium is responsible
for organising the 2013 symposium with financial
support from the Gates and Rockefeller Foundations
and SHOPS
www.pshealth.org
3. This webinar series provides
opportunities to set the
scene before the Sydney
meeting and to ensure that
those who may not be
attending the Symposium
have the opportunity to
participate in debates about
strategies for improving the
performance of health
markets in meeting the
needs of the poor.
4. Webinar series
• Facilitated by the Future Health Systems
Consortium
• Organised by a number of institutes
• Publicised widely to involve a wide audience
• The next webinar will be held in April
5. Organisation of webinar
• Introduction to the Bellagio Statement on Shaping
Future Health Markets (Sara Bennett)
• Commentary from:
– Dr Allan Pamba, Director of Public Engagement & Access
Initiatives, GSK
– Kwasi Boahene, Director Advocacy & Program
Development, Health Insurance Fund
– Kelechi Ohiri, Senior Special Adviser to the Honourable
Minister of State for Health, Government of Nigeria
– Guy Stallworthy, Senior Program Officer, Bill & Melinda
Gates Foundation
• Fishbowl discussion
• Question and answer session
6. What future for health
markets?
Dr. Sara Bennett
CEO
Future Health Systems
7. Why health markets?
• Health markets are pervasive
– Health related goods and services
– Sub-national, national and global
– Public and private sector actors
• Understanding how markets work will
enable us to intervene in them better,
particularly to protect the poor.
8. Health markets - The past 20 years
• Have learnt much: heterogeneity of private
providers, “informal” markets, contracting
for services, social marketing
• But much still to learn: scaling up effective
market interventions, improving quality of
services, especially for poor
• Increased importance of health markets:
due to economic growth, new technologies
e.g. ICTs, economic liberalization
9. Health markets – The next 20 years?
Supplier-side
• Consolidation to
stronger players
• Vertical integration
Consumer-side Governance-side
• New technologies • Push for UHC
• Consumer • Public finance for
education private providers?
• Non-communicable • Oversight
diseases
Evolving
market
dynamics
10. Process
Landscaping Identification Preparation Bellagio Research
analysis of key topics of meeting uptake
• Document • Regulation of background (December activities
review health markets papers 2012) • Bellagio
• Interviews with • Networking • Scoping papers • Consultation statement
range of providers and literature with diverse • Webinar
stakeholders • Learning in reviews stakeholders • Journal special
health markets issue
• Meeting with
HANSHEP
12. Strengthen data
• Lack of data on health markets continues
to plague decision making
• Identify key data that health market actors
should provide
– Require data provision as part of participation
in government financing schemes
• Pilot a market data platform – that draws
together different types of data from
diverse sources (eg. DHS, NHA, market
research)
13. Experiment with regulatory approaches
• Effective regulation requires bundles of
regulatory approaches
• Dynamic regulatory approaches are
required to respond to dynamic market
situations
• “Learn and do”
– Regulatory experimentation
– Real time, rigorous, assessment of effects
– Adaptation of strategy
– Lessons learned?
14. Strengthen government stewardship
capacity
• Governments frequently lack appropriate
capacities to manage health markets
• Develop individual skills and organizational
capacity for:
Leadership Technical Collaborative Analytical
skills – capacity – capacity – skills –
to balance to develop to work with to anticipate
powerful market civil society, future
interests information private developments
systems, providers, in health
contract out business markets
15. Sustain investments
• Donor funding has supported private sector
experimentation e.g. social franchising
• Such initiatives – often small scale, but some
provide critical services to poor
• How will these be sustained going forward?
• While initiative seek to develop sustainable
models, government financing is key to enabling
access for the poor
• Needs to be proactive engagement with
government on future sustainability
16. Link market and health worker policies
• Connections between health
workers and health markets
insufficiently acknowledged:
–Moonlighting
–Migration
• Future for community health
workers, if governments do not
funding their salaries?
17. Learn about and manage networks
• Business models are evolving – greater
networking and integration of previously
disorganized private providers?
• Networks can help to correct failures
typical of health markets:-
– Informational asymmetries
– Facilitate distribution of subsidies
• But, networks can also create monopolies
and exert political influence
18. Promote learning in health markets
• Better coordination and more consolidated
research on health markets needed
• Priorities?
Effects of
New Mobile and
information
regulatory informational
on consumer
approaches technologies
behavior
• Real time learning – need for alternative
evaluation approaches
20. Next steps
• HANSHEP – knowledge priorities group
• Collaborate with developing countries to
pilot data collection systems for health
markets
• Create a challenge fund to support
experimentation and learning on health
markets
• Broaden the debate, in particular including
more market actors
22. A shifting global landscape
Global economic downturn Market opportunities
Donor Developed
funding markets
Role of African
(and other
private emerging)
sector markets
Need to create a vision for future health markets and
create an enabling environment to support this transition
23. Challenges and opportunities
Challenges Opportunities
• Cultural shift towards • Reductions in public
private sector sector funding
• Alignment on • Rising middle class in
approach Africa
• Bridging between
existing solutions and
new markets
• Technology and
innovations
Need strong leadership
24. Next steps
Sharper Catalyse
Get health
framing of change Supporting
higher on
the issues through emergent
government
that need targeted innovation
agenda
addressing support
26. Context
• Health care is a public good and it is the primary
responsibility of governments to ensure that
proper care is provided to their citizens.
• But, sub-Saharan African (SSA) countries have a
chronic lack of resources for health care.
• Thus, supporting and involving the private sector
in the delivery of health care to achieve universal
health coverage (UHC) is complimentary.
• The weak States and the large informal sector
that characterize SSA means that rights and
laws are not consistently enforced.
27. Contributions of the Bellagio
Statement
• Must understand market dimensions, where
supply and demand apply and citizens make
choices.
• Addressing failures in health markets can
help minimize financial risks and improve the
capacity to deliver quality.
• Availability of data and effective analysis will
improve the functioning of health markets.
• A transnational, cross-sectoral community of
practice can be reinforced by initiatives that
support capacity building, policy making,
research and the development of business
models at local-level.
28. Conclusions
• Government and donor countries should recognize the
need to stimulate trust and investment, and avoid
crowding out.
• The private sector is important in the delivery of health
care.
• Access to capital and technical assistance is vital to
improving quality of care.
• Promotion of public-private partnerships (PPPs) in
health care development is key.
• The group in Bellagio overestimates the importance of
„development partners‟ in the development of
healthcare markets.
• Discussions on the healthcare package for UHC
should be central to initiatives and policies for
developing health markets
30. Outline
• Overview of the health
sector
• Addressing market
constraints
• Perspectives and moving
forward
31. Nigeria is a federation with 6 zones spanning 36 states and a diverse
population of over 160 Million people …
Region/state map of Nigeria
Sokoto Population in mn
(3.6) Katsina
▪ Constitutional structure
(5.7) Jigawa is a Federal system
Zamfara 4.3
(3.2)
Kano Yobe Borno with 36 states, 774
Kebbi (2.3)
9.3
(3.08) (4.1) LGAs and 9,565 wards
Kaduna Bauchi Gombe
▪ The Federal
6.0 (4.6)
(2.3) Constitution divides
Niger
(3.9) Adamawa
responsibility for
FCT
Plateau (3.1) healthcare across the
Kwara Abuja (3.1)
(2.3) (1.4) Nassarawa three tiers of
Oyo
(5.5)
(1.8)
Taraba government
Ekiti Kogi (2.3)
Osun (2.3) (3.2) Benue
▪
(3.4) (4.2)
Ogun
(3.7)
Ondo
(3.4) Enugu
The 1999 Constitution
Edo
Lagos (3.22) Anam-
(3.2)
Ebonyi
placed „Health‟ on the
(9.0) bra Cross
(4.1)
(2.1)
river concurrent list with no
North west (35.8)
Delta Imo Abia
(3.9)
(2.8)
North east (18.9)
explicit delineation of
(4.0) (2.8)
Akwa North central (18.8) responsibilities
Bayelsa
(1.7)
Rivers
(5.1)
lbom
(3.9)
South east (21) amongst tiers of govt
South South (16.4)
South west (27.5)
SOURCE: Nigeria Population Census 2006
32. There is a call to action to address health systems and structural
challenges, unlock the market potential of the private health sector
▪ High maternal, newborn and Expected vs actual level of engagement
Suboptimal child mortality rates with private sector
health ▪ Inequalities in health outcomes
outcomes and utilization
▪ Poor quality of health care
services in public and private
facilities
▪ ~23,000 health facilities
Mixed
health ▪ Private sector accounts for 50%
of healthcare service provision. Business environment in Nigeria vs SSA
system average
It is fragmented; variable quality
938
644
Insufficient ▪ Health insurance coverage is
457
317
protection minimal. Most payment remains 31 44 79 96
from out of pocket
financial ▪ National health insurance
Time to
enforce
Time to Time to start
prepare and a business
Cost of
start up (%
risk scheme currently covers mainly contract pay taxes (days) of income
the formal sector (days) (hours per yr) per capita)
33. The health sector is currently laden with market failures on the supply
and demand side with policy and regulatory constraints
▪ The private health sector is fragmented, dominated by small clinics and
Supply side hospitals, that are largely sole proprietorships
▪ Minimal scaleable platforms across the healthcare value chain
▪ Poor quality of care in facilities, inadequate health workforce and
frequent stock outs of essential commodities
▪ Most private health institutions are unable to qualify for regular bank
Demand side loans / investments, due to little financial / business management and
planning capacity among the majority of private health sector
organisations
▪ High cost of capital / hurdle rates for loans to the health sector
Public sector ▪ Inadequate organisation among private providers
engagement ▪ Minimal formal engagement with the public sector
▪ Limited organised advocacy platforms for communicating with policy
makers
▪ Current regulations do not actively foster private health sector
Regulation and development.
institutions ▪ Common challenges faced include, but are not limited to the following:
1) lack of enforced and enforceable quality standards; 2) constraining
regulations; 3) Bureaucratic bottlenecks
SOURCE: Interviews, consultations with the private health sector
34. However, there are opportunities to unlock the market potential of the
health sector by addressing critical constraints and shaping the market
1 ▪ Review of fiscal and monetary policies that affect the health sector;
Fiscal policy including import duty and tariffs of medical equipment, drugs &
consumables; tax regimes and other duties
2 ▪ Development of quality of care standards and accreditation system
Regulatory ▪ Review/clarify on regulations to provide consistent interpretation
environment ▪ Strengthening the regulatory framework of NHIS
3
▪ Innovative financing for health investments such as a healthcare
Access to intervention / investment fund; healthcare bond;
capital ▪ Capability building for business and management skills in the sector
4
▪ Revise Healthcare PPP Policy
Model ▪ To develop private sector led model PPP transactions that could yield
investment demonstrable and visible impacts in the health sector
projects
5
Engaging ▪ Activate the Nigeria Private Sector Health Alliance to mobilize business
broader private leaders towards a multisectoral approach to improving health outcomes
sector
35. Bellagio meeting proved to be timely and relevant and the output of the
meeting should be taken forward
Perspectives Steps for moving this forward
▪ Most of the issues were familiar and very
▪ Research agenda to
Issues
relevant to the country context
resonated generate evidence on
▪ Need for clarifying and framing the issue
health markets
▪ Health markets are complex adaptive
When not systems, evolving with pressures on
▪ Country „labs‟ for testing
regulatory innovations
what if? governments (Internally – responsiveness;
and contextual factors
externally – universal coverage).
▪ Governments can either engage now, within
the window of opportunity, or play catch up
▪ Community of practice
for sharing experiences
▪ Lack of routine data remains a key and learnings
Information challenge and must be addressed
is key ▪ Type of data needed from both private and ▪ Link all these initiatives
public sector should enhance stewardship to results using
function of government accountability
frameworks such as
▪ Regulatory innovation/evolution scorecards
Innovation ▪ New business models e.g. networks, low
cost models of care
▪ New labor market dynamics
37. It is quite possible to believe that...
On the one hand… And also…
• Healthcare delivery can be • People have a right to decent
usefully understood as a health and healthcare services
mixed (public and private) • The state is ultimately
system that has some responsible for the health of its
features of markets: citizens
– Transactions • Collective, public or mandatory
funding is the most effective,
– Interaction of supply and efficient and equitable way to
demand finance healthcare (financing ≠
– Customers exercising provision)
choices • Market outcomes are usually far
– Incentives from ideal; markets are to be
• Some things are best done managed
by non-state actors • People are not only motivated
by profit maximization
• Privatization is not an
appropriate goal
38. It is quite possible to believe that...
The private health sector is terrible: The private health sector is terrific:
it is a large part of the problem. If it: it is a large part of the solution. If it:
• Is self-interested and driven mainly by • Is particularly customer-friendly
profits, not public good • Is ubiquitous
• Is the source of much misuse of • Can do things to unprecedented
antibiotics and drug resistance scale
• Often exploits ill-informed patients • Is inherently results-based
• Routinely misdiagnoses patients and • Tends to be innovative and dynamic
provides inappropriate or even
dangerous care • Tends to be efficient
• Often plunges the poor into financial • Is often opposed for ideological
crisis reasons rather than for public health
efficiency and effectiveness
• Is often promoted for ideological
reasons rather than for public health
efficiency and effectiveness
The opposite of a fact is a falsehood, but the opposite of one profound truth may
very well be another profound truth. - Niels Bohr
39. Submit questions
How to submit
• Via the „Questions‟ box in
the GoToWebinar Control
Panel
• Via Twitter using the
hashtag #healthmkt
Be sure to include your name,
organization and location
with your question!
41. Questions?
How to submit
• Via the „Questions‟ box in
the GoToWebinar Control
Panel
• Via Twitter using the
hashtag #healthmkt
Be sure to include your name,
organization and location
with your question!