Recordings: How to achieve UHC goals with health financing reforms — top experts share insights

March 2, 2023

WASHINGTON, D.C. — At the Seventh Symposium on Health Systems Research (HSR2022) in Bogotá, Colombia, health financing experts from 13 countries discussed how to achieve the desired results from policy reforms. These discussions were recorded and are now available to the public.

As countries undertake health financing reforms to advance toward universal health coverage (UHC), the desired outcome or objectives of the reform, are often conflated with the instruments for achieving them. This has led to a proliferation of UHC pilots and schemes, as well as initiatives focused on specific interventions or diseases, that may be misaligned, or even work against, the objectives the reforms seek to achieve.

Over the course of four sessions high-level experts from national governments, academic institutions, NGOs and multilateral organizations discussed what it means to design “ends-driven” health financing reforms, and shared specific examples of challenges and progress.

Joe Kutzin, former coordinator for health financing at the World Health Organization, kicked off the series with the following questions: “How do we get the question right? If the question is: How do I subsidize the poor and get everyone else to contribute? Then I pretty much only have one policy option. But if it’s instead how to improve effective service use and with financial protection for people outside of the formal sector, then there are many policy options. So, it’s really about getting that question right, and also taking the entire system and population as the unit of analysis.”

Recordings of the sessions can be found below.

In session one, experts shared concepts and country experience from Argentina, Ghana, Malaysia, Mexico, and Uganda that illustrated the practical importance of separating ends (the objectives a reform seeks to achieve) and means (the instruments for achieving health systems reforms).

In session two, experts shared experiences from Burkina Faso, India and Tanzania targeting public spending on those most in need while strengthening foundations for universality in fragmented health financing systems.

In session three, experts focused on the theme of integration — how to achieve greater efficiency through cross-program integration, including across donor programs, how to achieve greater integration across sectors and how to achieve greater integration across different levels of government.  Country examples included Rwanda and Kenya.

In session 4, experts from Benin, Burkina Faso, India and Mexico discussed how to pursue ends-driven research at the systems level. The session discussed the challenges and opportunities for ends-driven research and proposed research questions to be taken forward.

The sessions were organized by Results for Development, the WHO, ThinkWell, Wellcome Trust and the Strategic Purchasing Africa Resource Center. They featured 18 speakers from Argentina, Benin, Burkina Faso, Ghana, India, Kenya, Malaysia, Mexico, Rwanda, Switzerland, Tanzania, Uganda and the United States.

Speakers included: Susan Sparkes, WHO; Joe Kutzin, WHO; Nirmala Ravishankar, Thinkwell; Octavio Gómez-Dantés (National Institute of Public Health, Mexico); Martin Sabignoso (Independent consultant, Argentina); Michael Reich (Harvard T.H. Chan School of Public Health); Joel Arthur Kiendrébéogo (RESADE, Burkina Faso), Kéfilath Bello, (CERRHUD, Benin); Wangari Ng’ang’a (Senior Program Officer, Bill & Melinda Gates Foundation; Board Member, R4D); Gemini Mtei (Abt Associates, Tanzania); S Pierre Yameogo (MOH, Burkina Faso); Parfait Uwaliraye (MOH, Rwanda); Aliyi Walimbwa (MOH, Uganda); Grace Achungura (WHO, India); Praneetha Vissapragada (University of Michigan); Scott Greer (University of Michigan); Nat Otoo (R4D); Rozita Halina Hussein  (Ministry of Health, Malaysia); Hélène Barroy (WHO, Switzerland); Agnes Munyua, (R4D/SPARC); Cheryl Cashin (R4D/SPARC); Edwine Barasa (KEMRI/Wellcome Trust).


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