Health Care Financing Strategy:Health Care Financing Strategy:Towards Universal Health CoverageTowards Universal Health Coverage

Md. Ashadul IslamDirector General

Health Economics UnitMinistry of Health and Family Welfare

Health Care Financing Strategy Health Care Financing Strategy

Strategic ObjectivesStrategic Objectives

1. Generate more resources for health2. Improve equity and increase health care

access especially for the poor and vulnerable3. Enhance efficiency in resource allocation and

utilization

Strategic InterventionsStrategic Interventions

1. Design and implement Social Health Protection Scheme

2. Strengthen financing and provision of public health services

3. Strengthen national capacity

Generate more resourcesGenerate more resources

• Advocacy• Meeting

Equity and AccessEquity and Access

Social Health Protection SchemeSocial Health Protection Scheme

• SSK• RMG• Civil Servant

Who will benefit from UHC Who will benefit from UHC

WHAT HEALTH ECONOMICS UNIT HAVE DONE TO ACHIEVE THE OBJECTIVES AND INTERVENTIONS

LEGISLATIONLEGISLATION

• National Health Protection Act– Drafted– Disseminated – Available in www.heu.gov.bd for comments– Translated into Bangla

• Accreditation Law– Drafted – Translated into Bangla

Developed an Implementation PlanDeveloped an Implementation Plan

• An Implementation Plan developed for 2 years• This plan is costed and disseminated to

development partners

DISEASE IDENTIFICATION ACCORDING DISEASE IDENTIFICATION ACCORDING TO THE LEVEL OF SERVICE DELIVERYTO THE LEVEL OF SERVICE DELIVERY• According to ICD-10 codes• 14500 diseases reviewed • Based on their incidence, prevalence and

expert opinion diseases were categorized level wise. (primary, secondary, tertiary)

BENEFIT PACKAGE IDENTIFICATIONBENEFIT PACKAGE IDENTIFICATION

• SSK - Completed• RMG – completed and WTP study is in plan

PRICING THE MANAGEMENT OF DISEASEPRICING THE MANAGEMENT OF DISEASE

• Some Management guidelines are completed• Identification of Management guideline is in

the process.• Price analysis is going on

ACCREDITATION ACCREDITATION

• HEU led the accreditation system in – – Hospital service – Medical education

HEALTH CARE QUALITY IMPROVEMENTHEALTH CARE QUALITY IMPROVEMENT

• HEU led health care service quality in - – Quality improvement strategy– Quality improvement cell– Quality improvement secretariat

DEVELOPMENT OF HEALTH CARE STANDARDDEVELOPMENT OF HEALTH CARE STANDARD

• HEU is developing health care standard – – Primary level service standard – Secondary level service standard– Tertiary level service standard

Service Quality standard according to Service Quality standard according to level of service led by 3 ex-DG, DGHSlevel of service led by 3 ex-DG, DGHS

UNIVERSAL HEALTH COVERAGE (UHC) UNIVERSAL HEALTH COVERAGE (UHC) MONITORING TOOLS MONITORING TOOLS

• Indicators identified– Health service– Financial Protection

• Baseline data collected

COMMUNICATION STRATEGY OF UHC DEVELOPED

• Meeting with Journalist• Documentary film is in process• Wide dissemination among health managers

conducted– Among health care professionals– Professional bodies

RESOURCE ALLOCATION FORMULA RESOURCE ALLOCATION FORMULA (RAF)(RAF)

• RAF developed• Widely disseminated• Software developed• Will pilot in LLP district

UHC MARKETINGUHC MARKETING

• Dissemination of UHC at the – Ministerial level– Directorate level– Medical colleges– Professional bodies– Civil society– Different stakeholders

With Journalist

At MinistryAt Ministry

At BSMMUAt BSMMU

At DGFPAt DGFP

HEALTH PROTECTION FUND FOR POOR – HEALTH PROTECTION FUND FOR POOR – SSKSSK

• Census Completed• Benefit Package identified• Management guidelines are finalized• BPL identified-primarily• Union Committee validation is ongoing• Implementation consultant group employed

Barcode used in CensusBarcode used in Census

Data Collectors: Existing Health workforce

HEALTH PROTECTION FUND FOR POOR – SSKHEALTH PROTECTION FUND FOR POOR – SSK

• Control Group is identified– Census is ongoing

• Base line research is ongoing – Methodology finalized– Household survey – Exit interview– Facility survey– FGD

• Consultant for IT and Financial is in the process

IT STRUCTURE FOR HEALTH INSURANCEIT STRUCTURE FOR HEALTH INSURANCE

• Concept shared with IT expert from – Oslo University– DHIS2 team– PATH

• Development of UHC indicator dashboard is ongoing

READY MADE GARMENTS – HEALTH READY MADE GARMENTS – HEALTH INSURANCE PROJECTINSURANCE PROJECT

• Benefit package developed• Baseline work completed• Willingness To Pay study is to be done

CIVIL SERVANT HEALTH INSURANCE CIVIL SERVANT HEALTH INSURANCE SCHEMESCHEME

• Concept paper is in development process• Benefit package is in development process

NATIONAL HEALTH ACCOUNTSNATIONAL HEALTH ACCOUNTS

• 4th round completed – BNHA 1997-2012• Technical working committee and Stakeholder

coordination committee endorsed the updated BNHA framework and estimates

• Meeting of national steering committee is in process

• Dissemination at national and divisional level will be done from this month

RESEARCH - OngoingRESEARCH - Ongoing

• Baseline evaluation of SSK• Health In All Policies• Health Care Seeking Behavior of Urban Slum

People

COLLABORATIONCOLLABORATION

• Institute of Health Economics, Dhaka University

• WHO• icddr,b• GIZ• KfW• Rockefeller foundation

Future PlanFuture Plan

Short term• Enactment of national health protection Act• Develop Roadmap for achieving UHC in

Bangladesh• Start the SSK pilot project• Start the RMG pilot project• Resource allocation formula piloting• Finalize the civil service insurance packages

Future PlanFuture Plan

Mid Term• Restructure and reorganization of HEU• Start the health insurance package for civil

servant• Ensure quality health care services

THANKSTHANKS