Expanding universal health coverage from the ground up Dec 12, 2016

Expanding universal health coverage from the ground up

Advocating for universal health coverage (UHC) is one thing; designing and implementing health system reforms to make it possible is another story. The Joint Learning Network for Universal Health Coverage (JLN) partners with countries to jointly develop resources, including DIY guides and interactive tools, that address the “how to” of everything from how governments can engage the private sector in primary health-care delivery to how governments can assess their provider payment systems. What have we learned since the initiative was launched in 2010?

In just over 6 years, the JLN has grown from an idea to a key global knowledge exchange platform for UHC. This growth—and the progress that’s been made since 2010—was evident at the network’s first global meeting, which was held in Malaysia earlier this year. Countries shared examples of how they had put JLN tools into practice and they co-developed an expanding technical agenda focused on both the financing and delivery of health care. With nearly 30 countries actively involved, the JLN is rapidly increasing the number of technical collaboratives and strengthening its partnership with other global networks, such as P4H and the new UHC 2030 Alliance, to expand its reach and help countries overcome persistent barriers to achieving UHC.

Co-creation of knowledge products and policies is key

Technical learning collaboratives are the heart of the network. Countries join and actively participate because they want to extract concrete value in terms of technical solutions and implementation insights for their own policy challenges and to co-develop new, practical knowledge that can help them improve their systems, and not because they need to be part of yet another community of practice or global entity. The process of co-producing products is as important as the final result—members consistently say that they value the opportunity to devote time to this kind of effort because the process and products help them succeed in their jobs at home, and offer them exposure to approaches and experiences that they would not otherwise have had. When structured well, this work feeds directly into urgent policy and practice challenges within member countries by producing products and findings that policymakers need to advance priority objectives. A recent JLN member survey found that 60% of members had adapted JLN knowledge products in their country context. 

Stability of membership and quality of facilitation help determine success

Within these collaboratives, both the quality and stability of membership and the quality of facilitation are key factors in determining success. These collaboratives normally exist for about 2 years, time enough to plot out an analytic framework, review intermediate products, and co-produce final guides or tools. Thus, stable membership among country members is vital to the success of these efforts—getting value from the process requires the same people iteratively working together and jointly problem-solving over time. Read more.
Additional contributors to this post are Amanda Folsom (program director, Results for Development); Somil Nagpal (senior health specialist, The World Bank); and Modupe Ogundimu (general manager, Nigeria National Health Insurance Scheme, and JLN Steering Group Co-Convener).