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This report summarizes the findings of the Health Financing Progress Matrix assessment, WHO’s standardized assessment of a country’s health financing policies, for Kenya. The report highlights both strengths and weaknesses in Kenya current health financing arrangements, assessed against the desirable attributes of a health financing system, based on global evidence. Based on the findings, the report suggests a number of policy adjustments to drive accelerated progress towards universal health coverage (UHC) in the country. Priorities for attention include addressing or mitigating the consequences of fragmentation, for example across the numerous health coverage schemes, making more effective use of data and information systems, and improving public financial management within the health sector. Given the context of devolved decision-making for a substantial part of overall government health spending, a realistic health reform implementation roadmap should suggest mechanisms to bring about greater overall coherence in the system, identifying those features which can be established nationally while recognizing the limits of what can be imposed centrally. The Health Financing Progress Matrix assessment provides guidance to policy-makers, building on international experience and evidence, whilst at the same time reflecting the unique features and context of the Kenyan health system.
This document outlines the background to and design of the Health Financing Progress Matrix (HFPM), WHO’s standardized qualitative approach to assessing country health financing systems. Primarily qualitative in nature, but drawing on extensive quantitative indicators, the HFPM assesses a country’s health financing institutions, processes, policies and their implementation, against good practice in the context of universal health coverage (UHC). Benchmarks are defined in terms of nineteen desirable attributes, which crystallize evidence about what works in health financing in order to make progress to UHC. The paper also details a number of processes which govern the implementation of the HFPM in countries, to ensure the results are objective and credible. While health financing is only one of the core functions of a health system, it significantly influences both the extent to which the population can access health services, as well as the extent to which they face financial hardship in the process. Through a forward-looking design, the HFPM not only assesses the current situation in a country, but also makes clear recommendations of priority directions for policy and implementation, both accelerating progress towards UHC, and helping to build resilience across the health systems.
This document provides detailed advice in support of implementation of version 2.0 of the Health Financing Progress Matrix (HFPM) released in December 2020, detailed in Assessing country health financing systems: the health financing progress matrix. Geneva: World Health Organization; 2020. The HFPM is WHO’s standardized qualitative approach to assessing country health financing systems, and comprises two stages. Stage 1 provides a descriptive landscape of the different coverage schemes and programmes in the health system, including how the health budget is organized. Stage 2 comprises thirty-three questions which look in detail at the way health financing institutions and policies are organized, and how they are implemented. For each question the guide discusses why it is important to ask, and what progress looks like, together with country illustrations. Thoughts on information sources and quantitative indicators which can support the assessment are also provided.
Increased global demand for land posits the need for well-designed country-level land policies to protect long-held rights, facilitate land access and address any constraints that land policy may pose for broader growth. While the implementation of land reforms can be a lengthy process, the need to swiftly identify key land policy challenges and devise responses that allow the monitoring of progress, in a way that minimizes conflicts and supports broader development goals, is clear. The Land Governance Assessment Framework (LGAF) makes a substantive contribution to the land sector by providing a quick and innovative tool to monitor land governance at the country level. The LGAF offers a comprehensive diagnostic tool that covers five main areas for policy intervention: Legal and institutional framework; Land use planning, management and taxation; Management of public land; Public provision of land information; and Dispute resolution and conflict management. The LGAF assesses these areas through a set of detailed indicators that are rated on a scale of pre-coded statements (from lack of good governance to good practice). While land governance can be highly technical in nature and tends to be addressed in a partial and sporadic manner, the LGAF posits a tool for a comprehensive assessment, taking into account the broad range of issues that land governance encompasses, while enabling those unfamiliar with land to grasp its full complexity. The LGAF will make it possible for policymakers to make sense of the technical levels of the land sector, benchmark governance, identify areas that require further attention and monitor progress. It is intended to assist countries in prioritizing reforms in the land sector by providing a holistic diagnostic review that can inform policy dialogue in a clear and targeted manner. In addition to presenting the LGAF tool, this book includes detailed case studies on its implementation in five selected countries: Peru, the Kyrgyz Republic, Ethiopia, Indonesia and Tanzania.
Between 2011 and 2019, WHO has developed and issued evidence-based policy recommendations on the treatment and care of patients with DR-TB. These policy recommendations have been presented in several WHO documents and their associated annexes, including the WHO Consolidated Guidelines on Drug Resistant Tuberculosis Treatment, issued by WHO in March 2019. The policy recommendations in each of these guidelines have been developed by WHO-convened Guideline Development Groups, using the GRADE (Grading of Recommendations, Assessment, Development and Evaluation) approach to summarize the evidence, and formulate policy recommendations and accompanying remarks. The present WHO Consolidated Guidelines on Tuberculosis, Module 4: Treatment - Drug-Resistant Tuberculosis Treatment includes a comprehensive set of WHO recommendations for the treatment and care of DR-TB. The document includes two new recommendations, one on the composition of shorter regimens and one on the use of the BPaL regimen (i.e. bedaquiline, pretomanid and linezolid). In addition, the consolidated guidelines include existing recommendations on treatment regimens for isoniazid-resistant TB and MDR/RR-TB, including longer regimens, culture monitoring of patients on treatment, the timing of antiretroviral therapy (ART) in MDR/RR-TB patients infected with the human immunodeficiency virus (HIV), the use of surgery for patients receiving MDR-TB treatment, and optimal models of patient support and care. The guidelines are to be used primarily in national TB programmes, or their equivalents in Ministries of Health, and for other policy-makers and technical organizations working on TB and infectious diseases in public and private sectors and in the community.
Analyses the experience with the financing reforms implemented by the countries of Central Europe, Eastern Europe, the Cauxasus and Central Asia.
This report summarizes the findings of the Health Financing Progress Matrix assessment for Zambia. Recognizing the remarkable progress towards UHC made by the country over the past twenty years, the report also highlights weaknesses in the current health financing system and, extending from this, those priority issues to be addressed in order to further accelerate Zambia’s progress towards universal health coverage (UHC). Specifically, the report notes the importance of sustaining levels of public funding for health, progressively reducing reliance on external funding, and reinforcing the provision of free services in primary care facilities. Further recommendations include the need to accelerate the shift from passive to strategic purchasing, and institutionalizing shifts in the public financial management system to ensure that adequate operational funds reach frontline service providers in a timely fashion. Finally, the duplication in benefits across the budget-funded EPHS, the National Health Insurance Scheme, and some services provided through vertical disease programmes need to be addressed, for example through the establishment of a unified benefits framework. The latest information on Zambia’s performance in terms of UHC and key health expenditure indicators are also presented. This report is intended both to inform current health financing policy, and to provide a baseline for the future monitoring of Zambia’s progress in developing and implementing UHC-oriented health financing reforms.