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CCG Newsletter Spotlight: Dr. Kurudeven Tamil Chelvan, CCG Coordinator, Malaysia
We are delighted to shine a spotlight on Dr. Kurudeven Tamil Chelvan, a pivotal member of the JLN Country Core Group (CCG) Coordinator Team for Malaysia. Dr. Chelvan’s dedication to healthcare reform and his insightful contributions have significantly strengthened Malaysia’s engagement with global knowledge and local practice. A Journey Rooted in Service and Vision Dr. Chelvan currently serves as a dental officer at the Health Transformation Office (HTO), Ministry of Health Malaysia, building on invaluable experiences from the National Health Financing Section and frontline service in the Pahang State Health Department. These early experiences provided him with a profound understanding of the challenges faced by healthcare implementers and underserved communities. His passion has evolved towards health policy, behavioural change, and enhancing healthcare access for marginalized populations. Dr. Chelvan firmly believes in the power of strategic reform to build a more inclusive, equitable, and sustainable healthcare system. His current national-level work consistently deepens his understanding of the critical interplay between planning, policy implementation, and system transformation. Beyond his professional life, Dr. Chelvan finds rejuvenation in nature, whether hiking or exploring quiet trails. He also possesses a creative flair, drawn to music, visual storytelling, and design. He views the arts not only as a refreshing pursuit but also as a means to cultivate empathy and critical thinking—qualities he deems essential for both healthcare quality improvement and public policy. Bridging Global Insights with Local Practice as a JLN Institutional Coordinator As a CCG Coordinator for Malaysia, Dr. Chelvan plays a crucial role in facilitating internal discussions for new collaboratives, cross-divisional meetings, and technical engagement sessions. He is also instrumental in disseminating JLN knowledge products to a wider audience through internal platforms and the Ministry’s postmaster system, enhancing awareness among healthcare personnel nationwide. This coordination role effectively positions him as a vital link between global knowledge and local application, ensuring that valuable insights are not just shared, but meaningfully applied to Malaysia’s health priorities. Key Lessons in Driving Meaningful Reform Dr. Chelvan emphasizes that meaningful reform necessitates both strategic direction and operational flexibility. He highlights that effective change is driven by strong leadership commitment coupled with the empowerment of implementation-level officers to experiment, adapt, and reflect. His team has found that integrating peer learning and cross-country experiences into local contexts is most impactful when diverse perspectives are engaged early, procedural rigidity is reduced, and open channels for dialogue across units are maintained. A Memorable Highlight: Enhancing Visibility and Engagement A significant achievement for Dr. Chelvan was the successful enhancement of internal visibility for the JLN knowledge platform. By strategically promoting resources during key planning periods and sharing them via the Ministry’s internal communications, there was a notable increase in interest and engagement across divisions. This experience underscored the power of structured dissemination in fostering broader institutional uptake. It also reinforced his conviction that achieving person-centred care requires integrating often-overlooked areas, such as oral health, into broader health system reforms. Despite the challenge of balancing competing operational priorities, Dr. Chelvan’s steady coordination and receptiveness to feedback have successfully maintained momentum and promoted the enduring value of collective learning. Thank you for your dedication, expertise, and advocacy, Dr. Chelvan! Your work is making a significant impact on global health security.
New Country Member – Welcoming South Sudan to the JLN Family
South Sudan The Joint Learning Network for UHC is growing! Help us extend a warm welcome to our newest member, South Sudan! Officially known as the Republic of South Sudan, it is Africa’s youngest nation, having gained independence on 9 July 2011. It became a full member of the East African Community on 5 September 2016, making it one of the eight member states. South Sudan is a landlocked country with an estimated population of 14.7 million (2023) spread across 619,745 km². While English is the official language, Arabic and indigenous languages such as Dinka, Nuer, Bari, Zande, and Shilluk are widely spoken. The government is steadfastly committed to achieving Universal Health Coverage (UHC) and has made significant progress over the years. Their vision is a nation where all individuals, regardless of socioeconomic status, can access quality healthcare without financial hardship. With support from the WHO and other partners, the Ministry of Health is actively rolling out the Boma Health Initiative (BHI). This initiative aims to deliver a free and quality health package of care to communities, especially in hard-to-reach areas lacking health services. Post-conflict, the ministry is dedicated to strengthening its health system through policy development, multi-stakeholder coordination, and capacity building to establish a resilient healthcare system. Collaboration with other government bodies, NGOs, and international organizations is crucial in defining a roadmap for UHC and addressing systemic challenges such as limited healthcare infrastructure, inadequate funding, and workforce shortages. Furthermore, the government has expressed its commitment to providing the necessary leadership to significantly decrease maternal and child mortality. The focus is on three (3) UHC priority areas: Expanding Access to Primary Healthcare: Strengthening community-based health systems to ensure essential services reach remote and marginalized populations. Health Financing: Developing sustainable financing mechanisms, such as pooled funding and insurance schemes, to reduce out-of-pocket expenditures and enhance affordability. Workforce Development: Building a trained healthcare workforce by investing in education, training programs, and retention strategies for health professionals. As South Sudan joins the JLN family, it aims to leverage JLN’s expertise and resources for designing a UHC roadmap tailored to South Sudan’s needs, fostering partnerships that provide technical and financial support for health system strengthening, and sharing South Sudan’s early experiences in UHC implementation to contribute to collective knowledge. Immediate areas of learning include: Understanding Health Financing Models: Exploring practical approaches to designing and implementing equitable healthcare financing mechanisms suitable for low-resource settings. Strengthening Service Delivery: Learning strategies to scale up primary healthcare services and integrate innovative technologies for healthcare access. Policy and Governance: Gaining insights into effective policy frameworks and governance structures for UHC implementation. Please join us in welcoming the Republic of South Sudan to the JLN family!
Accountable Autonomy: Giving Health Providers the Keys — Without Crashing the System
Author: R4D Technical Facilitation Team The Foundational Reforms for Financing and Delivery of Primary Health Care (PHC) Collaborative brings together practitioners from 14 member countries of the Joint Learning Network for Universal Health Coverage – Botswana, Burkina Faso, Colombia, Ghana, Ethiopia, Indonesia, Kenya, Liberia, Lebanon, Malaysia, Mongolia, Nigeria, Philippines, Vietnam. The practitioners to share lessons and problem-solve on how to transfer resources directly to PHC facilities and ensure effective use of these resources. At the inception of the collaborative, the practitioners identified three learning topics to tackle the pressing needs of the countries represented in the collaborative: resource allocation, provider payment mechanisms and provider autonomy. 26 members of the collaborative from Burkina Faso, Ethiopia, Ghana, Indonesia, Kenya, Malaysia, Mongolia, Nigeria and Philippines met in Accra, from April 23-24 2025, to delve into provider autonomy and the accountability mechanisms applied by countries. In this blog we share the key lessons from this meeting. If well-coordinated, multiple channels of PHC funds can ensure all inputs for PHC services are covered. Indonesia and Mongolia are examples of countries that are consolidating revenue sources to improve coordination. Indonesia and Mongolia have two predominant sources of PHC funds from the local government and from the health insurance fund (Jaminan Kesehatan Nasional – JKN and Health Insurance General Office – HIGO respectively) to the Puskesmas and Soum Health Centres respectively. Both sources have different financial management rules and are remitted to facilities through different payment methods. However, in both countries, these funds are received in a single bank account and providers are able to plan and budget for these funds as a single pot, which improves allocation of these resources at the provider level to the priorities at the PHC facility level. Countries should remain aware of the risks that a high level of fragmentation, with limited coordination, can present, and the administrative and reporting burden that it can pose to PHC managers. In countries where providers generate and retain internal revenue, they most commonly use these internally generated funds for medicines and operation and maintenance costs. The medicines are procured from different channels (1) central medical stores funded through the government budget, (2) private wholesalers and retailers with government budget funds or facility-generated revenue. In Burkina Faso, Gratuité funds are allocated to the medical stores – Centrale d’Achat de Médicaments Essentiels (CAME) for medicines. PHC facilities draw down from their allocation as needed. PHC facilities in Kenya can purchase directly from the Kenya Medical Supplies Authority (KEMSA) or the Mission for Essential Drugs and Supplies (MEDS) and the private market, when commodities are unavailable at KEMSA or MEDS. In countries where providers have autonomy for some of the PHC funds, there is a tendency to introduce a wide variety of accountability which can increase the administrative burden for PHC providers. Countries should assess the level of autonomy being granted to PHC facilities and take steps to achieve the right balance, keeping in mind the value of transactions taking place at this PHC level – particularly for high-frequency but low-value transactions. For example, in Ghana, once the regional directors approve their budgets, PHC facilities, which are recognized as budget management centres have the autonomy to spend their resources in line with their approved budgets and implementation plans. The facilities prepare financial reports and have finance officers to support financial management. This means they do not have to revert back to the regional director for approval for individual transactions after the budget and implementation plan are approved. Clearly defining indicators to measure accountability is an important step to help countries to strike the right balance to track the health outcomes that autonomy is expected to deliver. Most systems already have checks and accountability measures in place, and these can be sufficient to guide autonomy. Accountability without sufficient guardrails may also incentivize providers to prioritize expansion of services and profit over providing quality PHC services to the community. For example Mongolia has revised capitation rates four times since 2019, increasing resources for PHC, but the outcomes achieved were not commensurate with the increase in capitation funds. Mongolia is continuing to review regulations to better align provider behavior to achieve expected health outcomes. At the end of the meeting, participants summarized their key takeaways and actions they are taking to adapt the learnings from the meeting. As next steps, the technical facilitation team are consolidating the inputs from the meeting into a knowledge product that will describe the spectrum of provider autonomy across the 14 countries and the accountability arrangements in place. This will be validated at the final in-person meeting and disseminated as a global public good. Download Full Report
Powering Universal Health Coverage: 3 Lessons in Domestic Resource Mobilization
Universal health coverage (UHC) remains one of the world’s most consequential health goals, yet achieving it requires securing robust, sustainable financing—an increasingly complex challenge as many low- and middle-income countries are facing declining development assistance due to shifting geopolitical priorities. During the 78th World Health Assembly, we came together as part of the Joint Learning Network for Universal Health Coverage (JLN) to tackle this critical issue, sharing insights from domestic resource mob ilization efforts. From navigating complex budget negotiations to harnessing the power of collective knowledge, our experiences have revealed three strategic lessons that are reshaping how countries finance their path to health for all. 1. Strategically Earmarked Taxes Build Resilient Health Systems As practitioners working directly with domestic financing strategies, we’ve seen firsthand how governments can look to softly earmarked taxes as a politically feasible means to strengthen the sustainability and resilience of their health systems. In Ghana, the National Health Insurance Scheme was established with earmarked revenue from a consumption tax. While the system initially faced constraints from funding caps and delayed disbursements, recent policy changes signal a turning point. “The lifting of the cap speaks to the commitment of our country and government to make sure that there are funds available in-country locally to finance the health needs of our people,” explains Ruby, Director of the Strategic Health Purchasing Directorate of Ghana’s National Health Insurance Authority. Malaysia’s experience highlights the potential of soft earmarked taxation to meet evolving health system needs. Through sustained collaboration between the Ministries of Health and Finance, sugar and beverage taxes have been strategically directed toward health initiatives—creating dedicated funding streams while preserving fiscal flexibility. As Malaysia undertakes a comprehensive health sector transformation across both public and private sectors, policymakers continue to explore new sustainable health financing pathways that create a strong foundation for achieving universal health coverage. As Dinash, a member of Malaysia’s Health Transformation Office reflects, “Given fiscal realities, we are embracing creative and innovative approaches.” 2. Data-Driven Decision Making Maximizes Every Investment Sustainable UHC isn’t just about securing more money—it’s about using existing resources with maximum efficiency and impact. In Pak Ghufron’s role as President Director of BPJS Kesehatan (Indonesia’s Social Security Administering Body for Health), he’s learned that performance data is crucial for assessing the efficiency of health resource utilization. It’s not just about increasing funding, but about using existing resources more effectively. “It’s not just about more funding — it’s about smarter use of it.” – Dr. Ali Ghufron Mukti Indonesia’s experience showcases the power of data. The government captures and analyzes 1.9 million health claims and transactions nationwide, empowering policymakers and decision-makers with the information they need to strengthen care delivery, detect fraud, and make overall systems improvements across the health system. Building on these insights, they are now implementing phased reforms to: further optimize current resources, shift to outcome-based financing, and leverage private sector capacity to accelerate progress towards UHC. 3. Sustained Advocacy Turns Investment into an Imperative Perhaps the greatest challenge in domestic health financing isn’t technical—it’s political. Health ministers worldwide face the daunting task of competing for limited government resources against sectors that deliver more immediately visible returns, such as infrastructure projects like roads and bridges. External economic shocks and shifting donor priorities can further destabilize carefully constructed financing plans. In Ajay’s work as a lead economist with the World Bank, he has observed that successful health advocates must demonstrate how health investment drives outcomes far beyond the health sector itself. Practical tools can amplify these advocacy efforts. Resources like the Joint Learning Network’s evidence-based messaging guide, Making the Case for Health, provide health leaders with compelling, real-world examples and economic arguments that resonate with finance ministers and political leaders who control budget decisions. Our Collective Conclusion These three lessons converge on a powerful conclusion: achieving sustainable domestic health financing requires more than any single strategy. Success emerges from the strategic integration of innovative financing mechanisms, evidence-based resource optimization, and persistent, well-informed advocacy. As Joint Learning Network members, we continue to share experiences and advance collective knowledge. These lessons provide a roadmap for countries at every stage of their universal health coverage journey. The ultimate goal—health for all—remains ambitious, but the strategies to achieve it are becoming increasingly clear and actionable through our collaborative efforts. Acknowlegements About the Authors: Ali Ghufron Mukti, President Director BPJS Kesehatan (Social Security Administering Body for Health), Indonesia Dinash Aravind, National Health Financing, Health Transformation Office, Ministry of Health, Malaysia Ruby Aileen Mensah, Director, Strategic Health Purchasing Directorate. National Health Insurance Authority. Ghana. Michael Kent Ranson, Senior Economist, Health, The World Bank Ajay Tandon, Lead Economist, The World Bank and Lead Technical Facilitator, JLN Domestic Resource Mobilization Collaborative (Virtual) The authors would like to thank Hallie Goertz for her strategic communications support to the JLN, and Rahul S. Reddy Kadarpeta, JLN’s Executive Director, for his ideation, review, and editorial guidance on this article. For more information on how to join or partner with the Joint Learning Network, please email [email protected].
Authors workshop: Health Emergency Preparedness Collaborative
JLN Medical Audit Toolkit was adapted to design A decentralized audit system and scaled across states.
Basic Health Care Provision Fund (BHCPF) roll-out in Nigeria
JLN Strategic Communications Practical Guide & Planning Tool was used in Nigeria to operationalize the BHCPF.
JLN Medical Audit Toolkit: Institutionalizing Medical Audits in India
JLN Medical Audit Toolkit was adapted to design A decentralized audit system and scaled across states.