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HEALTH SECTOR

This presentation by Christine Bousquet discusses key trends at the policy level within the health sector. It emphasizes the need for a strategic framework and coherent policies to enhance healthcare access, particularly in underserved areas. The talk covers the importance of NGOs in building healthcare systems, monitoring changes at the national level, and promoting consumer voice. Additionally, it addresses challenges such as the role of the private sector, public-private partnerships, and the necessity for improved resource allocation to ensure the sustainability of healthcare initiatives.

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HEALTH SECTOR

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  1. HEALTH SECTOR ( Presented by Christine Bousquet, Independent Consultant)

  2. Key trends at policy level • Emphasis on a strategic framework and a coherent policy • Increasing health care in underserved and remote areas • Building of health system through contracting bodies (NGOs) • Promotion of increased consumer voice

  3. Among the main achievements: • A structured health system is functional with increased level of activities • Lessons learning process at all levels with improved collaboration, communication and transparency • Improved system in place for monitoring

  4. Actors of change at national level • Progress towards a strong institutional leadership and ownership • Donor efforts to coordinate external resources • A step further: pooling of donor funds • Increased role of universities

  5. Actors of change at field level(1) The Provincial Public Health Departments: • Increased role for coordinating operators, monitoring and problem-solving • Building capacity through PRR process • But strong reliance upon NGOs with unclear mechanisms for allocation of funds

  6. Actors of change at field level (2) • NGOs as non-state providers: fast in adapting to the new context with a risk of becoming “institutionalised” • Other NGOs as agents of social changes • Increased community participation

  7. Limiting factors to change: (1) The private for profit sector: does it matter? • Studies examining the efficiency and quality of private care are lacking • Limited role of private medical care in preventive interventions • Lack of consumer protection or regulation

  8. Limiting factors to change (2) The blurred line between public and private: • A majority of health professionals seek alternative sources of income • Forces to change fundamentally this system are weak • The contractors may have little influence over the practices of health professionals • Possible negative impact on the quality of care, on ethics and professional values

  9. Some issues for discussion (1) The necessity to take into account the private for profit sector: • Building public-private partnerships • Lobbying for regulation and enforcement • Performance based as opposed to process based • Are financial bonuses sufficient: what is the role of other incitation mechanisms (career, professionalism, media, peer pressures, law)?

  10. Some issues for discussion (2) The BPHS implementation: • Has gone fast • With an increased scope of activities How to maintain focus on results without compromising quality?

  11. Some issues for discussion (3) • Increased importance of national NGOs • The implementation of EPHS may remain with the MOPH • Some NGOs are responding to specific needs • How will the NGOs evolve in the future and what will be their added value?

  12. Some issues for discussion (4) Increasing the overall level of resources: • The current system is only sustainable if donor money continues to be forthcoming both for BPHS and EPHS • But uncertain level of donor commitment for the future • What can be the alternatives?

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