Just how can health benefits packages strengthen effective, efficient, and equitable delivery of primary care services? That was the question at hand at a recent “mini-exchange” in Hanoi, Vietnam last week, which brought together JLN members from India, Malaysia, and Vietnam.
The “mini-exchange”, facilitated by the JLN Primary Health Care Technical Initiative, enabled participants to:
- Share respective experiences surrounding benefits package design and implementation;
- Identify common challenges associated with benefits packages;
- Begin formulating a framework or tool to support the improved development, implementation, and adjustment of benefits packages for primary health care.
Participants in this mini-exchange included Dr. Kamaliah Noh, Deputy Director of Primary Care for the Malaysian Ministry of Health, Dr. Shambu Kallolikar, Principal Secretary for the Health System Project in Tamil Nadu, India, as well as several leading members from the host organization, the Health Strategy and Policy Institute (HSPI), who is working directly with the Vietnamese Ministry of Health on the structuring of the national package of basic health services. The mini-exchange was facilitated by Marty Makinen, Carleigh Krubiner, and Cicely Thomas from Results for Development with Dr. Ricardo Bitran, a leading expert in benefits package design.
Day 1 and 2 – Developing a Framework
Together, the group identified the need to consider PHC benefits package design and adjustment within the broader context of the health system – assessing strengths and limitations – to ensure that primary services detailed in the package can be sufficiently financed and delivered equitably, efficiently, and with high quality. The participants also discussed the need to complement benefits packages with additional inputs, ranging from innovations in payment mechanisms, to capacity building efforts, and in some case, mobilization of greater resources.
During the first two days of exchange, participants developed a preliminary framework to holistically approach design elements for PHC benefits packages. They further identified core elements of the framework through a focused examination of the benefits package in the Vietnamese context. This framework will be further developed and collectively produced over the coming months, with rich case studies from each participating country.
Day 3 – Making Site Visits
On Day 3, Vietnam’s Health Strategy and Policy Institute (HSPI) organized a site visit to Hai Duong province, where participants were able to physically observe health facilities in motion and connect with key health providers, management, and other staff. They started the day off at the Tu Ky District Heath Center, where they had the opportunity to pose questions about PHC delivery to a panel of key informants, including the directors of the provincial Department of Health and district health centers, the deputy director of the district hospital, the head of a commune health station (CHS), and a private clinic owner. From there, the group toured a CHS and private clinic, where they were able to see the facilities and ask further questions from providers, management, and staff.
The “mini-exchange” was a success. It not only provided a platform for participants to share their knowledge and experiences on benefits package design, but also enabled them to work together to jointly identify the key elements of a guiding framework with broad applications. The site visit promoted a deeper understanding of the PHC delivery system in Vietnam, providing critical perspectives from the range of actors involved in preventive, promotive, and curative care.
The JLN PHC Initiative extends its deepest appreciation and gratitude to HSPI for hosting this mini-exchange, especially Dr. Khuong Anh Tuan, Dr. Nguyen Khanh Phuong, and Dr. Hoang Thi Phuong, and thanks all the participants of the meeting for their invaluable contributions to this work.