09 May 2012 NPF From NMBF to UHC: The role of Health Insurance and Finance Technical Advisory Committee (“HIFTAC”) - By Mpingana Kalimba-Msimuko

09 May 2012 Universal Health Coverage Tool: National Health Insurance (“NHI”) 2

09 May 2012 National Health Insurance (“NHI”) Overall objective: promote equitable access to sustainable and optimum quality health care and providing increased financial protection for the people of Namibia. 3

09 May 2012 NHI: Expected Outcomes 1)Improve access and quality of health care services. 2) Provide a comprehensive range of health services, which would be free at the point of use to residents of Namibia. 4

09 May 2012 NHI: Expected Outcomes 3)High coverage of health insurance for both formal and informal sector employees and non- employed groups of Namibia. 4)Eliminate discrimination based on ability to pay when a Namibian needs health services. 5)Well informed citizens, who understand, support and own the NHI. 5

09 May 2012 Social Security Commission (“SSC”) mandate SSC Act 34 of 1994 National Medical Benefit Fund (“NMBF”) which shall provide “for the payment of medical benefits to employees”. 6

09 May 2012 Social Security Commission (“SSC”) mandate With consideration towards the Social Protection Floor (“SPF”), a United Nations’ initiative led by the International Labour Organization (“ILO”) and World Health Organization (“WHO”), that emphasizes the promotion of access to essential services and social transfers for the poor and vulnerable inclusive of health services, it is recognised that the NMBF is only a subset of the mechanisms available for the achievement of the SPF and UHC. 7

09 May 2012 NMBF status update Research study – by Delloite Initial report completed and some stakeholders submitted inputs – this was consolidated Important stakeholder, i.e., MOF, still to provide input Process on hold until MOF submit input 8

09 May 2012 NHI Mandate Ministry of Health and Social Services (“MoHSS”): NHI Workshop (September 2011) - preliminary results of Research Study was presented - NHI is a national issue: MoHSS - Health Insurance and Finance Technical Advisory Committee (“HIFTAC”) (a) Delegated NHI mandate to HIFTAC (b) Approved HIFTAC’s Terms of Reference (“ToR”) 9

09 May 2012 Health Insurance & Finance Technical Committee (“HIFTAC”) 10

09 May 2012 HIFTAC: objectives Advice and guide MoHSS on the development of a NHI with a focus on evidences and alternatives. Provide technical recommendations on the way forward. Delve into broader health financing issues as needed. 11

09 May 2012 HIFTAC: Membership Ministry of Labour and Social Welfare Ministry of Finance Ministry of Health and Social Services Ntional Planning Commission Medical Aid schemes and administrators: MAFAF Health Professions Council of Namibia International Labour Organisation 12

09 May 2012 HIFTAC: Membership International Labour Organisation NAMAF Namibia Medical Association Namibia Medical Society NANGOF National Employers Federation National Union of Namibian Workers PharmAccess Social Security Commission USAID World Health Organisation 13

09 May 2012 HIFTAC: Development partners Grant Funding: African Development Bank (N$5.2 million) Technical Support: Health Systems 20/20 USAID 14

09 May 2012 Way Forward (Road Map) 15

09 May 2012 Preparatory Phase 1 Fulltime ownership of the reform 2 multisectoral technical committee (HIFTAC) 3 Learn from Experience of Other countries 5 Understand the Current Situation and Future Prospects 6 Define Health Financing Model 7 Define Key Parameters (system components) 8 Consultation with Stakeholders 16

09 May 2012 Implementation Phase 1 Enact laws to provide legal sponsorship 2 Setting up the Administrative Structures 3 Develop standards and detailed operational Manuals 4 Awareness campaign and communication 5 Effective collaboration with key sectors 17

09 May 2012 Progress to date MoHSS delegated NHI mandate to HIFTAC Health Economist recruitment HIFTAC Meeting and Stakeholders Consultation Workshop – October

09 May 2012 THE END!