Download - Role of one health 08202013
Costing health plans in countries:Costing health plans in countries:the role of OneHealth the role of OneHealth
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Topics in this presentationTopics in this presentation
• What is OneHealth?• What is the purpose of OneHealth?• Who will use it?• Why and how was it developed?• How will it strengthen strategic planning? • What is new?• What are the challenges?
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What is OneHealth?What is OneHealth?
• A tool for medium term strategic health planning (3-10 yrs) at national level
• A software that incorporates UN epidemiology impact models to demonstrate the achievable health gains
• A unified tool in 3 ways:– For joint planning, costing, budgeting, impact analysis,
and financial space analysis– Disease programme + health systems– One UN
• Aligned with Joint Assessment of National Strategies (JANS) principles
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What is the purpose of OneHealth?What is the purpose of OneHealth?
Challenges: OneHealth Role:Too many toolsDe-linked planning cycles
Enabling integrated planning
Bringing partners togetherLittle consideration of health systems
Linking programmes to HSS platform
"First plan… then costing" Costing as part of the Planning process!
Budget should consider the country fiscal space
Strategic Planning for Better Health Outcomes4
Who should use OneHealth? Who should use OneHealth?
• A multi-disciplinary team
•Health Sector planners ( MoH Department of planning)
•Disease-specific programme planners (e.g. EPI, Malaria) , Health System component (e.g., Human Resource Department in MoH)
•NGOs and other agencies in countries
•Donors, academics and UN agencies5
How was OneHealth developed?How was OneHealth developed?
• Agreement to develop a joint UN model.• Inter-Agency Working Group on Costing (IAWG-COSTING) established in
2008 (WHO, UNICEF, WB, UNAIDS, UNFPA, UNDP).• Partner support:
– The Global Fund to fight Aids, TB and Malaria, The Global Health Workforce Alliance, The Health Metrics Network, Bilateral agencies, IHP+, have provided funding and technical support.
– Other partners: UNIFEM and projects like USAID deliver, Optimize provide technical inputs.
• Health Planners in Country Reference Group provide technical and user related inputs into model development (Burkina Faso, Cap Verde, Ghana, Mali, Mauritania).
2008: a meeting in Senegal reviewed 13 commonly used tools
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Pre-existing tools incorporated into OneHealthPre-existing tools incorporated into OneHealth
Tool Specific areas incorporatedMBB Bottleneck analysis, Fiscal space analysis;
Budget mappingWHO (stop TB) TB planningWHO (iHTP) Detailed intervention planning for
RMNCH (staff time minutes; drugs commodities)
LiST (Lives Saves Tool) Impact for child and maternal health
Resource Needs Model Costs for HIV/AIDS interventionsAIM, GOALS Impact for HIV/AIDS interventions
WHO ( Child Health Cost Estimation tool)
Intervention costing for child health; Overall Framework for Programme Activity Costing
FamPlan Impact for Family Planning interventions
UNFPA RH costing tool Costing reproductive health interventions
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Inputs Process Outputs Outcomes Impact
OneHealth supports a planning process from inputs and OneHealth supports a planning process from inputs and activities activities to outcomes and impact to outcomes and impact
Interventions & services, Inpatient days, outpatient visitsHealth Systems outputs (access, quality, availability, etc)
Coverage of interventions;
Risk behaviours, effective behaviours
Under 5 mortality
Maternal mortality
Nutrition outcomes
HIV/TB/malaria incidence, prevalence, mortality
Total fertility rate 8
Type of outputs (results) producedType of outputs (results) produced
1. Health impact: what will be my U5MR in 2020? Do I expect to reach my MDG targets by 2015?
2. Health Systems investments and service outputs: – Required investments in the Supply Chain – Total & additional bed days and outpatient visits; requirements
for hospitals, facilities and community services3. Costs: Costs by year, by programme, by inputs, etc.4. Financial projections, fiscal space and expected shortfall5. Scenarios: how is cost and impact different for
alternative scenarios of packages, targets and activities?
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Type of outputs: nutrition specificType of outputs: nutrition specific
1. Health impact: a. how many deaths are averted by nutrition interventionsb. Reductions in stunting, wasting, IUGRc. Breast feeding prevalence
2. Costs: a. Commodities, drugs and supplies, b. Programme costs: training, supervision, M&E, administration, etc.
3. Health Systems:a. proportion of health worker time used by nutrition interventions
4. Scenarios: comparison of service delivery mechanisms10
National
Hospital
Health Centre
Outreach
Community
HS4. Health Information
HS5. Governance and Leadership
HS6. FinancingPolicies
HS3. LogisticsHS1. Infrastructure and Equipment
HS2. Human Resources
Malaria
Disease Programmes
TB
HIV
Reproductive H
ealth
WA
SH
Imm
unization
Child H
ealth
Nutrition
NC
D
Health System
Envelope
Fiscal Space envelope
Service delivery planning O
thers
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What's new? What's new?
• User-friendly interface
• Modular format adaptable to different country contexts
• Flexible structure corresponds to the ways in which real-world health care system planning is performed
• User can choose the level of detail for planning
• Regularly updated software
• Direct links and checks built in between different modules
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How does OneHealth support How does OneHealth support programme planning to be programme planning to be
aligned with Health Systems aligned with Health Systems planning?planning?
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"Check" (calculated)
Nutrition Programme Minutes of staff time
required for patient care
Nutrition Programme #of staff that need
in-servicetraining
Link between programme MNCH-related activities and HSS investments (1/2)
HRHStaff requirements
Staff Costs
HRH planner decides on HRH plan
PROGRAMME
SYSTEM
Programme Planning & Health Systems implications:Programme Planning & Health Systems implications: #1 - Health Worker time#1 - Health Worker time
Potential adjustment of coverage targets
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Available health worker time
Estimated time required for programme scale-up
Programme Planning & Health Systems implications:Programme Planning & Health Systems implications: #1 - Health Worker time: example a#1 - Health Worker time: example a
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Direct input (calculated)
LogisticsTotal volume of commodities
>-Supply Chain Requirements >-Supply Chain Costs
Nutrition ProgrammeSpecific requirements
for drugs /commodities
PROGRAMME
SYSTEM
Programme Planning & Health Systems implications:Programme Planning & Health Systems implications: #2 - Demands on the Supply Chain#2 - Demands on the Supply Chain
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Programme Planning & Health Systems implications:Programme Planning & Health Systems implications: #2 - Demands on the Supply Chain: example#2 - Demands on the Supply Chain: example
Volume of commodities transported in Logistics system,
% share by programme
2011 2012 2013 2014 2015 2016 2017 2018 2019 2020
Non Communicable disease
Nutrition
Vaccination
HIV/AIDS
Malaria
TB
Child health
Maternal/newborn and
reproductive health
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• Baseline situation analysis: Epidemiology, Demography, current coverage, and some HSS.
• Intervention standards: drug and supply cost per average case (based on WHO treatment guidelines + international drug prices from UNICEF, MSH and IDA) + estimated personnel type & time required.
• Disease Programme activity standards: e.g., specific training courses; surveys; specific equipment, etc.
• Standardised activities for health system strengthening: Activities for Logistics, Governance, etc.
• Prices: from WHO-CHOICE database, WHO, MSH, UNICEF
• Expenditures & GDP growth: WHO/NHA database, IMF
Responding to data challenge:Responding to data challenge:Availability of Default data in the toolAvailability of Default data in the tool
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Website: http://www.internationalhealthpartnership.net/en/Website: http://www.internationalhealthpartnership.net/en/working_groups/working_group_on_costingworking_groups/working_group_on_costing
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User Guidance & Technical DocumentationUser Guidance & Technical DocumentationHelp screens in the tool
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• Common platform for national programmes + Health systems.
• Ensure that health system capacity is driving the planning process, to set realistic goals.
• From situation analysis activities outcomes
• Use evidence on expected health impact to inform priority setting process.
• A "checklist" function, promote comprehensiveness and inclusiveness.
• Transparent and accountable planning.
How can YOU use OneHealth to make a How can YOU use OneHealth to make a difference?difference?
How can YOU use OneHealth to make a How can YOU use OneHealth to make a difference?difference?
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• FLEXIBILITY – Country contextualisation
• STANDARDS– Internal consistency, use of standards and defaults
• INTEGRATION
3 key words3 key words3 key words3 key words
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