Show & Tell Seminar on Social Protection Geneva, 12 May 2010 Existing WHO approaches/frameworks/tools relevant to Social Health Protection Varatharajan Durairaj and Xu Ke with inputs from Guy Carrin, Dan Chisholm, Ole Doetinchem, Riku Elovainio, David Evans, NHA Team, Inke Mathauer, and Jean Perrot Health Systems Financing, World Health Organization Show & Tell Seminar on Social Protection Geneva, 12 May 2010 Better financing for better health Health Systems and Services (HSS)

Better financing for better health Health Systems and Services (HSS) Health financing review - Assessing the health financing system National Health Accounts - Resource availability and tracking SimIns - Health financing trajectory Household expenditure analysis – Monitoring social health protection Contracting - Engaging the non-state sector and intra-sectoral partnership CHOICE - Priority setting Social Health Insurance Guidebook – WHO-ILO-GTZ Better financing for better health Health Systems and Services (HSS)

Health financing review Situation analysis Socioeconomic, political and health sector context Past and ongoing reforms Resource mobilization Level and adequacy of funding, sources of finance and accessibility and fiscal space Risk pooling mechanisms - Number and type of risk pools Efficiency in resource use - Provision/Purchasing mechanisms Assessment of institutional and organizational capacity & strength OASIS - Organizational Assessment for Improving and Strengthening health financing Options for future Critical challenges Strengths and weaknesses of existing health financing options Likely future pathway of existing options Emerging new options Institutional arrangements required for the future OASIS is an approach that has been tested in several countries and based on the country experiences, it was further developed and fine-tuned. Better financing for better health Health Systems and Services (HSS)

NHA describes all funds flowing through a health system It tells where the money comes from, who spends, how much, for what and on whom Available methodological Resources http://www.who.int/nha/en/ Remember that you have to write a message on top of each slide and that the message is an active statement summarising the content of the slide. The roadmap is reproduced in miniature in the upper right corner. This is a milestone to remind the audience where each visual fits into the presentation. Shade the current section and add the topic or sub-topic being presented. Place it in the same position on each visual. Better financing for better health Health Systems and Services (HSS)

Better financing for better health Health Systems and Services (HSS) What is SimIns? www.who.int/health_financing/tools/simins A tool to analyze the basic mechanism of health insurance for policy-making Covers community-based health insurance and social health insurance Includes input for tax financing and subsidies to health insurance Illustrate different policy options with respect to key health insurance variables (not setting policies) Facilitate search for financial equilibrium: which sets of contributions and/or utilisation patterns and/or health care costs are compatible with this goal? Examine the impact of health insurance on the overall structure of national health financing The structure of general government health expenditure Burkina Faso (with ILO), Ethiopia, Lesotho, the Philippines, Swaziland Uganda & Yemen Better financing for better health Health Systems and Services (HSS)

Household expenditure analysis Key indicators Questions answered Who needs what kinds of health services? Who use what kinds of services and from whom? Access to needed care Distribution of OOPs & catastrophic exp. Who pays, how much and for what services? Who suffers catastrophic expenditure? How many households are impoverished? To what extent the poor become even poorer? Poverty impact Better financing for better health Health Systems and Services (HSS)

Contracting http://www.who.int/contracting (Engligh and French) Capacity building Multicounty workshops and training – Benin, Indonesia Country support Establishing National Contracting Strategies - Niger, Mauritania, Chad, etc. Supporting other policy responses through contracting - Ethiopia, PNG Performance incentives for health providers – inter-country workshop in Benin, Rwanda (forthcoming) With other Development Partners Documentation and dissemination of best practices – books & documents Best use of contracting for health system strengthening OASIS is an approach that has been tested in several countries and based on the country experiences, it was further developed and fine-tuned. Better financing for better health Health Systems and Services (HSS)

Better financing for better health Health Systems and Services (HSS) CHOosing Interventions that are Cost-Effective (http://www.who.int/choice/publications/p_2003_generalised_cea.pdf) CHOICE is WHO's work programme on cost-effectiveness Use of a common set of tools and methods Enhances comparability between diseases / risk factors CHOICE Components DISMOD Epidemiology / disease burden POPMOD Intervention effectiveness CostIt Resource inputs / costs MCLeague Uncertainty analysis Results summarised in WHO regional C-E databases available for country-level adaptation / analysis Better financing for better health Health Systems and Services (HSS)

Population-level disease model (PopMod) INCIDENCE Susceptible Population Disease REMISSION CASE FATALITY Dead Calculates total disability-adjusted life years over a defined period Better financing for better health Health Systems and Services (HSS)

Better financing for better health Health Systems and Services (HSS) CostIt components Better financing for better health Health Systems and Services (HSS)

Better financing for better health Health Systems and Services (HSS) Our website http://www.who.int/health_financing Thank you Better financing for better health Health Systems and Services (HSS)