Bangladesh
Developing an Investment Plan for the Health Care Financing Strategy
February 2013 – Having approved the Health Care Financing Strategy (HCFS), the Health Economics Unit (HEU) of the Ministry of Health and Family Welfare (MoHFW) is working towards the implementation. The next step will be the development of an Investment Plan (IP) that lays out the implications of implementing the HCFS, including costs and systems readiness/capacity and institutional needs. The IP is expected to provide feasible and sustainable options for the road ahead. Using platforms like the Health Financing Resource Task Group (HFRTG) will ensure integration and alignment with the national planning process and broader multi-sectoral stakeholder involvement. Joint support of the P4H network members for the IP will include strengthening the HEU (e.g. by providing international experts), a rapid health systems analysis and assessment on specific issues (e.g. costing) and the facilitation of consultations to build consensus on a 2013/14 operational plan.
October 2012 - Approval of the Health Care Financing Strategy
Following an intense one-year development process, the Ministry of Health and Family Welfare (MOHFW) approves the Health Care Financing Strategy (HCFS) 2012-2032, 'Expanding Social Protection for Health: Towards Universal Coverage'.
The Health Economics Unit of the MOHFW will play a central role in the implementation of this strategy. The proposed next steps are: to strengthen the technical and coordination capacity of the HEU; and support to the development of an investment plan for the HCFS. This plan will serve to explore feasible and sustainable options for the implementation of the HCFS.
29 November 2011 - Health Financing Resource Group Meeting
The HFRG meeting was chaired by the Secretary of health.
- Presentation of the health care financing strategy workshop and roadmap by the Joint Chief of the HEU, and agreement on the next steps, e.g. to hire a lead consultant to provide support to the the working groups; equity, effectiveness and resource mobilization.
- The Secretary welcomed new members to the HFRG (SIDA, USAID and BRAC/Dr. T. Evans) joining the open support network of the P4H partners WHO, WB and GER (GIZ, KfW).
- The next meeting of the HFRG was set for mid-February 2012 when it is expected that the three small groups could report on progress and present their work to date – the first full draft of health care financing strategy document is due in mid-March 2012.
November 2011 - Review of a health insurance pilot proposal.
The Health Economics Unit of the MoHFW, in collaboration with KfW, has designed a health insurance pilot intervention to tackle the high OOP spending and other health system issues. The Secretary of health has asked the (P4H) network partners to review the current proposal in support of a successful pilot testing various health financing assumptions and strategies.
End of October 2011 - vision, goals and objectives of the new health financing strategy
The MoHFW Health Economics Unit (HEU) has prepared a first draft of the vision, goals and objectives of the health financing strategy for further discussion.
October 2011 - Social Protection Conference in Bangladesh
The Government:
- resolves to have a comprehensive Social Protection Strategy finalized and ready to launch preferably by September 2012; and
- calls on Development Partners and Civil Society to contribute to the process of developing the social protection strategy and in further improving the delivery of individual programs over the coming years.
The following processes and milestone dates are envisaged:
- adoption of a detailed road-map outlining necessary processes & actions (Oct- Dec 11);
- consultations and program reviews (Jan-Apr 12);
- drafting of the National Social Protection Strategy (May-Jun 12);
- review and finalization of the strategy (Jul-Aug 12);
- launch Strategy (by Sep 12).
October 2011 - a roadmap for the health financing strategy process
The health financing workshop concluded with the development of a roadmap for the health financing strategy process. The roadmap implementation will be led by the HEU with inputs from the Health Financing Resource Group. Milestones of the roadmap include:
- the development of a vision for UC, goals and objectives for the HF strategy by end of Oct 2011 (max 2-page document to be prepared by HEU, commented by network partners; should keep in mind the identified key challenges such as improving resource mobilization, reducing OOP spending, improving resource allocation and efficiency; should be guided by WHO’s framework and the 3 dimensions of universal coverage);
- a meeting with the Honorable Prime Minister before mid-November; and
- the development of a draft document outlining strategic components / thrusts to address the vision, goals and objectives by mid of Jan 2012.
2-5 October - health financing strategy workshop
From 2-5 October 2011, the MoHFW - with support from WB, GER [GIZ and KfW], SIDA, USAID and WHO - conducted a workshop to initiate a health financing strategy process in Bangladesh. Conclusions of the kick-off event: Bangladesh is faced with the challenge of high OOP (60%); low public spending for health; efficiency issues in allocation process and budget execution (unspent funds in large SWAP) The first two days focused on conceptual HF and UC / SHP issues with inputs from WHO and WB, and country experiences of Thailand, India and Sri Lanka. The 3rd and 4th day included discussions on a roadmap, networking and joint (P4H) support.
April 2011 - Planning for a kick-off event for a health financing strategy
Beginning of April 2011, the P4H Coordination Desk received information from GIZ Bangladesh that the MoHFW together with WB, SIDA, EU and GDC (GIZ, KfW) have resumed the planning process for the earlier announced health financing workshop. Workshop date shifted to July 2011.
October 2010 - the idea of a health financing strategy has been taken up
By October 2010, the P4H CD has been informed that 'following discussions between MoH, World Bank, Germany (GTZ) and P4H Coordination Desk in the Maldives, the development of a Health Care Financing Strategy is now part of the Government of Bangladesh's draft Health Population and Nutrition Sector Strategic Plan 2011-16.
July 2010 - Follow-up on Maldives Workshop
The World Bank and GTZ met with the Director General Health Services and on his recommendation sent the action plan the GOB developed in the Maldives to the Secretary as a first step in the process of engaging higher level policy makers and getting their support for the development of a health financing strategy for Bangladesh.
June 2010 - "High-Level Forum on Health Financing in South Asia" in the Maldives
From 2-4 June 2010, representatives from Bangladesh, WB, GTZ and the P4H CD attended a "High-Level Forum on Health Financing in South Asia" in the Maldives. The objectives of the Forum were to jointly consider the broad concepts and policy implications of key issues in health economics and the objectives and functions of health financing systems in the South Asia region. During the Forum, the team from Bangladesh came up with the following action plan: Initiation of policy dialogue with relevant stakeholders (i.e. MOHFW, MoF, MOLGRD, other ministries, civil society) with an aim to formulate a health financing strategy which explores the options how to:
- increase mobilization of resources;
- distribute resources based on need and equity;
- manage resources more efficiently and effectively.
In early 2010 the P4H Coordination Desk (CD) has been informed that GER (GTZ), WB, WHO and the EU were planning a joint workshop on health system financing in September 2010. One objective of this event was to draft a roadmap, which would outline steps for identifying reform options.