Improving and increasing investments in the health outcomes of the poor

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Oct 28, 2013 (3 years and 8 months ago)

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WHO/OMS


Improving and increasing investments
in the health outcomes of the poor





Macroeconomics and Health

in
context







Dr. Sergio Spinaci, WHO

Senegal, February 2005

WHO/OMS

Presentation profile


Towards achieving the MDGs


Overview of Health Spending


Overview of national MH process


Macroeconomics & Health:Responses by WHO


Capacity
-
building at country level


Achievements in Ghana, India, Mexico and the
Caribbean


Conclusions

2

WHO/OMS



3

The CMH Report :
Towards achieving the MDGs


CMH recommendations support scaling up of
systems, financing and outcomes, essential
for achieving MDGs. Acknowledging that the
poor:



Suffer disproportionately from preventable disease


Are in danger of catastrophic out
-
of
-
pocket health
expenditures


Are subject to geographic, economic, and social factors
that limit access to care



WHO/OMS



4

Health Spending in selected countries

Source: Human Development Report, 2004.

WHO/OMS



5

Poor Suffer Disproportionately from Disease



Source: The Millennium Development Goals: Rising to the
Challenges. World Bank, 2004.


WHO/OMS



6

Catastrophic Health Expenditures



Number of people with catastrophic expenditure and
impoverishment due to health spending

Source: Evidence and Information for Policy, WHO

WHO/OMS

MH: Participating countries and regions

n


Africa
:



11 countries

West Pacific:

6 countries




Europe:

3 countries



The Americas :



2 countries, 3 sub
-
regions

(
Andean
Region, MERCOSUR,
Caribbean Community
)




South East Asia:


7 countries

Eastern

Mediter
ranean
:



6 countries




Countries
:
n
Engaged in macroeconomics and health work



n
Developing health and development plans



n

n

n

n

n

n

n

n

n

n

n

n

n

n

n

n

n

n

n

n

n

n

n

n

n

n

n

n

n

n

n

n

n

n

.

.

.


.
Sub
-
regional

Initiatives

7

WHO/OMS

8


Overview of national MH process



Advocacy:



Disseminate CMH findings and raise political commitment to health


Establish multi
-
sectoral technical groups and mechanisms to
implement the MH process


Research and planning:



Assess health situation and infrastructure (epidemiology, health
system capacity, funding gaps, cost analyses of investment options)


Establish health investment plans for prioritizing investment


Define implementation strategy



Implementation:



Implementation of health investment plan


Monitor MH process and long term impact


WHO/OMS




In this setting, WHO and its partners support the
linking of national health priorities with PRSPs,
achievement of MDGs, SWAps and other
development agendas.

MH: Responses by WHO

9

WHO/OMS

Capacity
-
building at country level


Foster sustained political support for long
-
term
investment in health



Improve coordination among stakeholders for more
effective policy dialogue (SWAps, cross
-
sectoral
support, etc)



Support MoH to produce a comprehensive health sector
strategy, linked to the MDGs, costed and budgeted in
line with MTEF



Ensure health is strongly reflected in PRSPs




Macroeconomics and Health supports countries to:

10

WHO/OMS

Capacity
-
building at country level


Focus on financing health systems that can deliver
essential health services for the poor and vulnerable



Strengthen institutions to manage increased
resources



Improve local capacity for country
-
relevant research
that inputs into national policy making



Strengthen monitoring and evaluation mechanisms,
including tracking resource flows for health

11

WHO/OMS

Case Study
-

Ghana



The Ghana Macroeconomics and Health Initiative (GMHI)
-

pro
-
poor
approach to expand essential health services and close to client
facilities.



The investment plan
-

collection and analysis of data on disease
burden, non
-
financial constraints, health expenditure and poverty at the
district level.



Revision of the Ghana Poverty Reduction Strategy (GPRS)
-

A step
towards operationalising the health and health related MDGs. The plan
is a key input into the revised Ghana Poverty Reduction Strategy and
the Ministry of Health programme of work for 2007
-
2011.

12

WHO/OMS

Case Study
-

Ghana






The GMHI has had several key objectives:


Disseminate and discuss the findings and recommendations of the
CMH report


Develop a long
-
term health investment plan


Provide strategic options for scaling
-
up investments in sectors that
influence the health status of Ghanaians


Mobilize political support and advocacy at the local and international
levels

13

WHO/OMS

Case Study
-

India



In January 2003, the Indian government set up a National Commission
for Macroeconomics and Health (NCMH), co
-
chaired by the Minister of
Health and Family Welfare and the Minister of Finance.




The objectives are t
o assess the impact of increased investments in the
health sector on poverty reduction and the overall economic
development of India and to establish an evidence base for long
-
term
scaling up of essential health interventions.



Report of the commission will present to the GoI the cost of providing
and options for financing package of interventions.



14

WHO/OMS

Case Study
-

Mexico


Mexican national commission (CMMS)

set up July 2002 by Minister
of Health to study health


economic development relationship and
identify priority actions to link health and economic policies



Working Groups:


diagnosis of health status of Mexican population and public health
system vis a vis MDGs


health, economic development and poverty reduction


intra
-

and inter
-
sectoral health
-
related public policies


health insurance and social protection


global and regional public goods for health in Mexico



CMMS Report

presented November 2004, circulated to key
stakeholders



Strong support by key MoH officials

provides momentum

15

WHO/OMS

Case Study
-

Caribbean sub
-
regional initiative


Caribbean Commission for Health and Development formed and
charged with the responsibility of providing guidelines to action
for the 15 members of Caribbean Community. The Secretary
General of the Caribbean Community (CARICOM) chairs the
Commission



Planned activities: promote essential operational research on
health and poverty priorities, policy roundtables, advocacy in
CARICOM major events, estimates of investments needed



Final report to be presented to the Caribbean Community's
Council on Human and Social Development and to Heads of
Government in 2005



MDGs

are explicit targets


16

WHO/OMS

Impact





17


Integrate health system, poverty reduction and disease
-
specific initiatives to maximise outcomes towards achieving
health and development goals



Addressing the overarching issues including the role of the
civil society and private sector, effective financing schemes
and safety nets for the poor, better monitoring of the flow,
etc.



Coordinate collaborations/partnerships between recipient
countries and development community