Providing for Health (P4H)

Transcription

1 Providing for Health (P4H) Together towards Universal Coverage and improved Social Health Protection Dr. Michael Adelhardt P4H Coordinator WB regional meeting Maldives 2-4 June 2010

2 WHAT IS P4H? Providing for Health (P4H) is a global initiative aiming at improving social health protection (SHP) in low/middle income countries. P4H has been launched during the G8 summit in Berlin, in response to the global challenge of poor access to health services and impoverishment due to seeking health care. P4H is working through a network of organizations comprising Germany, France, ILO, World Bank and WHO. The goal of P4H is to improve access to essential quality health services and financial risk protection, in particular for the poor

3 SOCIAL HEALTH PROTECTION...is viewed by P4H as a system based on prepayment and financial risk pooling and that ensures equitable access to essential quality health services at affordable prices; whereas contributions to the system are based on capacity-to-pay, while benefits are based on need a set of measures against ill-health related cost of treatment, social distress, loss of productivity and loss of earnings due to inability to work.

4 EXPANDING ALL DIMENSIONS Universal population coverage Complete prepayment/ Financial protection Essential benefit package Extend benefits Reduce out -of- pocket Services & Benefits Extend coverage Expenditure on health Prepayment/ Pooling Population coverage

5 PROVIDING FOR HEALTH STRATEGY What? Improved Social Health Protection Sustainable mechanisms for SHP Systems development How? Network for... Awareness dialogue bigger picture of SHP SHP in national policy, strategy and plans Harmonised joint support to Capacity Development P4H With whom? Local actors and Stakeholders (Ownerhisp and Stewardship) France Germany ILO WHO Worldbank (P4H partners) Link to IHP+, UN SPF,...

6 FINANCING AS STRATEGIC INSTRUMENT Complex transition process Need for a strategic approach with inclusive stakeholder involvement Intermediate stages of coverage Universal coverage Social Health Protection Tax-based financing; Social Health Insurance; Mix of taxbased and SHI Absence of financial protection Mainly Out-of- Pocket spending Mixes of community-, cooperative-, enterprisebased health insurance; social health insurancetype coverage for specific groups; limited tax-based financing Source: WHO, Carrin et al.

7 Sustainability Quality BIGGER PICTURE OF SHP AND UC Objectives Efficiency Access Equity Context Policital and economic environment Health Perspective Health Systems Focus: Health Financing, Financial Protection Development Perspective Pro-poor orientation Process values holistic approach Social Health Protection Social Perspective Social Protection Social Capital Rights Social Justice Good Governance Participation Solidarity Values

8 FORMULA FOR HARMONISATION INFORM AND INVOLVE A P4H partner informs other partners about SHP related (1) requests (e.g. Uganda) (2) planned activities (e.g. Nepal) (3) ongoing activities (e.g. Cambodia) and at least one more (however preferably all) P4H partner is/are getting involved in the support and coordination process

9 COUNTRY WORK INITIATED OVERVIEW (JAN 2010) Country Initiator Other P4H partners involved Uganda WHO WB, ILO, GER, FRA Kenya GER WHO, WB, FRA Rwanda WHO GER, WB Senegal FRA, WHO WB, ILO Tanzania GER WHO, WB, ILO, FRA Cambodia WHO WHO, ILO, GER, FRA Mongolia GER WHO, ILO, ADB Nepal GER WHO, ILO

10 INITIATED DIALOGUE (JAN 2010) Country Philippines Bangladesh Indonesia India Pakistan Vietnam Potential partners involved WHO, WB, ILO, EC, ADB, GER WHO, GER WHO, WB, GER WB, WHO, GER WHO, GER, WB FRA Burkina Faso FRA, WHO, others?

11 CAMBODIA GERMANY, FRANCE, ILO, WHO P4H support: Formation of local (P4H) network for joint support to SHP Memorandum of Understanding signed in June 2009 Decentralised P4H support model Results: Bigger picture of SHP addressed through SHP Master Plan Development of joint action plan (GER, FRA, WHO, ILO) Improved collaboration integration of support from different levels Study on catastrophic payments (WHO HQ) Integration of SP and employment policies (ILO HQ + EU project); Potential areas of collaboration: costing of current and future social protection programmes including for health, fiscal space analyses and identification of minimum social insurance and assistance packages

12 KENYA - GERMANY, FRANCE, ILO, WB, WHO P4H support Study tour (France, Germany, UK) 3-months assignment of WHO staff Support to stakeholder meetings Results: Orientation towards SHP/UC Inclusive and advanced strategy process Improved collaboration - harmonisation of work streams WB SHP reforms included in sector programme SP schemes of MoGCSD linked to HCF strategy ILO HQ coordination of upcoming visit on UN SPF issues GTZ and DFID pilot HCF strategy

13 KEY MESSAGES P4H is about the bigger picture of Universal Coverage / SHP Health financing and broader health systems development; different perspectives, interests and values; social and economic objectives Health financing as strategic instrument to achieve health sector objectives Transition process with inter-sectoral stakeholder involvement P4H is about joint and harmonised support to UC / SHP Commitment to improving SHP Country ownership Coordination and synergies of different work streams Continued flexible and tailored support for capacity development

14 KEY MESSAGES (2) P4H is an open network Opportunity for collaboration together we can achieve more Opportunity to strengthen each partners mandate not a straight jacket No pooling no collaboration for the sake of collaboration P4H as catalyst for scaling-up support Mobilising more resources for UC/SHP (strategy as basis for investment) Capacity Development for health financing and SHP Awareness and cross-country learning P4H is an open invitation to other partners committed to UC and SHP to work together.

15 Thank you!