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The principal goal of the program is to provide intensive, state-of-the-art knowledge and training on options for health sector development.
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- Objectives
The growing requirements of aging populations, changing epidemiology, and the demand of new costly technology are exerting new pressures on reform. The MENA Regional Flagship Program aims at building the needed capacity in the region to deal with these new challenges facing the health sector.
The principal goal of the program is to provide intensive, state-of-the-art knowledge and training on options for health sector development, including lessons learned and best practice from country experience. The program supports the generation and sharing of knowledge for development and helps bridge the gap between the development of ideas and their practical implementation.
The Program aims to help participants achieve the following objectives:
- Speak a “common language” about dimensions of health sector reform and sustainable financing options;
- Assess how well their national health system rates on performance criteria such as efficiency, equity, and sustainability;
- Understand the process for mobilizing funds for health care, regulate and pay providers;
- Understand how to select and apply tools and procedures to make desired changes and to assess their effects.
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- Module Listing
Analyzing Health Sector Performance
Ethics, politics and economics all influence how health systems work and how they are judged. This module introduces the concepts of equity and efficiency, explores their philosophical and analytical bases, and shows how to apply them, including national health accounts and other quantitative measures. It provides an under- standing of how markets in general operate and what they can achieve, and how markets for health care and health insurance differ from other markets.
Financing Health Care
The sources of funds to pay for health care include taxes, obligatory insurance, voluntary insurance and out-of-pocket payment. Different sources have different implications for equity, efficiency and costs, which depend also on how resources are pooled and channeled through funding institutions. Government has a crucial role both in raising funds through taxes and social security, and in regulating public and private insurance.
Designing Benefit Packages and Targeting Beneficiaries
There are several criteria for choosing which health services to offer or finance. This module analyzes them, with emphasis on cost-effectiveness of interventions. It covers the composition and costing of a package of services, in relation to health status, demand and capacity to pay, as well as the criteria and mechanisms for targetingpublicly subsidized care to particular groups of beneficiaries.
Paying, Contracting and Regulating Providers
How providers of health care are remunerated affects who produces what, how much it costs, and who benefits, because different payment mechanisms have distinct economic incentives and consequences for performance. Remuneration often involves contracting in advance for services: this module will discuss the corresponding requirements, models and experience relevant to the regulation of provider efficacy, safety and quality of care.
Organizational Reform and Management of Public Providers
Throughout the world, governments are reassessing their role in health service delivery. They are doing so in response to common problems with public sector service delivery: inefficiency, poor quality and responsiveness to users, waste, and sometimes, fraud and corruption. Towards improving performance, health sector policy makers are applying a variety of organizational and management reforms, often with an emphasis on autonomization and corporatization of service providers. These reform modalities share the characteristics of maintaining (predominantly) public financing as well as public ownership while simultaneously mimicking best practices from the private sector - such as more performance oriented organizational and management structures, stronger incentives and exposure to increased market pressures. The objective of this module is to explain the reasons behind these new organizational reforms, and to focus on options, instruments and tools for reform, especially of public hospitals.
Decentralization: Sharing Resources and Responsibilities
In the effort to improve equity, efficiency and responsiveness, many health systems have experimented with deconcentration, devolution and decentralization. This module will treat the sharing of funds, authority and responsibility with sub-national levels of government and with public health care institutions. The emphasis will be on the fiscal, policy and managerial requirements and risks of such efforts.
Planning, Buying and Using Pharmaceuticals
Pharmaceuticals are essential to the production function of health care, and often account for 20-25 percent of costs. This module will consider how to determine needs and organize purchasing, storing, and distributing, as well as regulating production, prescription and use. Waste and inefficiency occur all along this chain; reducing them, and assuring that health services do not fail for lack of drugs, is crucial.
Investing in People, Buildings and Equipment
Current losses, waste and inequities in health care provision often reflect irreversible and mistaken past investments. This module will treat how to invest in health sector inputs in relation to future needs and demands, relative input prices and substitution, and policy goals. Participants will learn about evaluation of investments, using rate of return, cost-benefit and cost-effectiveness analysis, and will contrast government planning, financing and regulation with market mechanisms.
Leading Institutional Change
To carry out any institutional reform, it is crucial to understand why organizations operate as they do, and what it takes to change them. This module will cover theory and experience of institutional reform: incentives, politics, commitment, and how actually to promote reform. The goal is to facilitate application of knowledge from the course, to participants countries and institutions when they return home.
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- Content & Design
Three principles guide the Flagship learning style. It will emphasize implications of different options in terms of efficiency, equity, and sustainability. It will be evidence-based, seeking to distill lessons learned and best practices from country experience. It will complement understanding of “what to do” with evidence on “how to do it”.
A typical day of training in each module will be organized into three sections. The first part will introduce the policy relevance of the subject or sub-issue, theory, analytical framework, expectations, and hypotheses. The second part will review evidence from country case studies—what was tried, what was learned. The third part will involve participants in the case-method of learning, whereby students will grapple with the context and facts of a real-life management or implementation issue, and work out ways of resolving it.
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- Audience
Participants of the MENA Regional course will be largely middle to high level health managers in the public and private sectors who are actively involved in planning or managing programs in relation to health care reform or financing issues. Participation will also be drawn from academic institutions, NGOs, and from multilateral agencies working in the region.
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- Targeted Region
The course is targeting participants from the Middle East and North Africa Region.
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- Partner Institution
The MENA Flagship course is offered as a partnership between the World Bank Institute (WBI) and the American University of Beirut’s (AUB) Faculty of Health Sciences.
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- Outcomes
At the end of the Flagship Program training, participants should be better equipped with the tools to analyze the structure and performance of their health systems, identify alternative paths their health system could take and to develop plans for implementing relevant health sector reforms.
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- Evaluation
Training will be evaluated for its processes and outcomes. Processes consist of how participants have been immediately affected by course instruction. This includes their estimation (opinions) of the value of the material and its relevance to their needs. Both process and outcome information will be collected through pre – and post- module assessments, and through end-of module questionnaires provided to participants.
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