We are delighted to announce the JLN Knowledge Product (KP) Showcase Series to provide greater exposure to JLN’s recently concluded and ongoing work. The KP Showcase Series aligns with the interest of JLN Country Core Groups, providing an…
The Joint Learning Network for Universal Health Coverage (JLN) is pleased to announce the election of Prof. Ali Ghufron Mukti, M.Sc., PhD, as the new Co-Convener of the JLN Steering Group. Prof. Mukti, who currently serves as the President and Director of Indonesia’s Social Security Administering Body for Health (BPJS Kesehatan), brings a wealth of experience and proven leadership to this vital role. In his acceptance message, Prof. Mukti expressed his gratitude to the Steering Group members Country Core Group members, Amref Health Africa and various organizations, supporting JLN, including the World Bank, Bill & Melinda Gates Foundation (BMGF), and all other parties involved. He emphasized the collaborative spirit and shared commitment that has been pivotal to his election. Prof. Mukti’s extensive experience in health administration and his successful implementation of Indonesia’s National Health Insurance Program are expected to significantly benefit JLN. Under his leadership, BPJS Kesehatan has achieved remarkable milestones, including: Universal Health Coverage: Extending health insurance to 97% of Indonesia’s population, totaling 271.05 million members. Financial Stability: Transitioning the national health insurance program from a deficit to a surplus. Service Quality Improvement: Enhancing health service delivery by providing down payments to hospitals, increasing health service tariffs, and boosting patient satisfaction. Reduction in Out-of-Pocket Expenses: Lowering out-of-pocket health expenditures from 49.7% to 25%. Prof. Mukti is also recognized as a distinguished lecturer at several world-renowned institutions, including Oxford University, Harvard Medical School, and Johns Hopkins University. “I hope I can bring this success story to JLN,” Prof. Mukti said. “I will certainly continue to establish good cooperation and communication ahead. I hope that JLN News and the Country Core Group Newsletter, as well as any type of meeting both online or offline, can always be used to communicate among us, to build new knowledge products, to consult, to assist, and to share practical experiences among JLN member institutions. I’m sure that JLN can be more advanced in the future.” The JLN community welcomes Prof. Mukti’s vision and leadership and looks forward to advancing universal health coverage goals globally under his guidance, Ebrahim Al Nawakhtha Secretary General, Supreme Council of Health, Bahrain is the Convener of JLN Steering Group, and the other co-convener is Mr. Dinash Aravind, Senior Principal Assistant Director, National Health Financing, Planning Division; Ministry of Health, Malaysia The JLN Steering Group guides the strategic direction of the network and ensures it is country-led and country-driven. 80% of the seats on the steering group are occupied by country representatives elected by the JLN member countries. In 2024, representatives from Ethiopia, Ghana, India, Indonesia, Nigeria, Philippines, South Korea, Vietnam, Bahrain, Kenya, Malaysia, and Senegal are part of the Steering Group. This leadership structure is designed to foster a collaborative environment where countries can share their experiences and strategies for achieving universal health coverage and set the agenda according to identified priorities. JLN also works closely with in-country stakeholder groups drawn from key ministries and institutions in the government (designated as country core group), the private sector, civil society, and development partners to make sure that representatives who are nominated to participate in JLN activities are a good fit (i.e. they are in an active role in making decisions and/or implementing policies related to the topics covered in the JLN activities). JLN relies on communication with these stakeholder groups to understand the country-specific technical priorities and local landscapes relevant to UHC. Commenting on the election, Dr. Rahul Sankrutyayan Reddy Kadarpeta, Executive Director, JLN stated, “We are thrilled to have Prof. Ali Ghufron Mukti step into the role of Co-Convener of the JLN Steering Group. His impressive track record in advancing health coverage in Indonesia through innovative and effective strategies makes him an invaluable asset to our network. We look forward to his leadership in guiding JLN’s mission to achieve universal health coverage worldwide. About JLN: The Joint Learning Network for Universal Health Coverage (JLN) is an innovative community of policy- makers and practitioners from around the world engaged in practitioner-to-practitioner learning to address challenges and co-produce practical solutions to implementing reforms toward universal health coverage. Learn more For More Information Contact: Dr. Rahul Sankrutyayan Reddy Kadarpeta, Executive Director, JLN. [email protected]
Throughout my nearly 25-year professional career in public health, I have faced achievements and challenges as a champion of Universal Health Coverage (UHC). In my own country, Mexico, I oversaw planning and evaluation agencies for designing and implementing national health and social protection policies, including the 16-year-old insurance scheme targeted to the population not covered by social security -Seguro Popular and the 22-year-old conditional cash transfer program – Progresa/Oportunidades/Prospera. These programs, despite being recently cancelled, were instrumental in significantly reducing out-of-pocket and catastrophic expenditures, a testament to my expertise in financial management. They also played a crucial role in diminishing child and maternal mortality, improving access to health services and nutrition, and reducing extreme poverty. The most recent change in government in Mexico also left me needing a policymaker or implementer space to pursue further UHC in my own country. I overcame this challenge by continuing my academic career, which I began nearly twenty years earlier when I earned my doctoral degree at the Johns Hopkins University School of Public Health. I have been a professor and researcher at the National University of Mexico for the past five years, where I have published evidence on improving health systems’ performance. On the global stage, I have been an active and dedicated member of the Joint Learning Network for Universal Health Coverage (JLN) since 2015. This platform, which I am deeply committed to, has provided me with the opportunity to share my health policy experiences with a diverse range of members. I am particularly proud of my service on its Steering Committee, where I had the privilege of chairing it as the Convener from 2018 to 2021. One of my most memorable experiences was participating in a 2016 Kosovo workshop funded by the World Bank, where I collaborated with colleagues from Ghana and the Philippines. Back then, we were able to offer valuable insights on our experiences implementing national insurance schemes in our respective countries, which proved to be highly relevant to the health care reform efforts in Kosovo. Affordable quality care for everyone still needs to be achieved in my country, Latin America, and many other countries, including the JLN members. Mexico needs to rebuild its health system after suffering significant setbacks caused by the COVID-19 pandemic and a negligent federal government. Out-of-pocket expenditures are still high, public financing needs to be more efficient, and the Ministry of Health needs to be stronger. Fortunately, windows of opportunity still exist in the academic setting and through the JLN, where I can help set the path toward UHC both in my country and abroad. Adolfo Martinez Valle is a JLN Country Core Group (CCG) Member, Director General, Performance Evaluation, Ministry of Health, Mexico
Authors:Oswald Essuah-Mensah, Rahul S Reddy Kadarpeta , James Soki, Isha Sharma JLN’s technical initiatives are meticulously crafted to foster knowledge exchanges that adeptly address the priorities and needs of the member countries. These engagements embody practitioner-to-practitioner and cross-country learning, skillfully facilitated by technical experts and revered thought leaders. The focus is on delving into specific thematic issues, culminating in collective problem-solving endeavours. The result is a global knowledge product, curated from innovative ideas and best practices from tacit knowledge of the policymakers and practitioners transcending geographical boundaries. This transformative process empowers participating leaders to navigate the intricacies of healthcare challenges with a comprehensive global perspective. It not only fosters a profound sense of solidarity but also cultivates a shared commitment to the discourse on Universal Health Coverage (UHC). JLN has so far produced 45 plus knowledge products in over a decade, and in more than 30 instances these have been adapted and implemented to address health systems issues in countries. Strategic Communication for Universal Health Coverage: Planning Tool is one such knowledge product. This tool was an output of a JLN Learning Exchange “Institutionalizing Explicit National Priority Setting Learning Processes” developed by the JLN member countries in collaboration with the Health Finance and Governance (HFG) Project, with funding from the USAID. It was developed drawing lessons and experiences from eight-member countries including Ghana to help UHC policy champions and communicators in the design of comprehensive strategic communication plans. It guides communicators through a structured plan, outlining process and includes guiding questions specifically related to strategic communication for UHC. The tool was adapted and implemented by the Ghana National Health Insurance Authority (NHIA) in the country for the design of comprehensive strategic communication plans for the digitalization of member registration for expanding population coverage. NHIA was established under the National Health Insurance Act 2003, Act 650, later revised to ACT 2012, Act 852 with a mission to ensure basic healthcare services for all residents. It has the function of securing the implementation of a national health insurance policy that ensures access to basic healthcare services to all residents to attain universal health insurance coverage. Enrollment or registration of eligible households is an integral and crucial part of expanding coverage. This requires simplifying enrollment procedures, information campaigns, subsidies, user-friendly registration processes, and community engagement. Tailoring these strategies to Ghana country context and fostering collaboration between the NHIA with various stakeholders was vital for success. Learnings from several countries suggest that digital technological innovations could bridge access gaps and streamline the registration or enrollment process. As part of expanding population coverage, in December of 2022, the NHIA embarked on a digitalization of member registration. The MyNHIS App was developed to align with the government’s digitalization agenda. This underscores a commitment to leveraging technology to enhance healthcare delivery and accessibility, aiming to boost membership and advance towards UHC. Research had proven that some barriers to enrolment included the distance of registration points to members, and long queues that had to be navigated to enable new registrations or renewals. The cornerstone of this digitalization drive was the seamless integration of mobile and app-based platforms for member registration and renewal. With the implementation of the project planned from September 2021 to December 2021, it was important to ensure proper communication to the different stakeholders not limited to citizens, residents, healthcare providers and civil society organizations. “Ghana being a member of the JLN since 2010, tapped into the JLN Knowledge products database and identified the Strategic Communication for Universal Health Coverage: Planning Tool. This tool provided a comprehensive framework for crafting strategic communication plans, tailored to promote digital products and services crucial for achieving UHC.” The communication strategy centered on convenience, speed, and empowerment of individuals through cell phones (for mobile renewals) and smartphones for the APP users. The communication was designed to fortify and amplify the policy, and digital innovations designed to attain UHC in Ghana. The intervention was presented as a new product to ensure convenience to members for efficient, convenient, and faster registration. The tool was modified and tailored towards marketing digital products and services offered by the scheme. Some of these were – the mobile renewal of membership (*929#) and the mobile app (MyNHIS App) for new registration, renewals, and linkage with the national Ghana Card) and for use with third parties as well. A major part of the tool was used especially with the illustrative communication channels where key messages were passed on to both primary and secondary audiences using traditional electronic media and the new media (social media channel) NHIA’s strategy unfolded in several well-orchestrated steps, from identifying the technological gaps to setting up a dedicated project team, and from developing culturally resonant key messages to piloting and large-scale rollout. A significant aspect of this strategy was the local translation of key messages, ensuring inclusivity and understanding across Ghana’s diverse linguistic landscape. The identification of key messengers, such as the corporate affairs directorate and regional and district Public Relation Officers, was crucial in conveying these messages effectively. As shown in figure 1.Fig 1: NHIA Strategy Implementation Journey: Steps and Key Components. The tool was detailed and easy to adopt at the country level. It highlights the importance of sustaining effective communication and government support in driving UHC. The mobile renewal service in Ghana has since won three prestigious awards and serves as the most convenient means to actively stay on the NHIS for about 80% of the members. The Mobile App has over 77,000 people signing up for themselves and third parties since its launch in December 2022. NHIA plans to use the tool as a communication guide to the NHIS as the scheme continues to develop new digital inventions to drive its membership. JLN’s exemplary support to member country-driven knowledge exchange including adapting and implementing knowledge products advance the mission towards UHC. The transformative journey of Ghana’s National Health Insurance Authority (NHIA) exemplifies the power of knowledge exchange and strategic communication in driving policy initiatives towards Universal Health Coverage (UHC).
Authors: Vrishali Shekhar, Dr. Anthony Adofo Ofosu, Mouhamed Mahi SY In response to popular country demands, Joint Learning Network (JLN) launched a new collaborative on Digital Health, between November 8-10, 2023, in Jakarta, Indonesia. The Digital Health Collaborative convened key decision makers from 15 countries including Bahrain, Bangladesh, Cambodia, Ethiopia, Ghana, India, Indonesia, Kenya, Malaysia, Nigeria, Pakistan, Philippines, Tajikistan, Senegal, and Ukraine to brainstorm on the scoping activities of the collaborative and initiate associated knowledge products. Technical facilitation support for the collaborative is provided by the World Bank along with the Digital Health Exemplars initiative, including the Center for Global Digital Health Innovation at the Johns Hopkins Bloomberg School of Public Health, eHealth Lab Ethiopia, the McKinsey Health Institute, Gates Ventures, and Exemplars in Global Health. One of the highlights of the in-person Collaborative launch meeting in Jakarta was the field visit to the BPJS Health or the Health Social Security Organizing Agency’s office premises. The field visit included warm welcoming remarks by Dr. Ali Ghufron Mukti, President Director of BPJS-Health followed by a technical presentation by Dr. Donni Hendrawan, Deputy Director of Data and Information Management. President Ghufron Mukti, fondly called Pak Ghufron, gave the audience an insight into Indonesia’s health reform process with the implementation of the national health insurance program- Jaminan Kesehetan Nasional or JKN. Indonesia’s journey with JKN which successfully covers over 95% of the country’s population, or over 250 million people, is not only remarkable but also aspirational to other low-middle income countries that are looking to achieve universal health coverage in their countries. In its ten years of existence, Pak Ghufron underscored the importance of digital health transformation as a crucial factor in the success of a relatively young JKN program. He acknowledged the significance of digital health innovations to secure equitable and universal access to high-quality affordable health services; improve health system efficiencies; promote health-seeking behavior; disease prevention and diagnosis management; amongst others very early on in its health reform process. He also highlighted the criticality of building a sustainable e-health ecosystem in alignment of the national vision promoting evidence-based decision-making in the health system. One such initiative supporting the transformation of health service quality is the launch of the i-Care JKN. I-Care JKN, an innovative application is focused on improving the accessibility of the medical history of JLN participants over the past year to the health facilities, hence allowing them to provide faster and more precise care to its beneficiaries. By facilitating communication and collaboration between doctors and health facilities, i-Care JKN allows doctors to plan appropriate treatment based on more real-time, actual, and factual data. By adhering to the rules in Law Number 27 of 2022 concerning Personal Data Protection (PDP Law) and ISO/IEC 27001 standards as well as cooperating with the National Cyber and Encryption Agency (BSSN) and the Ministry of Communication and Information Technology, BPJS-K has maintained security and protection of the BPJS Health participants’ data. Edwin Aristiawan, Director of Information Technology BPJS Kesehatan, proudly noted that endeavors to ensure the strengthening of data security and protection were high priority and that the encryption process and passwords minimize data leakages. President Director of BPJS Kesehatan Ghufron Mukti explained the operational system of BPJS Kesehatan to delegates from 15 countries participating in the Joint Learning Network (JLN) at BPJS Kesehatan Head Office, Jakarta, Wednesday (8/11/2023). The field visit included a real-time demonstration of the command center that displayed the magnitude and relevance of the data that is visualized by the BPJS analytics teams. This gold mine of data, which comprises 112 million data transactions per day in the JKN Program or 1,296 data transactions per second, plays a pivotal role in the data-driven implementation and optimization process of the JKN program. The 397.8 billion raw data are visualized as live dashboards on a range of areas such as problematic equipment at facilities; contributions; claims; population coverage; access to health services and region-level service profile; and facility and region-level ICD-10 diagnosis rates etc. The BPJS IT team also substantiated creating a standalone sample of their data, representative of the BPJS Kesehatan system, that allows for analytical work by researchers, academics, practitioners, and other related parties. The digital health strategy of BPJS-K recognizes its influential role in changing health outcomes in Indonesia. As a result, BPJS-K has been making concerted investments in governance and capacity building of its workforce to allow for maximum utilization of the modernized benefits in the health sector. However, it is equally important to acknowledge that the implementation of appropriate digital health interventions may not be an easy task for low and middle-income countries that face financial and infrastructural constraints. In this context, Indonesia’s e-health journey offers potential lessons and solutions to JLN member countries that are looking to incorporate the vision for the digitalization of the health sector aimed at improving health system efficiencies in their respective country contexts. About the Authors: Dr. Anthony Adofo Ofosu, Deputy Director-General of the Ghana Health Service. He is also the CCG Chair from Ghana. Mouhamed Mahi SY, Director of UHC digitalization, ANACMU Senegal Vrishali Shekhar, Focal point for Country Core Groups and Country Engagement,Joint Learning Network for UHC