The need to strengthen primary health care is gaining momentum with countries across the globe as they tackle a milieu of challenges with rising health costs, emergence of non-communicable diseases, and growing population demand.
Members of the JLN’s Primary Health Care (PHC) technical initiative working together to co-develop the how-to’s of strengthening PHC-oriented health systems came together in a series of face-to-face joint learning activities in Seoul, in December 2017, to further advance their objectives.
Focusing on common policy and implementation challenges, the JLN’s PHC technical initiative is aiming to co-develop practical approaches to ensure that: (1) health financing choices enhance PHC, (2) both public and private providers contribute to PHC, and (3) evidence-based decision-making continually strengthens PHC systems. JLN country members have grouped into three collaboratives under the initiative – Private Sector Engagement, Health Benefits Policy, and Measurement for Improvement – to achieve these objectives.
Members from the Private Sector Engagement and Health Benefits Policy collaboratives met December 5-6 to share learnings from country implementation assessments and discuss their next steps as both the collaboratives near completion after starting out in 2015. The two collaboratives met as part of a week-long string of JLN events and meetings, hosted by South Korea’s Health Insurance Review and Assessment Service (HIRA), the National Health Insurance Corporation (NHIS) and the KDI School of Public Policy and Management, which included convening the JLN Steering Group and the Domestic Resource Mobilization collaborative.
Over the two days following JLN’s kick-off event on December 4, the two collaboratives took a deep dive with the country members on their experiences and challenges, and continued synthesis of practical knowledge on their respective topics.
Private Sector Engagement Collaborative
The Private Sector collaborative met for a face-to-face learning exchange, bringing together six countries including Ghana, Kenya, Korea, Indonesia, Malaysia, and Morocco to discuss active stewardship and engagement of both public and private sectors. The learning exchange focused on: (1) sharing experiences and preliminary findings from country assessments of the health regulatory systems that govern private primary health care; (2) co-developing lessons learned and recommendations from the regulatory system assessments across countries to inform the forthcoming Module 3 of the collaborative’s practical guide; and (3) discussing and reviewing an outline for Module 4 on contract management, the last module of the collaborative’s practical guide.
Through the session, members also reviewed the already produced content of the practical guide titled Engaging the Private Sector in PHC for UHC: Advice from Implementers for Implementers. Members engaged in a robust discussion to learn from the country assessments of the health regulatory system and synthesize the cross-country learnings. They examined the various facets of provider contracting for PHC to inform Module 4 of the Private Sector Engagement practical guide.
Health Benefits Policy Collaborative
In parallel, the Health Benefits collaborative met to share learnings from their country’s health benefits package implementation assessments, which describe how countries prioritized certain health objectives when creating their health benefits packages and shed light on if and how they engaged with certain policy domains to achieve those objectives. The collaborative included representation from Ghana, Kenya, Korea, Indonesia, Malaysia, Mali, Morocco and Vietnam.
The exchange focused on (1) sharing experiences and preliminary findings from the assessments to apply the health benefits policy framework developed by the collaborative in 2016 to each country’s unique experience in designing and implementing a new health benefits package; and (2) identifying common challenges and useful approaches from the assessments across countries to inform a synthesis report. Activities during the session included revisiting the health benefits policy framework developed by the collaborative to provide a structured way for policymakers to think through the potential objectives of PHC-oriented policy reform and the range of complementary policy domains that ensure those objectives are met. Members also participated in activities on prioritization of country health objectives; validation and synthesis of cross-country learnings from the benefit package implementation assessments; and implementation research presented by USAID’s HFG partners to help inform finalization of the assessments.
Cross-Cutting and Hands-On PHC Learning
On Wednesday, December 6, both collaboratives came together to reflect on the PHC initiative as a whole, including accomplishments thus far as well as priorities moving forward. Following a quick overview session on the progress of the initiative, country members participated in a knowledge “marketplace” where members presented their country’s work from their respective collaborative to other country members across the initiative, as well as to members of JLN’s Domestic Resource Mobilization collaborative. The activity afforded a unique opportunity to all participating country members to uncover common challenges across the collaboratives and hear recommendations from other countries.
In the afternoon, members from both the collaboratives learned about the work of the Measurement for Improvement collaborative, the third concurrent collaborative under JLN’s PHC initiative. Members were given a preview of the collaborative’s soon-to-be-launched toolkit for their feedback, which created further synergies on cross-cutting PHC topics.
On December 7-8, PHC initiative members had the opportunity for a site visit to HIRA and NHIS headquarters in Wonju. During this site visit, participants learned about the Korean national health insurance scheme and were able to experience South Korea’s centralized data-centers first hand.
Looking Ahead with JLN’s PHC Initiative
In total, 21 PHC initiative members attended the week’s events, along with partners from USAID’s Health Finance and Government (HFG) Project and representatives from the Bill and Melinda Gates Foundation, a key supporter of the collaboratives.
Co-locating learning exchanges for PHC’s Private Sector Engagement and Health Benefits Policy collaboratives and holding them alongside wider-focused JLN events provided the members with a unique opportunity for integrating their learnings, while solidifying the JLN community around PHC. The rich agenda interlinking the sessions in Seoul allowed members from PHC initiative collaboratives to learn more about their colleagues’ work across collaboratives, revealing new insights into their own work. Members benefited from informal joint learning, while being able to support the development of global knowledge products for universal health coverage.
The final wrap-up session in Seoul saw a robust discussion on the future of the PHC initiative in which countries shared their upcoming priorities in relation to primary health care and discussed the kind of support that would be most useful from JLN’s future activities.
Meanwhile, for the global UHC community, three new PHC tools are in the pipeline, due for launch in the early part of 2018:
- The Private Sector collaborative will finalize country regulatory system assessments and synthesis report and outlines for Modules 3 and 4 of Engaging the Private Sector in PHC for UHC: Advice from Implementers for Implementers.
- The Health Benefits collaborative will also complete its country implementation assessments and develop a synthesis report, collating the country experiences.
- The Measurement for Improvement collaborative will integrate inputs from PHC initiative members, and finalize its toolkit in the new year.