Rapid assessment methodology and experience - Relevance for Cambodia Valerie Schmitt, Social Security Specialist, ILO DWT Bangkok Skill Training Workshop to diagnostic the extension of Social Protection and Promoting Employment Phnom Penh, 2-4 Nov 2011

Assessment methodology & some concrete examples Countries where the assessment has been conducted/is planned & main achievements Relevance for Cambodia? Agenda

ASSESSMENT MATRIX (INVENTORY OF SCHEMES, GAPS AND IMPLEMENTATION ISSUES, RECOMMENDATIONS)  Assessment methodology RAP PROTOCOL: DATA COLLECTION FOR THE COSTING, TRANSLATION OF THE RECOMMENDATIONS INTO SCENARIOS, COSTING SOME OF THE RECOMMENDATIONS  FINALIZATION OF THE ASSESSMENT REPORT, TRANSLATION, DISCUSSION WITH POLICY MAKERS, DECISION ON NEXT STEPS  NATIONAL DIALOGUE  NATIONAL DIALOGUE # 1  NATIONAL DIALOGUE # 2

Assessment matrix The assessment based national dialogue uses the Social Protection Floor framework to assess the whole Social Security situation (and not just non-contributory Social Protection schemes) According to the SPF framework, all the population should enjoy four guarantees –Access to health care –Income security for children –Minimum income for the working age –Income security for the elderly and the disabled Is it the case in the given country? 

Assessment matrix Health care Minimum income for working age Income security for elderly/disabled Existing provision s Gaps/issues Recommendations/ priorities Income security for children What are existing programs? Analysis: Is all population covered? Are benefits adequate? Other issues?? Policy gaps & Implementation issues New schemes Recommendations Expansion of existing schemes Higher levels of benefits 

Assessment matrix - Thailand  Describe present and planned SP provisions: legal framework, overview of schemes, indicators Identify design gaps and implementation issues Priority policy options decided through national dialogue SPF Guarantees: Health / Children / Working Age / Elderly

Assessment matrix Does the country has already a complete SPF? What is missing? What is not functioning? What can be recommended to fill the SPF gap? The assessment matrix answers three questions: 

National dialogue # 1 Objectives: –Share the SPF concept and framework –Discuss the diagnostic made of Social Security situation with main stakeholders –Complete the Assessment Matrix –Formulate jointly (in group works using the World Café exercise or Jeopardy…) recommendations to bridge the Social Protection gaps and overcome implementation issues  Example of recommendations on health in Indonesia

National dialogue # 1 Recommendations on Health in Indonesia  R1- Develop & apply a specific benefits package that can be guaranteed by the Jamkesmas program, establish a checklist of services and interventions that should be available at the different levels of the health care pyramid (health clinics, centers, hospitals…), ensure that HC staff is sufficiently trained and available to provide at least the services included under benefit package, inform beneficiaries on the guaranteed benefit package and establish control / monitoring and appeals mechanisms (hot line) *R2- Include other costs such as transportation costs in the benefit package of the Jamkesmas program  R3- Improve Jamkesmas database of members and targeting methods  R4- Improve payment methods/procedures/tools of hospitals under the Jamkesmas program by reviewing existing tools and methods and sharing an updated database of members with all health care infrastructures  R5- Improve reception of patients (covered by Jamkesmas) in HC infrastructures  R6- Increase enforcement of Jamsostek Law in the private sector (by establishing adapted supervisory & labour inspection mechanisms – see the TWIN service developed in China)

National dialogue # 1  R7 - Design adapted enrolment & contribution mechanisms for Informal Economy sector (e.g. the creation of professional or area based associations, the development of micro- insurance schemes to facilitate enrolment and collection of premiums and serve as “agents” for Jamsostek)  R8 - Develop a Database and mapping of informal economy workers (for the above to take effect) *R9 - Explore the possibility of extending Jamkesmas to all informal economy workers or a larger part of informal economy workers, notably those not targeted by Jamsostek (cost calculation, fiscal space analysis, learning from experiences in Bali and other provinces that have expanded coverage to the whole provincial population)  R10 – Support the development of regulations for the implementation of the Law 40, 2004 on the coverage of Informal Economy workers - or if not at national level, start in a few provinces  R11- Expand benefit packages of PT Askes and PT Jamsostek to include more diseases and provide higher levels of benefits *R12- Calculate the additional cost of covering HIV-AIDS related care by all schemes

ASSESSMENT MATRIX (INVENTORY OF SCHEMES, GAPS AND IMPLEMENTATION ISSUES, RECOMMENDATIONS)  NATIONAL DIALOGUE Assessment methodology RAP PROTOCOL: DATA COLLECTION FOR THE COSTING, TRANSLATION OF THE RECOMMENDATIONS INTO SCENARIOS, COSTING SOME OF THE RECOMMENDATIONS  FINALIZATION OF THE ASSESSMENT REPORT, TRANSLATION, DISCUSSION WITH POLICY MAKERS, DECISION ON NEXT STEPS   NATIONAL DIALOGUE # 1  NATIONAL DIALOGUE # 2

RAP Protocol 

 Demographic data & projections

 Active population data & projections

 Economic data & projections GDP Inflation Poverty line Average and minimum wage Useful for the costing of scenarios Useful for cost of new provisions in % of GDP

 Economic data & projections Government expenditure Useful for cost of new provisions in % of Government expenditure

RAP Protocol: translation of recommendations into scenarios  Recommendations on Health *R2- Include other costs such as transportation costs in the benefit package of the Jamkesmas program *R9 - Explore the possibility of extending Jamkesmas to all informal economy workers or a larger part of informal economy workers, notably those not targeted by Jamsostek *R12- Calculate the additional cost of covering HIV-AIDS related care by all schemes Scenario 1: Extension of Jamkesmas to all informal economy workers Scenario 2: Provision of higher levels of benefits under the Jamkesmas program to all informal economy population Scenario 3: Inclusion of HIV treatments and checkups for all the population Scenario 4: Introduction of a universal package to reduce Mother to Child HIV Transmission

RAP Protocol: costing of scenarios  Scenario 1: Extension of Jamkesmas to all informal economy workers To calculate the cost of scenario 1 we need to know: 1- The unit cost per head of the HC benefit package in The administrative costs in Inflation rates from 2011 to 2020 (both HC package cost and admin cost will increase with inflation) 4- The percentage of population to be covered in 2011, 2012, … The total population in 2011, 2012, … 2020

RAP Protocol: costing of scenarios  Scenario 1: Extension of Jamkesmas to all informal economy workers Unit cost per head of the HC benefit package Admin costs per head Inflation rate (ECO) Total population (POP) Percentage of the population covered HC AC I %62.9% 2020 Total cost per year (HC + AC) * Pop 2011 * 32% 2012 (1 + I 2012 ) * HC Pop 2011 (1 + I 2012 ) * AC Pop 2012 (HC AC 2012 ) * Pop 2012 * 40% 40.0%

RAP Protocol: costing of scenarios  Scenario 1: Extension of Jamkesmas to all informal economy workers Year Unit cost per head 66,75470,452 73,62276,56778,91981,25183,688 86,199 88,78591,448 Admin cost per head 1,6091,6911,7481,7981,8341,8671,9021,9391,9772,016 Coverage (% of total population) 32.0%40.0%50.0%60.0%62.9% 32.0% Total cost in million IDR 5,183,62 4 6,916, 742 9,133, ,520,691 12,577,568 13,088,205 13,625, ,180, ,753,397 15,344,231 Total in % GDP 0.07%0.08%0.10%0.11% 0.10% 0.09% Total in % Govt Expenditure 0.38%0.45%0.53%0.60%0.58%0.55%0.52%0.49%0.46%0.44% Status quo: without expanding coverage Total in % GDP 0.07% 0.06% 0.05% 0.04% Total in % Govt Expenditure 0.38%0.36%0.34%0.32%0.29%0.28%0.26%0.25%0.24%0.22%

National dialogue # 2 Objectives: –Validate the assumptions used for the RAP protocol –Share the result of the costing –Confirm the scenarios or propose new scenarios and cost them –Train participants for the utilization of the costing tool

ASSESSMENT MATRIX (INVENTORY OF SCHEMES, GAPS AND IMPLEMENTATION ISSUES, RECOMMENDATIONS)  NATIONAL DIALOGUE Assessment methodology RAP PROTOCOL: DATA COLLECTION FOR THE COSTING, TRANSLATION OF THE RECOMMENDATIONS INTO SCENARIOS, COSTING SOME OF THE RECOMMENDATIONS  FINALIZATION OF THE ASSESSMENT REPORT, TRANSLATION, DISCUSSION WITH POLICY MAKERS, DECISION ON NEXT STEPS   NATIONAL DIALOGUE # 1  NATIONAL DIALOGUE # 2

Finalization of the assessment Finalization of the assessment report Presentation & discussion with policy makers  which recommendations will be implemented? which institutions (Government, DPs…) will be involved? Start design & implementation : Extension of existing schemes (more people covered, higher levels of benefits) or Creating new schemes ; Trying to find solutions to implementation issues … 

Assessment methodology & some concrete examples Countries where the assessment has been conducted/is planned & main achievements Relevance for Cambodia? Agenda

Countries where the assessment has been conducted/is planned Workshop BKK Viet Nam Indonesia Nov 2010Jan. Thailand Vanuatu Solomon Is. AprilJulyOctDec. MarchJune 2011 Cambodia? Philippines? Lao PDR? 2012 Development of the methodology and training of participants from 5 countries & UN Adaptation of the methodology & assessments in Viet Nam, Indonesia and Thailand The assessment methodology is used systematically to review existing Social Security situations and develop National plans on SP (UNDAF, DWCP…)

9 May Maluku Literature review & consultations May JuneJuly August SeptOctNovDec. Assessment matrix completed through workshops Data collection for Costing tool Choice of scenarios and cost calculation National validation workshop Finalization of assessment report Dissemination of recommendations & costing results 5 July NTT 20 July East Java 26 May, Jakarta 1-4 August 4 August Consultations Experts meeting Dec Relevant ministries, UN Agencies … Relevant ministries, UN Agencies, Statistical office Maximum duration: 6-7 months Valerie is late…

What was achieved? Viet Nam Assessment matrix IndonesiaThailand Scenarios & costing Report finalized Decisions of extension by policy makers & feasibility studies National dialogue Ongoing Nov-Dec 2011 Ongoing (#1,2)(#1) Dec 2011 Beginning of 2012

Examples of results in Viet Nam –R1 - Elderly pension at the level of the poverty line for elderly not covered by the contributory pension –R2 - Employment guarantee scheme of 100 days per household per year and social assistance for those who are unable to work –R3 - Child allowance for all poor children aged 0-15 years old 0.7% GDP Cost in 2020: Examples of recommendations (Not exhaustive): 0.8% GDP 0.6% GDP Simulation of impacts on poverty rates of the different benefits components of the Social Protection Floor

Recommendations included in the new DWCP and ILO plan in Viet Nam –Actuarial review of the old age pension scheme and feasibility study of the extension of the non contributory pension scheme –Design and establishment of PWPs The child allowance component is being supported by UNICEF Examples of results in Viet Nam

Examples of results in Indonesia –R1- expand JAMKESMAS to all informal economy (package US$8/year) –R2- expand JAMKESMAS with higher levels of benefits (package US$17/year –R3- include HIV treatments and checkups for all the population –R4- universal package to reduce HIV Transmission between mothers and children 0.09% GDP 0.18% GDP 0.3% GDP Cost in 2020: 0.01% GDP Examples of recommendations on health care (Not exhaustive): Other recommendations on income security for children, working age, the elderly…

The ILO in the framework of the implementation of the Indonesian Jobs Pact will support the extension of health care coverage, the design of a UI scheme and the establishment of a SWS (to facilitate access to employment and social protection) Examples of results in Indonesia

Preliminary results in Thailand The assessment based national dialogue of social protection in Thailand provided several recommendations that are part of the UNPAF on social protection

Assessment methodology & some concrete examples Countries where the assessment has been conducted/is planned & main achievements Relevance for Cambodia? Agenda

In Cambodia we don’t start from scratch ASSESSMENT MATRIX (INVENTORY OF SCHEMES, GAPS AND IMPLEMENTATION ISSUES, RECOMMENDATIONS)  We have: We don’t have: Inventory of schemes / situation analysis … with the SPER and other background documents Agreement on gaps and implementation issues Joint recommendations on the way forward Indicators of coverage and benefits level (with the SPER) Complete and consolidate the Assessment Matrix at National level and in a few provinces Validation workshop of the Matrix Next steps?

In Cambodia we don’t start from scratch We have: We don’t have: Data collection for the costing (POP, EAP, ECO, Govt Expenditure) – thanks to the Social budget model Shared recommendations Come up with shared recommendations and realistic scenarios This can be done through a national dialogue and also field experience (in the provinces) Finalize the costing & train people to use the RAP Next steps? RAP PROTOCOL: DATA COLLECTION FOR THE COSTING, TRANSLATION OF THE RECOMMENDATIONS INTO SCENARIOS, COSTING SOME OF THE RECOMMENDATIONS  Assumptions & parameters to translate the recommendations into scenarios that can be costed

In Cambodia we don’t start from scratch Once the Assessment matrix and RAP protocol are completed : Decisions on priority schemes Feasibility studies Pilot testing & rolling out phases The Assessment matrix can then be used as a monitoring tool to monitor the progress of the extension of social security coverage (number of persons covered, levels of benefits), and should be regularly updated. The pilot testing of new schemes enables to refine the parameters which are used for the cost calculations … The Assessment process (matrix and RAP) is not a One time exercise but can be repeated over time

… Take away message The assessment, based on social protection floor framework, helps assessing social security situation and identifying priorities The recommendations are translated into scenarios and the RAP protocol gives an indication of their cost Feasibility studies need to be conducted for the detailed design of the new schemes Assessment matrix and RAP can be repeated over time…