Health Reform Progress in Honduras

1998-2001

Outline of this presentation

• Change of government and new health reform initiative

• USAID cooperation to reinforce, focus and leverage this movement

• Progress achieved in two + years

• Expectations for the future

Background of the 90´s

• Expansion of rural health services through Acceso Project (decentralization)

• USAID supported:

– Regional decentralized health planning

– Community participation

– Local management of funding

– Results based performance management

Changes in 1998• New government: “Nueva Agenda”

• USAID sees new opportunities:

– Requests PHR assistance including long-term advisor

– Sends 17 health leaders to Health Reform course in Santa Cruz. They prepared a draft health reform agenda resulting in “Transformation of the Health Sector in National Reconstruction” document

Objectives outlined in the Policy

– Health sector reform

– Reorganization of the health model and management strengthening

– Institutional development of the Ministry of Health

– Decentralization and local development

– Health promotion

Focus of USAID on Health Reform

• Enhancing the policy-making skills of the government officials and other health care planners

•Improving equity of health care by expanding access to the poor and developing user fee policies for those who can pay

•Decentralization of the health care system

•Reorganization of the MOH and inclusion of the private sector

Achievements to Date

•MOH begins assuming role as regulator, facilitator

•Minister forms advisory committee on health reform, including key USAID and PHR staff

•Decentralized regional program reviews in the field

•Established results-based management

•Quality assurance and facility licensing and certification units, strengthened planning unit

Achievements of Health Reform

•National Health Accounts Study

•Assessment of Community Drug Funds

•Assessment of User Fee Systems

•Support for management and financial information system

•National Council for Drug Policy

•Strong donor coordination established

Future initiatives and challenges

• Health reform agenda - national and local - major theme in new SOAG

• Further decentralization: planning, budget distribution, local participation and integration

• Using reconstruction to strengthen health information, epidemiology, laboratory support

• Pilot user fee initiatives • Links to National Poverty Reduction and Debt

alleviation Strategies• Challenge: new government in 2002

Key factors to keep supportingHealth Reform

• Strengthened TA team and key mission links to GOH

•Strong interest, support, participation from LAC initiative

•Other donor participation, coordination

•Coordinated efforts CA’s

Working together for Honduras