Joint Learning Network for Universal Health Coverage

The Joint Learning Network for Universal Health Coverage (JLN) Expanding Coverage (EC) Track has developed a prototype country-level “information dashboard” – an interactive, electronic interface that will routinely synthesize data and display progress against key indicators related to expansion of coverage to disadvantaged and/or underserved populations.

EC Track members first voiced a need for readily available data on expanding health coverage at the June 2011 workshop, “Expanding Coverage to the Informal Sector,” held in Mombasa, Kenya. Workshop participants came together in a special session to brainstorm and prioritize information needs related to expanding coverage.

Between 24th and 27th September 2012, I participated, as part of Ghana’s team, in a workshop themed “Equity in Universal Healthcare Coverage: How to reach the Poorest” jointly organized in Marrakech, Morocco by the Moroccan Ministry of Health, the Financial Access to Health Services Community of Practice (FAHS CoP) and the Joint Learning Network for Universal Health Coverage (JLN).

The workshop provided an opportunity to review efforts by countries in Africa and Asia in their march towards universal health coverage for their populations. As the theme of the 2011 World Health Report, as well as of a number of international and regional conferences over the past 18 months.

In co-operation with the Moroccan Government and the Financial Access to Health Services Community of Practice (FAHS CoP), the Expanding Coverage Track of the Joint Learning Network for Universal Health Coverage (JLN) recently organized a workshop in Marrakech, Morocco on the subject of “Equity in universal health care coverage: how to reach the poorest”. Immediately following the four day workshop which took place from September 24-27, 2012, the JLN hosted a one day session member on September 28, 2012 for JLN member countries from Sub-Saharan Africa to review action plans developed over the course of the workshop and to collectively brainstorm potential areas for peer and JLN support.

This was the first time that a JLN sponsored event supported the participation of parliamentarians focusing on the health sector.

What do we know about how to effectively cover the poorest? What are the options? How can equity in UHC be measured? From September 24th to 27th, around 80 international experts from 12 countries will gather in Morocco. They will work on strategies to ensure that health systems reach the poorest. In this blog post, Allison presents the main objectives of the workshop.

There is enormous global interest today in “universal coverage”, which was the theme of the 2010 World Health Report, the just released Lancet series, as well as of a number of international and regional conferences over the past 18 months, including several focusing specifically on Africa. One key question remains that of access to health care for the poorest, sometimes referred to by policy makers as “indigents”.

While in Nairobi, R4D Program Director Stephanie Sealy and Program Officer Abeba Taddese met with representatives of the National Hospital Insurance Fund (NHIF), program managers for priority disease prevention and promotion programs, JLN partners and other stakeholders. The team held discussions with each of these groups to better understand NHIF priorities in prevention and promotion, the challenges that preventive and promotive programs face in Kenya, and to identify where NHIF could play a role in helping these programs reach their full potential.

As a result of these discussions, NHIF and the Expanding Coverage team will focus their work over the next few months on assessing non communicable disease prevention and promotion programs in Kenya.

On June 9, 2011, in Mombasa, Kenya, I made a presentation (in a “fishbowl” format) to the participants in the Joint Learning Network on Universal Health Coverage (JLN) workshop on covering the informal sector. During that session, I posed as an advisor to the Minister of Health of "Jasmania," a fictional country that is trying to expand universal health coverage to their informal sector.

I presented Jasmania’s situation and the issues I was confronted with in advising the Minister. I then asked a panel of experts comprised of JLN workshop participants from Ghana, India, Indonesia, Malaysia, and the Philippines to provide me with advice from their own countries experience. Session participants were also invited join in the discussion and provide advice.

I was grateful for, and impressed by, all of the advice and insights I received from the JLN panel and fishbowl participants.

The Joint Learning Network (JLN) for Universal Health Coverage held its third workshop, “Expanding Coverage to the Informal Sector,” in Mombasa, Kenya on June 6-10, 2011.

Over 120 country level policymakers and practitioners from Bangladesh, Cambodia, Ghana, India, Indonesia, the Philippines, Kenya, Malaysia, Mali, Nigeria, Rwanda, and Vietnam participated in four days of discussions and problem-solving on issues related to providing health coverage to poor and informal sector populations.

Delegations gathered on the first day for site visits of private and public hospitals in Mombasa including Pandya Memorial Hospital, Coast Provincial General Hospital, Mombasa Hospital and Jocham Hospital.

At the Mombasa workshop on expanding coverage, participants had the opportunity to participate in four site visits of Kenyan medical facilities, including one private and one public facility.

Touring Pandya Memorial Hospital, a not-for-profit private facility located on the coast of Mombasa, I was struck by the similar sets of issues faced here and many other hospitals – including our JLN member countries. These include quality, revenue generation, administrative logistics, and integration of information systems. The facility began in 1947 as a small clinic, comprising a maternity unit and surgical wing, and was the first private multiracial hospital in Kenya. It has since expanded to a 95-bed facility offering outpatient and casualty, laboratory, renal, maternal and child health services, among many others.

Our group had the opportunity to walk throughout various parts of the hospital, visiting the pharmacy, ICU, and general, children’s, and maternity wards.

Health Minister Aaron Motsoaledi unveiled South Africa’s national health insurance (NHI) plan last Friday that seeks to extend universal health coverage to all citizens by 2025. The plan will be phased in over the next 14 years, starting with pilot schemes in 10 areas in April 2012. The idea of extending coverage to all was first discussed at the African National Congress’s (ANC) 52nd Annual Conference in December 2007 and reinforces South Africa’s Bill of Rights provision that “everyone has the right to have access to healthcare services, including reproductive healthcare.”

Under South Africa’s current two-tiered approach, health care is heavily skewed towards the private sector. Though only 20% of South Africans seek care in the private sector, the majority of resources are concentrated there and it has effectively distorted pricing across the public sector.

At the Mombasa workshop on expanding coverage, participants had the opportunity to participate in four site visits of Kenyan medical facilities, including one private and one public facility.

Having flown in from 12 different countries, participants from Nigeria, Ghana, India, Mali, Bangladesh, Indonesia, Malaysia, Philippines, Vietnam, Rwanda, Thailand and Cambodia joined our Kenyan ho