Health Systems Science Thematic Group

Transcription

1 Health Systems Science Thematic Group Presented by: Gemini Mtei

2 Outline Health System Science: General Focus Specific focus: Research project past 5 years Financing Human Resources for Health Service delivery Governance Assets and strengths Training activities Services Strategic areas of work

3 Health System Science: General Focus Guided by the WHO health systems blocks

4 Health Systems Science Thematic group focus area Main Objective: Contribute to strengthening of the health system through informing policy and interventions in relation to service delivery, human resources, financing and governance Support efforts to achieve Universal coverage (UC) Access to health care for all Enhancing equity Ensure financial protection Past five years research concentrated in following priority areas Health system financing Human resource for health Service delivery Governance

5 Health System Financing Equity in health care financing and benefit distribution Analysis of equity in distribution of health care payments Analysis of the distribution of health care benefits by socio-economic status Health insurance effect Monitoring and evaluation of health system financing reforms towards achieving universal coverage Introduction of TIKA MMAM (cut across- service delivery and human resource) Facility bank accounts Change in CHF/TIKA national management Findings from these studies contribute to the process of formulating National Health Financing Strategy

6 Payments as a share of income Quintile share of total distribution Financing: Distribution of payments, benefits & needs 15% 12% 9% 6% 3% 0% Least poor Q4 Q3 Q2 Poorest ALLTAXES OOP NHIF CHF 100% 90% 80% 70% 60% 50% 40% 30% 20% 10% 0% THF Total benefit NEED Poorest Q2 Q3 Q4 Least poor The poorest pays higher share of OOPs (regressive) The poorest have greatest needs but get least benefits share

7 Financing: Insurance effect Probability of using outpatient care Probability of OOP 0 Poorest Q2 Q3 Q4 Least poor 0 Poorest Q2 Q3 Q4 Least poor Insured Uninsured Insured Uninsured Insurance increase probability of using health services Insurance reduces the probability of paying OOPs

8 Human Resources for Health RESPONSE TO HR crisis Supply, deployment and retention Previous research projects focused on Identifying factors influencing mid-level providers motivation, performance and retention Intervening to strengthen human resource management & supervision in order to improve workers staff satisfaction & retention Enroll community volunteers- To address immediate needs of newborns (Breast feeding, Hygiene during delivery, and care for newborns with low birth weight) Testing the model of paid community health workers against volunteers Interventions: Training community health workers and deploy them to provide MNCH services align CHW to the scheme of service- salary based payment

9 Service delivery Focus on improving access to quality health care services Collaborative initiatives between district authority, facility committees, and community to improve service delivery to mothers and newborn Developing quality improvement toolkit (QIRI) Established quality improvement indicators Introduction of RDTs More patients tested for malaria Improved efficiency reduce unnecessary dispense of anti malaria drugs Intervention to improve monitoring and supportive supervision Introduction of electronic quality of care assessment and improvement tool (e- TIQH) Strengthening the management of CHF to: Improve financial access for the members and Increase resource mobilization for healthcare services

10 Governance Focus on: Strengthening accountability structures at community and health facility levels Training health providers Develop training manuals for CHSB & HFGC Development of supervision checklist Promote patient/provider rights through client service charter

11 Assets and strengths Skill mix within research team (health economists, sociologists, ICT experts, Statisticians, etc) Good and trusted relationships and networks in over 23 districts across Tanzania, Existing methodologies, models, toolkits and approaches Solid datasets drawn from previous interventions Close link with policy makers and implementers

12 Training Teaching support to Masters in Public Health Research (MPHR) program at Nelson Mandela University (Plan to start in September 2013) Enroll PhD and Masters students in other various universities Provide opportunity for internship for students from various universities

13 Services Contribute to national advisory committees and working groups Maternal and new born working group health financing working group regional and district health service working group Monitoring and evaluation working group Commission for information and accountability for women health Short term assignments/consultancies National Health Account & Public Expenditure Review Health insurance regulatory framework review Review of Council Health Service Boards Assessment of EMOC Zanzibar Inclusion of persons with disability in the health financing system in Tanzania

14 Strategic areas of work: Service delivery Quality improvement Service availability Human resource deployment, retention and motivation Evaluation of different training systems Health financing various models for attaining universal coverage Purchasing Financial protection and equity Revenue generation Governance and accountability improve reporting and financial management systems Social determinants of health Medicine & technology

15 THANKS