1. National Health Fund (NHF) Progress, Challenges And Preparing for the next 10 Years

2. Turks and Caicos - October 28, 2015 Jamaica’s Demographic ProfileHealth Financing in JamaicaAbout the NHFChallenges and Unresolved IssuesMeasures Taken to Address Gaps Outline

3. Turks and Caicos - October 28, 2015 Total population 2.7m Population growth of 23% between 1982 and 2011 Ratio of male to female is 1:1 Life expectancy is 71 years for male and 76 years for females Jamaica’s Demographic Profile

4. Turks and Caicos - October 28, 2015 2008 Estimates 2050 Projections Jamaica’s Demographic Profile

5. Turks and Caicos - October 28, 2015 Health Service Financing In Jamaica

6. Turks and Caicos - October 28, 2015 About The NHF 2003 NHF Formed by Act of Parliament 2004 Assumed responsibility for JADEP 2011 Took over operations of Health Corporation Limited including Drug Serv Pharmacies 2014 Commenced take over of Pharmacy Services

7. Turks and Caicos - October 28, 2015 Funding Sources 20% SCT on tobacco products 1% payroll deduction collected through NIS 5% of SCT on imports of petroleum products, alcohol & tobacco, & motor vehicles Sale of Pharmaceuticals

8. Turks and Caicos - October 28, 2015 NHF Card subsidy 16 Chronic Conditions 1,400 drugs covered JADEP 10 Conditions 73 items covered Individual Benefits Combined Over 630,000

9. Turks and Caicos - October 28, 2015 Increasing threat of NCDs NCD deaths are 5 times more than deaths from other diseases NCDs account for 65% of the disease burden in Jamaica Individual Benefits

10. Turks and Caicos - October 28, 2015 Individual Benefits - Claims Experience

11. Turks and Caicos - October 28, 2015 Individual Benefits - Claims Experience

12. Turks and Caicos - October 28, 2015 Provide grants to public and private sector institutions. Financed over 550 Projects relating to infrastructure development, education and primary care services Expenditure to date over US$9.8m Over 85 Active projects Institutional Benefits

13. Turks and Caicos - October 28, 2015 Over 300 community interventions annually Over 120,000 screening tests conducted per year Own and Operate Mobile Clinic Wellness Programmes Brochures and Other Information Health Promotions and Prevention

14. Turks and Caicos - October 28, 2015 Pharmacy Services Procurement Competitive Tender Process VEN List Items Warehousing Over 1500 items Value at over US$58m Supply over US$34m annually Distribution Own Fleet Island-wide Dispensing 13 Locations Over 1 million prescriptions annually Over 3 million prescription items

15. Turks and Caicos - October 28, 2015 Political and Social FactorsIMF agreements since 2010 No User Fee PolicyExpanded role of the NHF Challenges and Unresolved Issues

16. Turks and Caicos - October 28, 2015 High Out Of Pocket Expenditure No major change in NHF Benefits Package No Clear Way ForwardNo true demand established Challenges and Unresolved Issues

17. Turks and Caicos - October 28, 2015 Collaboration with MOH and PAHO on deepening the way forward with UHC Sustainability study conducted of the fund Measures Taken To Address Gaps

18. Turks and Caicos - October 28, 2015 Board and Management reviewed financing model and proposal made to Minister of Health Proposal in place for establishing Health Financing Unit at the NHF Discussions have commenced around defining and costing a package of care relevant to the population needs. Measures Taken To Address Gaps

19. Turks and Caicos - October 28, 2015 Closing NHF is fully aware of the support of WHO/PAHO of UHC including the resolution adopted by member states at the of UHC – 53 rd Directing Council meeting in 2014. We Acknowledge the role of NHF in advancing Health Financing in Jamaica. Board and Management remains committed to fulfilling mandate.

20. Turks and Caicos - October 28, 2015 Closing Who will walk the walk?

21. Turks and Caicos - October 28, 2015