World Health Organization 23 August 2019 Making giant strides towards UHC in Sudan....... What more can Sudan learn from international experience? Dr. Matthew Jowett - WHO Geneva Sudan NHP Endorsement Meeting 6-7 February 2018
Universal entitlement to (essential) health services Looking back 12 months Conference on Universal Health Coverage Khartoum, Sudan 22-24 January 2017 Universal entitlement to (essential) health services To progress towards UHC, need good health policies backed up by adequate funding, spent wisely… Adequate public funding for health Better use of funds (efficient, equitable)
Impressive developments in Sudan New health financing strategy and NHIF legislation NHIF internal reorganization / management improvements Shift of facility ownership; transfer of free care / U5 programmes to NHIF Significant increase in potential for greater risk sharing & strategic purchasing
Sudan now focuses resources on priority services & priority population 1.5m poor families subsidised under NHIF in 2017. Additional 1 million in 2018.
Good policy often gets stuck at the implementation phase Why are budgets not fully spent in some states? Why do some NHIF members not use services at all, or use very little? Why is higher spending not resulting in better quality services?
Current priority: better understand causes of under-performance
Focus on improving the fundamentals and sequence reforms carefully THAILAND SPEND 10 YEARS BUILDING SERVICE DELIVERY CAPACITY - Mandatory rural service for doctors (early 70’s) - Capital investment in hospitals frozen for 5 years - Extensive expansion of rural facilities in 1980s Thailand – all in the 1980s…. PHILIPPINES ran ahead with insurance coverage, despite poor access to services.
World Health Organization No short cuts; solutions lie in Sudan; address the fundamentals World Health Organization 23 August 2019 Major progress on range of policy issues Continue to strengthen understanding of the constraints to improving performance; M&E Address both supply-side issues (e.g. facilities, human resources, service quality, medicines/supplies), and……. ….demand-side issues: health and treatment-seeking behaviour