India drew on its participation in the JLN’s Medical Audits Collaborative and adaptation of the Medical Audit Toolkit to implement a medical audit system that could be decentralized and scaled by India’s states to review claims, identify fraud, and ensure the quality of health services being provided to patients.
Nigeria’s implementation of the Strategic Communications Practical Guide and Strategic Communications Planning Tool to address underlying facilitators and barriers to the BHCPF led to the first appropriation for the fund and an increase in interest in BHCPF services. The communication plan is thought to have improved the targeting and perception of the rollout communication processes. In 2014, the Government of Nigeria signed the National Health Act into law. The act provides a legal framework for the coordination of the three health care agencies and the entire health system in the country. The Federal Ministry of Health (FMOH), the National Health Insurance Scheme (NHIS), and the National Primary Healthcare Development Agency (NPHCDA), including their corresponding state-level and local government structures, are mandated to implement the specific provision, known as the Basic Health Care Provision Fund (BHCPF), which focuses on removing financial barriers for primary healthcare, particularly for poor and vulnerable Nigerians. This sweeping health reform did not, however, provide an operational roadmap to implement the BHCPF. There were many challenges with operationalizing the National Health Act including but divergent views within the federal government about how to best implement provisions. This case study profiles the use of the Strategic Communications Practical Guide and Strategic Communications Planning Tool in Nigeria to align stakeholders to ultimately operationalize the BHCPF. A team from the Nigeria CCG participated in the Strategic Communications for UHC collaborative funded by the United States Agency for International Development (USAID) through the Health Finance and Governance (HFG) Project and in the co-development of the collaborative outputs which were then customized and used in Nigeria to aid in the BHCPF rollout. The team was able to use these JLN tools to gain a better understanding of key stakeholders in order to better target them with pertinent information. The team also used the stakeholder analysis data to design their action plan, including prioritizing key audiences and co-creating messages specific for these audiences, including specific information to address barriers for community members, health facility workers and budget holders. Ultimately in 2018, the FMOH team received the first appropriation for the BHCPF of approximately USD180 million. This was an accomplishment four years in the making, from the signing of the health law through the development of the implementation and communication plan.
Mongolia’s use of the Empanelment Assessment Tool enabled a shift to a person-centered approach for PHC. Linking empanelment to a mobile technology initiative providing team-based PHC home visits has contributed to a national empanelment approach and shifts in health care seeking behavior. This case study profiles the use of the Empanelment Assessment Tool in Mongolia. Mongolia decided to implement person-centered integrated care (PCIC) best practices to improve health services and outcomes among underserved populations who faced geographic barriers to PHC because they live in extremely remote and rural provinces. They did this by building PCIC best practices into another project they were scaling up at the same time, a mobile health pilot project focused on home visits. Mongolia integrated two pillars of PCIC into the mobile health project: a multi-disciplinary approach to the home care visits and the rostering of all co-habitants. These new approaches, after participating in the JLN’s PCIC collaborative, helped the Mongolian Ministry of Health connect more members of nomadic or geographically dispersed populations to PHC providers, an important step toward universal health coverage.
This resource shares the results of a global review of country efforts to prioritize public spending in the health sector, intended as background reading material developed during the course of the JLN’s Domestic Resource Mobilization (DRM) collaborative. On Prioritizing Health: A Background Analysis includes a global review of health share of public spending across 20 low, middle, and high-income countries, to identify successful cases of reprioritization. Subsequent efforts based on this analysis can focus on a deep dive for a sub-set of countries that have sustained recent reprioritization efforts toward health. Health is often seen as an unproductive sector, which can make it challenging for Ministries of Health to make the case for greater investment. By gathering insights into successful reprioritization efforts, countries and policymakers can better understand how successful efforts have overcome common bottlenecks.
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