What is the Joint Learning Network for Universal Health Coverage?
The JLN is a network of countries that are implementing reforms to achieve universal health coverage. Practitioners and policymakers from JLN member countries share knowledge and co-develop new products that focus on the practical implementation challenges of achieving UHC. By pooling their collective knowledge, members can more quickly find solutions to address tough reform challenges and accelerate national progress towards UHC.
How can my country become a JLN member?
The JLN accepts new members on a rolling basis. New applications are approved by a global Steering Group that is comprised of member country and donor organization representatives. Our current membership includes 27 countries in Asia, Africa, Europe, Latin America, and the Middle East at different levels of development and different stages of health systems reform. To initiate an application, a senior government-level representative should submit a short expression of interest (1-2 paragraphs) to the JLN inbox (JLN@r4d.org).
What is People-Centered Integrated Care (PCIC)?
PCIC represents an emerging care model that ultimately aims to improve the effectiveness of health service delivery – a key component of Universal Health Coverage – and aims to provide the right service, at the right place, at the right time, and at a cost affordable to society and individuals. PCIC organizes care around the health needs of individuals and treats patients as people, rather than cases of disease, by integrating care delivery across provider settings. The World Health Organization framework for PCIC includes a broad range of strategies and attributes for people-centered health services delivery, including the central role of primary health care (PHC) as the entryway into the delivery system.
The increasing burden of non-communicable diseases (NCDs), rapidly aging societies, fragmented care delivery, and a tendency for health systems to focus on more reactive treatment than on better health drives many countries to turn to PCIC. JLN country leaders have signaled a desire to explore approaches to redesigning existing delivery systems to better meet population health needs through PCIC strategies. The PCIC Initiative will support JLN countries in collaboratively identifying appropriate elements of PCIC on which to focus and defining the sequence of implementation strategies most likely to result in desired outcomes.
When will the Service Delivery/PCIC Initiative be launched? What is the timeline for this work?
This grant will support a JLN learning exchange on the topic of PCIC vertical integration, which will be led by Aceso Global. This exchange aims to: (1) strengthen care integration across provider settings, (2) support the planning and design of PCIC-oriented vertical integration initiatives through activities and knowledge products, and (3) promote cross-cutting activities and close collaboration with other JLN technical initiatives, especially those related to aforementioned Service Delivery Collaborative. It is anticipated that the scoping and planning phase for the learning exchange will commence May or June of 2017 with implementation by October, 2017.
What does the Provider Payment Mechanisms (PPM) Initiative focus on?
A core challenge that most countries will face as they work towards UHC is how to pay for services to ensure effective coverage and promote quality while maintaining financial sustainability. All payment mechanisms involve trade-offs and may lead to unintended consequences, making it challenging for practitioners and policymakers to select appropriate payment methods, design and implement them effectively, and monitor whether they are supporting service delivery objectives and UHC goals.
The objective of the PPM Initiative is to enable countries to develop improved knowledge, resources, and use of robust provider payment systems that ensure efficiency, quality, and financial sustainability. In the first five years of the JLN PPM Initiative, countries focused on co-producing tools and guides to support the provider payment policy cycle, creating a foundation to better leverage incentives and provider payment for universal coverage. JLN countries have articulated, however, that a gap continues to exist in understanding how different payment systems can work together and be harmonized to create the right incentive environment to support and advance integrated health service delivery, and the PPM Initiative will continue to focus on this and related areas as its work moves forward.
What does the Information Technology (IT) Initiative focus on?
In many developing countries, information and communication technology (ICT) leaders working to implement UHC are grappling with the fact that, although their insurance information systems are just now being formed, there are often underlying legacy health information systems that have historically been used to collect data for managing health care service delivery quality. Similarly, national electronic health (eHealth) leaders struggle with how to link disparate information systems and harmonize many primary care projects that are often funded outside of the official health system—projects that collect data in slightly different ways, each in different information systems.
The objective of the IT Initiative is to increase country knowledge and resources for leveraging IT to effectively and efficiently support health care service provision and pay for those services through sustainable health financing operations. Moving forward, country participants have articulated challenges and interest in exploring health IT topics related to improving payer operational efficiencies, increasing interoperability between health care delivery systems and payer systems, and increasing capacity around health informatics.
How can my country get involved in the new and existing JLN initiatives?
A call for Expressions of Interest (EOIs) will be forthcoming to allow countries to get involved in the Service Delivery, PPM, and/or IT initiatives. EOIs are typically a 1-2 page document that:
- Summarizes how the topic is of high relevance in the country’s current UHC policy agenda;
- Highlights particular experience or tools that the country can share; and
- Identifies representatives and summarizes their professional background and position, demonstrating relevance to the topic (see the list of possible participant types below);
The technical facilitation teams will review all Expressions of Interest and make every effort to accommodate all countries for which the topic is of high relevance to the country’s UHC agenda. The country should also have significant experience to share with other members. Though we welcome interest from all member countries, the JLN technical initiatives do aim to manage the size to build a close-knit community of peers and to allow for maximum participation and exchange. Therefore, space for new members may be limited. Any tools or products produced by the will be made public so that all countries will be able to benefit.
What types of individuals should be involved?
If your country is interested in joining any of these initiatives, we would like your assistance in helping to identify a team to participate. To maximize the potential for learnings to translate to action, it is important that the participants who are identified form a small team and can demonstrate the following success factors:
- Their commitment to action at home, such that their complementary strengths can be channeled towards collective action and improvement;
- Their focus on improvement as the ultimate objective, with a strong team member who is focused on building capacity for improvement;
- Their current involvement in implementing, monitoring and/or analyzing in areas relevant to the topic such that the initiatives can focus on concrete challenges and solutions;
- Their understanding of the complexities involved in the work;
- Their time availability and ability to engage continuously with the initiative.
What is the level of commitment expected from involvement in this work?
Each member country will designate representatives to:
- Regularly participate in virtual and in-person meetings to share experience;
- Gain access to the JLN member portal (http://www.jointlearningnetwork.org/), where countries can ask questions and share work in progress, ideas, and tools; and
- Contribute to the global evidence base on the identified topic.
What does the Country commit to?
Regular and active engagement in virtual and in-person meetings;
Contribution of feedback on the country’s experience by presenting country experience during virtual and in-person meetings;
Contribution of country examples and technical inputs to any tools that are co-produced.
What support will be provided to country participants?
The JLN will provide funding to support the participation of identified representatives in in-person meetings. Full and associate member countries may also access support via the Joint Learning Fund.
What is a Country Core Group? How can I obtain support for creating a Country Core Group?
The core strength and sustainability of the JLN lies in its country ownership, which allows the network to articulate country demand and co-create responsive products. A Country Core Group (CCG) is an in-country stakeholder group with representatives from key institutions supporting a country’s UHC efforts. A CCG is responsible for defining and communicating country priorities and ensuring learning is shared and applied within country. CCGs deepen network engagement at the country-level by bringing together representatives from key institutions engaged in UHC reform. CCGs identify country specific priorities, coordinate JLN activities at the country-level, ensure that learning from global JLN activities are shared and applied within the country, and document country experience to share across the network. If interested in forming a CCG, please reach out to the JLN Network Coordinator at email@example.com for more information.
What type of support can I receive from the World Bank in creation of a country core group or other such JLN coordination mechanism at the country level?
The World Bank aims to provide support to the creation of new Country Core Groups and strengthening of existing country-level coordination mechanisms. For example, it can support the creation of the Country Core Group and communicate with senior leadership in the healthcare sector to inform about the Joint Learning Network and how it can benefit the country. Local offices can make available, where feasible, venue and communication facilities for the Country Core Group to connect with other JLN stakeholders and join or organize webinars of the network. The World Bank also strives to help identify partners with technical expertise and/or financial support to help sustain the network.