Social Health Protection some WHO tools Varatharajan Durairaj

Social Health Protection: some WHO tools Varatharajan Durairaj and David B Evans with inputs from Guy Carrin, Jean Perrot, NHA Team, Xu Ke, Ole Doetinchem, Inke Mathauer, Dan Chisholm, and Riku Elovainio Social Protection Floor: Inter-agency technical meeting Turin, 13 -15 October 2009 Better financing for better health Health Systems and Services (HSS)

Functions and Goals of Health System Building Blocks or Functions I SERVICE DELIVERY N HEALTH WORKFORCE P Goals / Outcomes of the system Quality Coverage Responsiveness (the way people are treated and the environment) INFORMATION U T Health MEDICAL PRODUCTS, VACCINES & TECHNOLOGIES LEADERSHIP/GOVERNANCE S FINANCING (COLLECTING, POOLING AND PURCHASING) Better financing for better health Efficiency Fairness in financial contribution Health Systems and Services (HSS)

Three core health financing functions Equity and Transparency Revenue collection Collect sufficient funds efficiently Pooling Share costs - not borne only by people who are ill Better financing for better health Purchasing Buy or provide effective health interventions Health Systems and Services (HSS)

Existing approaches/frameworks/tools relevant to SHP ü National Health Accounts - Resource availability and tracking ü Sim. Ins - Health financing trajectory ü Household expenditure analysis – Monitoring social health protection ü Contracting - Engaging the non-state sector and intra-sectoral partnership ü Modular costing tool – for both MDG and non-MDG diseases and for systemic components ü CHOICE - Priority setting ü OASIS - Assessing the health financing system ü Social Health Insurance Guidebook – WHO-ILO-GTZ 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/ Better financing for better health Health Systems and Services (HSS)

What is Sim. Ins? www. who. int/health_financing/tools/simins ü A tool to analyze the basic mechanism of health insurance for policymaking o Covers community-based health insurance and social health insurance o Includes input for tax financing and subsidies to health insurance ü Illustrate different policy options with respect to key health insurance variables (not setting policies) ü ü ü 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 o the overall structure of national health financing o The structure of general government health expenditure Uganda, Ethiopia, the Philippines, Yemen, Lesotho, and Swaziland 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) ü ü CHOICE is WHO's work programme on cost-effectiveness Use of a common set of tools and methods o enhances comparability between diseases / risk factors Sectoral, population-level CEA o effectiveness: healthy years gained (or DALYs averted) o resource costs: patient + programme level (intl $ or local units) Results summarised in WHO regional C-E databases o available for country-level adaptation / analysis Better financing for better health Health Systems and Services (HSS)

Health Financing Review/OASIS ü Scenario analysis o ü Institutional analysis (OASIS - Organizational Assessment for Improving and Strengthening health financing) o ü to systematically assess the health financing functions and the performance of a health financing system to identify bottlenecks in the institutional design and organizational practice of health financing by understanding incentives and interests of health financing actors Health financing options o to develop options and propose changes concerning the design and functioning of the health financing system so as to improve the performance and to move towards universal coverage Better financing for better health Health Systems and Services (HSS)

I would like to invite you to visit our website http: //www. who. int/health_financing Thank you Better financing for better health Health Systems and Services (HSS)