This toolkit was created to address gaps in practical knowledge by providing guidance on setting up medical audit units, a step-by-step review of claims to identify providers prone to fraud or poor quality of care, conduct investigations, and use the results of the medical audit.
A digital companion course to the JLN Costing of Health Services for Provider Payment manual.
The Primary Health Care (PHC) Measurement for Improvement Collaborative was launched in partnership with the Primary Health Care Performance Initiative (PHCPI) in April 2016, with the goal of developing practical tools and approaches to improve country-level measurement of PHC performance, address priority measurement gaps, and develop strategies for better utilization of measurement to drive improvements in the PHC system. To this end, the group has developed a PHC indicator inventory, intended to serve as a menu of measures currently utilized by countries, inclusive of routine systems and national surveys and complemented by globally recognized indicators, to allow countries to review indicators, identify gaps, then learn from example indicators other countries are using to measure PHC performance. The inventory is organized according to PHCPI’s Conceptual Framework for PHC, which outlines the key inputs, service delivery processes, and goals of an effective PHC system. In addition to the inventory itself, users will find an instruction manual and collection template. The inventory is intended to be a “living” tool that will be regularly updated with additional country indicators and as the global indicator sets evolve. Individuals interested in submitting indicators from their country may complete the collection template and email it to Allyson English at [email protected] with their name, title, and organization. Strong PHC depends on data that are routinely available and comparable within and across countries. This tool is a critical first step to increasing the availability of data in important areas of PHC delivery.
A carefully developed provider payment system can be a powerful instrument for making progress toward universal health coverage.
What is it? Advice from Implementers to Implementers is a practical manual that contains step-by-step guidance along with real-world examples and case studies to help facilitate public-private sector engagement around primary health care (PHC). The first two modules of the Manual provide practical guidance on Initial Communications and Partnership Around PHC and Provider Mapping. Future modules will cover Provider and Facility Regulation, Accreditation, or Empanelment; Provider Contracting and Payment; and PHC Systems M&E. Who is it for? Advice from Implementers to Implementers is a resource for public sector policymakers and practitioners interested in engaging and partnering with private sector actors to improve PHC to achieve universal health coverage (UHC). Why is it useful? Policymakers are increasingly interested in working with the private sector to provide PHC services in order to achieve UHC, but lack the information and resources to do so. This manual was co-developed to fill this resource gap. Please view the graphic below for instructions on how to use the manual: