Many JLN member countries are promoting access to high-quality primary health care (PHC) services in their pursuit of universal health coverage (UHC). A key step is often defining a PHC benefits package, but for that package to work well, policymakers have found they must address various complementary policies simultaneously, creating holistic health benefits policies.
Methods such as health technology assessments exist to help policymakers determine relative cost-effectiveness of goods and services for a PHC benefits package, but there is a lack of practical guidance on how to align these with available resources, policies, practices, and stakeholders in a particular health system.
For example, how can policymakers align promised coverage for caesarian section deliveries with limited availability of anesthesiologists; or promotion of preventive services with existing practices that heavily incentivize hospital care-seeking? As they design or revise a PHC package, JLN members want to know where to start, what to consider, and how to proceed amid these many interrelated and moving parts.
JLN member countries convened the Health Benefits Policy (HBP) collaborative because they believed joint learning could help them bridge this resource gap—for themselves in the short term and for others in the future.
The objective of the collaborative is to co-develop roadmaps and guidance based on lessons learned from countries in various stages of PHC-oriented benefits policy reform. Participating policymakers can learn and adapt successful strategies immediately as they co-develop these resources, connect them with existing global best-practices and expertise on benefits package design, and share final products with peer countries.
What Are Health Benefits Policies?
Put simply, health benefits policies (HBP) comprise a government’s strategy and policies to ensure coverage of access to primary health care services.
Effective HBPs clearly articulate objectives of PHC-oriented policies, use those objectives to define a PHC benefits package and deploy a range of complementary policies to ensure coverage of access to services in the package.
Next Steps for the Health Benefits Policy Collaborative
The HBP collaborative developed a roadmap/framework in 2015-16 through several in-person and virtual meetings, which combined international expert advice and JLN member country experience.
Several collaborative teams will next apply the framework in their countries to
generate useful recommendations for themselves or other domestic policymakers
involved in HBP reform. These case studies will be written by policy advisors and
experts who have recently concluded or are currently revising primary care benefits policies.
The policymakers will document their experience engaging with the HBP Framework domains, explain the challenges they faced, and the solutions created to overcome barriers to success—sharing findings with peer teams from other countries as they work.
Ultimately, the HBP collaborative plans to use these case studies to “crowdsource” a resource compendium for policymakers currently addressing their own PHC benefits policies.
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A multi-stakeholder survey design to help countries assess whether their health financing approaches are well aligned with primary care initiatives.