1. 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)

2. 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)

3. 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)

4. 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
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Better financing for better health
Health Systems and Services (HSS)

5. Better financing for better health Health Systems and Services (HSS)
What is 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)

6. 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)

7. 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)

8. Better financing for better health Health Systems and Services (HSS)
CHOosing Interventions that are Cost-Effective (
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)

9. 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)

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

11. Better financing for better health Health Systems and Services (HSS)
Our website
Thank you
Better financing for better health
Health Systems and Services (HSS)