Supported By
Organized By
Background
Universal health Coverage (UHC) is an important issue for both developed and developing country. Recognizing this, in 2005 the Member States of the World Health Organization (WHO) adopted a resolution by encouraging countries to develop health-financing systems with the aim to provide universal healthcare coverage. This was defined as ensuring equitable access, by all citizens, to essential and appropriate preventive, promotive, curative and rehabilitative health services at affordable cost. In addition to financial risk protection, the Universal Health coverage incorporates three complementary dimensions, i.e., the extent of population coverage or ‘breadth’, and the extent of health service coverage or ‘depth’ and level of financial coverage of these benefit packages such as copayment and deductibles (height). Many developing countries question its sustainability and achievement, particular on the health financing systems and health services provision. Thailand is not an exception, although we have achieved UHC since 2002, we are still facing such problems as equity, service quality, accessibility, and escalation of medical care expenditure. Nevertheless, with 10 full years of experience and knowledge from both local and international experts, we do have individual, institutional and network capacities to share and learn from other developing countries, in the region and beyond. With the WHR 2010 on UHC, the WHA 2011 resolution (WHA 64.9) and the movement towards a UNGA discussion on UHC in the forthcoming session, it is very timely to create a mechanism whereby developing countries can work together to share their experience and knowledge, to build more capacity, and to collectively move towards UHC.
Program Goal
To establish a sustainable mechanism to promote technical collaboration to ensure successful policy formulation and implementation on Universal Health Coverage (UHC)
Program Objectives
- Plan and convene activities on south-south technical collaboration on UHC aiming at building up sustainable capacity in developing countries, in all essential areas of UHC including the resource mobilization, provider payment, use of IT, governance, and health systems reform based on UHC. These activities include active arrangement, or well prepared managed workshops, field visits, internship, apprenticeship, as well as possible technical assistance services. International resource persons will also be mobilized to support these activities.
- Support development of sustainable technical capacity in other developing countries that are moving on achieving UHC.
Program activities to serve different targeted participants
- Policy level workshops. These workshops aim at building knowledge and capacity to advocate and formulate appropriate UHC policy as well as building necessary mechanisms, governing structure, and environment to support successful implementation. This workshop would be 3-5 days with field visits. It will be mainly based on the Thai experiences. However, experiences from other developing countries, including the participants, as well as the developed countries will also be discussed.
- Technical level workshops. These workshops aim at building technical capacity on the essential technical skills that are important to the successful implementation of the UHC policy, including but not limited to resource mobilization and costing, provider payment mechanisms (including essential tools such as capitation, global budget and case mix tools), essential information and IT, complaints handling and compensation, and other essential technical skills. Initially, it is planned to convene one 7-10 days workshops per year and when there are more demand, two workshops per annum is envisaged.
- Tailor made activities based on request. These activities will be arranged to respond to special requests of participants or/and potential partners. These can be tailor made field visits or workshops as well as consultancy services and opportunity for fellowship and intership
Organizations involved
There are seven organizations involve in this training course for international participants including HSRI, HISRO, IHPP, HITAP, HA, NHSO, NU. Experts from these agencies would serve as faculty for the training workshop. They are responsible for detail design of the course modules, including detail objectives, content of the module, reading materials and references, preparation of power points for presentation, discussion points. The coordinating office is HSRI, as it has the most comparative advantage to convene partners.
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Experts from several agencies would serve as faculty for the capacity building.
- Dr. Suwit Wibulpolprasert, Senior Advisor on Disease Control, Ministry of Public Health (MOPH)
- Dr. Winai Sawasdivorn, Secretary General, National Health Security Office (NHSO)
- Dr. Viroj Tangcharoensathien, Senior Advisor on Health Economics, Ministry of Public Health
- Dr. Pongpisut Jongudomsuk, Director, Health System Research Instituted (HSRI)
- Dr. Samrit Srithamrongswat, Director, Health Insurance System Research Office (HISRO)
- Dr. Phusit Prakongsai, Director, International Health Policy Program Thailand (IHPP)
- Dr. Yot Teerawattananon, Director, Health Intervention and Technology Assessment Program (HITAP)
- Dr. Jadej Thammatacharee, Director, Bureau of Policy and Plan, National Health Security Office (NHSO)
- Dr. Tassanee Channoi, Director, Thai Case-mix Centre (Thai-CMC), HSRI
- Dr. Anuwat Supachutikul, Director, Healthcare Accreditation Institute (Public Organization)
- Dr. Pinij Faramnuayphol, Director Health Information Development Office.
- Dr. Supasit Pannarunothai, Dean, Faculty of Medicine, Naresuan University.
Course Module
- There are a number of half- and full-day modules relevant to policy makers and practitioners and implementers:5 Tracks, 13 Modules
- The design of each workshop will be tailored-made to the country needs and specific requests for which the results of country assessment are helpful in the design.
- An interactive discussion with proposed participants of the program to ensure their interests are captured.
Course Modules 5 Track, 13 Modules
| Modules | Track 1 | Track 3 | Track 3 | Track 4 | Track 5 |
| Policy makers 2-3days [4-6 half day slots] | Technical levels 5-6days [10-12 half day slots] | Special requests for technical level, 1-2 weeks (days) | Internship 4weeks 20 working days (days) or based on special requests | On site support [low cost for country], 2-3 Thai experts 5days [10 slots] |
| 1. A to Z: overview what is and how to? 1/1day (plus Overview of Thai health delivery system and Quality of healthcare ) | 2 inclusives | 2 | 1 | | 1 |
| 2. Population coverage expansion, ½day | ½ | 1 | | | 1 |
| 3. Policy process towards UHC, 1/1day | ½ | 1 | | | 1 |
| 4. Policy implementation, ½ day | ½ | 1 | | | 1 |
| 5. Design of benefit package, ½day | | 1 | | | 1 |
| 6. Effective purchasing and provider payment, 1/1day | | 1 | very popular 3days | 5 | 1 |
| 7. Intelligence of health systems, ½day | ½ | 1 | | | 1 |
| 8. Information systems for schemes, financial management and audit, 1/1day | | | very popular 1days | 5 | 1 |
| 9. Monitoring and evaluation of outcome , ½day | | 1 | | 5 | 1 |
| 10. Governance of insurance fund, ½day | | 1 | | 2 | 1 |
| 11. Field visit (health delivery systems), 1/1day | 2 including wrap up | 2 including wrap up | 1day | placement in field 3days | |
| 12. Quality of healthcare, ½day HA Institute | | | | | 1 |
| 13. Country report | | One country report on HS and financing profiles | Produce existing mechanisms on areas of concerns | Produce existing mechanisms on areas of concerns | One country report on HS and financing profiles |
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Module details
| Course modules |
1. A to Z: overview of ‘what is what’ and ‘how to?’ (plus overview of Thai health delivery system and quality of healthcare ) - Half day walk through for policy makers on what UHC is (plus)
- Overview of Thai health delivery system, including referral system, human resources for health and quality of healthcare.
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2. Population coverage expansion experiences: the long march from targeting to universality- The poor covered by the welfare scheme
- Public and private sector employees covered by Social Health Insurance system
- The informal sector covered by voluntary public subsidized insurance scheme
- The path towards UHC and overall of UHC: CSMBS, SHI and UCS
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3. Policy process towards UCS which includes - Context, actors and the interaction among policy makers, technical experts and civil society
- Window of opportunities and the vital role of policy opportunists
- Political agenda setting in favour of UCS
- Policy formulation and contents of UCS, UHC Cube: three dimensional matrix of population coverage-breadth, service coverage-depth and financial risk protection-height
- Policy choices on priority population groups to be covered: the formal sector private employee or the poor and vulnerable,
- Policy choices on financing of insurance schemes for the informal sector: crossroads between contributory and tax financed schemes in the light of limited fiscal space
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4. Policy implementation- Health systems resilience to rapidly scaling up to nation-wide coverage
- Management of change, adaptation by healthcare providers in light of major reform e.g. from supply side financing to demand side
- Transition from integrated model (with MOPH playing the combined role of purchaser and services provider) to purchaser-provider split
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5. Design of benefit package- Role of evidence on cost effectiveness, and other dimensions such as ethical concerns, prevention of catastrophic health spending and health systems capacity to deliver new interventions
- Inclusion of health promotion and diseases prevention into the benefit package, should focus both on clinical service and community settings
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6. Effective purchasing and provider payment- How to design, enforce and monitor contractual agreement by purchaser organization
- DRG development and implementation: data and technical requirements,
- Capitation: estimation and application for purchasing primary care services: data and technical requirements
- Costing of hospital services: a foundation for development of sustainable provider payments
- Positive and negative experiences from fee for services provider payment methods in Thailand, and non-successful reform experiences
- Performance-related payments for staff
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7. Intelligence of the health systems:- Capacity building in health policy and systems analysis in support of UHC
- Benefit of networking of these agencies
- Effective mechanisms in translating evidence to policy decision
- What lessons were learned and how the successes can be replicate in your countries
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8. Information systems for scheme and financial management- Beneficiary registration,
- Clinical data management
- Field visit on how it operates
- The systems design of essential information in support of transactions, monitoring quality and outcome
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9. Monitoring and evaluating the outcome of UHC - Equity in utilization, financial risk protection against catastrophic health expenditure and impoverishment across rich and poor groups, equity in budget subsidies (benefit incidence analysis)
- Household level data platform such as national representative household surveys by NSO e.g. SES, HWS, MICS, which facilitate regular monitoring of impact at household levels.
- Administrative data platform for regular monitoring of clinical outcomes and practice variations such as national IP dataset
- Feedback loop from M&E results for policy fine tuning and reorientation
- What lessons were learned and how they could be replicated in your country
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10. Governance of insurance fund of NHSO- Participatory process of decision making: NHSO board, committee and subcommittees
- Mechanisms to ensure good governance of insurance fund management
- Mechanisms to ensure responsiveness of insurance fund to beneficiaries, listening to the patients’ views, hotline 1330, and grievance management
- Mechanism to ensure healthcare providers are satisfied with the services and financing, regular poll monitoring (both patients and providers)
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11. Field visit to implementation sites such as - Visit to purchaser organization: essential functions such as information systems, Information Technology, claims management and audit, quality monitoring, centrally managed programs such as dialysis, central bargaining and bulk procurement of essential medicines,
- Protection of client: hotline services, complaints management and conflict resolution
- Governance of purchaser organization
- Healthcare providers: at district, provincial and central level, role of primary care gatekeeper,
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12. Quality of healthcare- What mechanisms and instruments applied by purchaser organization to improve and ensure quality standards of care are provided to their clients
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13. Requirement: one country one report - Each country team is required to produce a brief country situation analysis to ensure participants enjoy maximum benefit from the workshop
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*Working language English
*Venue Bangkok, Thailand
* First Training of 2012
Monday February 27th ~ Saturday, March 3rd, 2012
*Application information
Application deadline: 3 February 2012
Program Requirement
We have requirement for this training, to ensure participants enjoy maximum benefit from the training and support countries in achieving Universal Health Coverage,
- Participants are encouraged to apply as a group of at least 3 people from the same country. Thai would help facilitating a group discussion using participants’ country experiences as inputs in program learning activities.
- Each country team is required to produce a country report of situation analysis (if possible before the start of program activity). This would help preparing data to support discussion and information sharing among participants from different countries.
For more Information please contact
CAP UHC Training Program..
Health Systems Research Institute (HSRI)
National Health Building,Ministry of Public Health, Nonthaburi, 11000
Ms Wilailuk Wisasa/Program Coordinators
Email: wilailuk@hsri.or.th , http://www.hsri.or.th/en
Tel:+66-84-751-1633/ Fax: :+66-2 -832-9201
And websites of our related organizations at
http://www.nhso.go.th/eng/page-uhc.html
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