Many countries and agencies are strongly committed to the goal of Universal Health Coverage (UHC) in health. This five-day course applies the Flagship analytic framework to enable structured and strategic thinking about how to move health systems towards Universal Health Coverage.
Policy-makers from ministries of Health, Finance and Social Security/Insurance and their development partners will engage in systematic analysis of the challenges, opportunities and potential risks associated with using different policy levers to move health systems towards Universal Health Coverage. The course approach and purpose is not advocacy but analysis. During five days of intensive interaction with peers and faculty, participants apply tools and concepts to assess where their health systems are relative to their coverage goals, the determinants of progress and health system performance, and feasible policy options.
The course premise is that Universal Health Coverage is not an end in itself, but a means—a means to better health, financial protection, and user satisfaction. Moreover, there are many possible paths towards Universal Health Coverage. A country’s starting point – defined by its existing patterns of financing, service delivery and financial protection mechanisms, as well as each country’s economic, political and social situation – determines which directions are feasible.
Participants will consider the extent to which different population groups have access to the health services they need, and their level of financial protection when using those services. The course will emphasize that what really matters is not coverage “in principle” or “on paper” but the actual, effective availability of health services, taking into account the costs to users and payers, and service quality/effectiveness. Affordability is always a concern and a constraint. New policies and programs aimed at achieving Universal Health Coverage may generate future entitlements and expectations that can easily overwhelm systems. This makes it essential to ensure that new entitlements are matched by expansions of services – whether provided by the private or non-profit or public sectors. Prevention and health promotion are vital – the healthier the population, the more feasible and affordable is UHC.
The Flagship framework takes participants beyond the design of health systems and their financing to also consider important ethical and political issues, and the different interests of the main groups and stakeholders affected by health policies (e.g., health care providers, patient groups, international pharmaceutical companies, private sector entrepreneurs, etc.). Most importantly, the Flagship approach focuses attention on implementation issues, such as organization and management, regulation, the design of payment systems, incentives and mechanisms for behavioral change, and the capabilities that are needed for successful implementation of different policy options.
The course methodology uses case studies specifically related to Universal Health Coverage. Group work sessions give participants the opportunity to apply the course concepts and content to the specific situation in their own countries, and to interact with and draw on the experiences of other participants/countries. Participants will gain a clearer sense of the options, opportunities, constraints and priorities in considering the next major steps towards UHC in their country.
Topics/themes that will be discussed/analyzed during the course include:
- What Universal Health Coverage involves and its relationship with ultimate outcomes
- Different strategies for promoting Universal Health Coverage
- The Flagship framework – enhanced to include the health system “building blocks”
- Ethics and the political economy of Universal Health Coverage
- Intermediate outcomes: quality, efficiency and access
- Financing options for Universal Health Coverage
- Paying and reimbursing providers
- Expanding coverage and the design of benefit packages
- Setting priorities and controlling expenses
- The importance of health promotion and prevention in making UHC feasible
- Improving performance in the public sector to expand coverage
- Engaging the private sector in helping achieve Universal Health Coverage
- Leadership for implementing change