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Summary of P4H telco -/09/2012 - P4H Network

Summary of P4H telco -/09/2012

Participants: EC: Peter Herzig, Christopher Knauth, Andrea Milkowski; WHO: Joe Kutzin, Solomon Kagulula; WB: Jack Langenbrunner; CHAI: Catarina Andrade, Jan Willem van den Broek; GIZ: Holger Thies; P4H CD: Michael Adelhardt.

The telco served to connect the key development partners (DPs) supporting Zambia on health financing (HF) issues; to exchange information about how each DP perceives the situation in Zambia, as well astheir ongoing and planned activities.  

MoH is working on exploring alternative ways of HF since 2006; support for analytic work and feasibility studies from WHO, WB and ILO; mounting pressure from civil servants to have their own health insurance (HI) scheme; more recently development of a concept for a National Health Fund supported by CHAI; new government (2011) keeps policy directions on HF, requests support for an implementation plan (2 CHAI consultants) and for a roadmap (EC and otherDPs).

DP support is coordinated through a country level HF technical working group (CHAI, WB, WHO, JICA, etc.); MoH reports to a multi-sectoral committee on HF issues.

Key points raised:

  • Revenue generation acceptable with MoF aiming at Abudja target; room for improvement re pooling (fragmentation) and use of resources [WB]
  • Hence, WB would not agree with proposed new revenue sources outlined in NHF concept note, May 2012
  • WB and WHO advise caution on starting with schemes for the better-off; this does not lead to scaling-up coverage; important to get other groups in the pool right from the start.
  • Develop a HF strategy before designing ‘schemes’; starting with schemes can be at odds with broader UHC objectives;
  • Re further DP support, some advise to separate civil servant scheme (will go ahead anyway) from HF strategy towards UHC [EC, WB];
  • Need to build more national capacity (think tank for analytic work, guiding HF policy), establishment of a health innovationfund (exchange programmes with universities, trainings); road not yet well defined, flexible funding for development of such a unit [EC].

Collaboration: all participants are open to enhance networking and collaboration; WB invites other DPs to work closely with WB economists in their country office, since many issues go beyond the health sector and are linked to broader economic policy; DPs should get behind a joint approach; EC offers to coordinate their investment with other DPs, invites other DPs to participate in the planning/mission for the remaining EDF10 funds (EUR 24 Mio.);

P4H Coordination Desk (CD) points out the ‘inform and involve’ principle; think of and factor in the complementary resources and capacities of the network at regional and global level; keep P4H CD informed; avoid parallel planning processes by making use of ongoing and planned interactions of DPs with govt. or in country level task force and bring other DPs on board; CD is not a substitute for country level coordination – more of a complementary service desk connecting the regional and global level of interested DPs.

Next steps: 

  • Continue info exchange through this email group;
  • P4H CD to provide summary of discussion;
  • DPs, in particular EC to consider involvement of other partners in their EDF planning process (including regional and global structures of P4H network)
  • WB to keep other partners informed about the outcome of the current mission.