Palestinian Health Sector Reform And Development Project“The Flagship Project”
The Palestinian Health Conference
“Toward Quality and Sustainable Health Services”
May 7-8, 2009
Presentation on Health System Reform Findings and ComprehensivePriority Response
The Institutional Development Plan
(I. D. Plan)
Health System Assessment Process
•MoH/Flagship utilized USAID Health Systems Assessment Approach tooland adapted it to the Palestinian setting.
•MoH established six technical working groups within the MoH to conductthe assessment with technical and administrative support from the FlagshipProject team.
•MoH/Flagship conducted the assessment to ensure Palestinian ownershipof the assessment, buy-in for recommendations, and sustainability inreforms.
•MoH technical working groups presented their findings and strategies foraction to an audience including the Minister, Deputy Minister, USAIDofficials, and MoH staff.
•The assessment report is a compilation of the findings and suggestedstrategies identified by the MoH.
Health System Elements Assessed
•Governance
•Finance
•Service delivery
•Human resources
•Pharmaceutical management
•Health information system
Governance
•Strengthen MoH capacity to utilize data in management, planning &informed policy formulation.
•Establish mechanisms to involve citizens’ participation in healthpolicy formulation and decision-making.
Finance
•Issue/implement the proposed government health insurance law.
•Initiate a dialogue with national & international stakeholders to agree ona minimum set of dependable resources over next 5 years to effectivelyuse available limited resources.
•Allocate more resources to preventive & Primary Health Care to reducecosts for delayed care.
•Support initiatives demonstrating corporate social responsibility forpublic/private partnerships.
•Maintain rigorous criteria & guidelines for prioritizing referral treatment.
•Develop capacity within MoH to be strategic in procurement of drugs,equipment, and supplies.
Health Service Delivery (1)
•Standardize administrative and operational policies and proceduresto respond to patients’ needs.
•Establish mechanisms to receive and respond to feedback frompatients about quality of care received.
•Review, upgrade, and improve functioning of PHC clinics torespond to needs of patients.
•Establish & implement strengthened referral & discharge follow upsystems.
Health Service Delivery (2)
•Review PHC programs to focus on pregnant women with anemia &reproductive health care needs of post-menopausal women.
•Install medical waste management systems & personnel safetyprocedures.
•Establish an integrated Quality Improvement Program for deliveryof hospital & PHC services.
•Respond to MoH needs in infrastructure, renovation, furniture andequipment.
Human Resources
•Update, standardize & enforce Palestinian standards to:
1.License/relicense and certify health professionals and healthworkers.
2. License and accredit health facilities.
•Update recruitment, hiring, transfer, promotion & deploymentregulations & procedures.
•Provide supervisors with training on supportive supervision & managingstaff performance.
•Develop continuous education programs for all health professionalsincluding residency programs & encourage health staff to participate &reward them for participation.
•Initiate ongoing leadership training for managers.
Pharmaceutical Management
•Issue pharmaceutical procurement law; write, & implementsupporting regulations.
•Adopt & implement a drug procurement plan to include efficientmechanisms for drug pricing, quality assurance & distribution, andencourages national pharmaceutical production.
Health Information Systems (HIS)
•Install computerized information system with networking inside& between hospitals with central management unit at MoH.
•Develop/install HIS to manage: patient registration, admission,appointments, care received, referral & follow-up.
•Develop & maintain an effective HR data base.
MoH Response to Health AssessmentPriority Areas for Reform andIntervention
•Based on assessment findings, MoHdeveloped its 5-year Institutional DevelopmentPlan (IDP)/project action plan to provide animplementation framework to institutionalizeaspects of health sector reforms.
ID Plan Priority Reform Areas and Interventions
Create a Center of Excellence at the Palestine Medical Complex (PMC)
•Why: An opportunity to demonstrate capacity of MoH to providequality care to serve needs of Palestinian people in a cost-affordablemanner. A package of health reform interventions applied on a smallscale at the PMC will serve as a demonstration/model of how to improveclinical services at hospitals and primary health care centers throughoutWest Bank.
Develop a Comprehensive & Integrated Health Information System
•Why: A cross-cutting issue that affects entire health system. Goesbeyond procurement & installation of software & equipment, and buildscapacity of MoH to use data for management, planning, & informedpolicy formulation.
ID Plan Priority Reform Areas and Interventions
Implement the New National Health Insurance (NHI) Program
•Why: An efficient & modern NHI program strengthens MoHcapacity to provide quality care and to generate revenues to improveand sustain health programs.
Design a Medical Facility Accreditation Program
•Why: Represents a commitment to quality care by health careinstitutions through establishing a process to ensure that a facilitymeets a set of requirements/standards to improve safety and qualityof care.
ID Plan Priority Reform Areas and Interventions
Create a Relicensing System of Health Professionals Representingall Health Cadres
•Why: Verifies that the practicing professional workforce is engagedin technically updating their knowledge to provide quality healthcare.
Design a Continuous Education Program to Enable and SupportHealth Professionals to Continually Update their Knowledge
•Why: Creates options to enable health professionals to access andupdate their knowledge and practice to provide quality health care.
ID Plan Priority Reform Areas and Interventions
Improve Performance Management
•Why: Introducing and using new performance managementapproaches & tools results in more motivated staff with a clearunderstanding of jobs that they need to do, establishes peer supportand supportive supervisory staff to provide quality care.
Training and Fellowship Programs in Health Administration andManagement
•Why: Training and system reform requires equipping individualswith new approaches and tools to lead the process of change.
ID Plan Priority Reform Areas and Interventions
Improve the Quality of Clinical Emergency, Primary, Secondaryand Tertiary Health Care (Modules 11, 12 and 14)
•Why: Effective and appropriate care at each level results inincreased patient satisfaction, better health outcomes, and efficientuse of MoH financial resources.
Strengthen Service Delivery and Clinical Guidelines
•Why: Current, evidence-based, user-friendly and available clinicalguidelines serve as basis for quality service delivery by trainedservice providers.
ID Plan Priority Reform Areas and Interventions
Improve Medical Waste Management
•Why: Having specific legislation, regulations, standards, and the authorityand capacity to implement effective waste management practices willimprove the safety of personnel, patients, and environment.
Improve Health Communications and Community-Based HealthServices (Modules 13 & 16)
•Why: Optimal health outcomes can only be achieved through acombination of clinical and community-based interventions that alsoaddress knowledge, beliefs, attitudes and skills of the public and healthprofessionals. Influencing behavior and practices assures relevant andresponsive health programs, actively mobilizes the participation andresources of the community, and promotes improved health status of thepopulation.
ID Plan Priority Reform Areas and Interventions
Support Passing and Implementation of the Health CommoditiesProcurement Bylaws
•Why: Need for regulations is one of the tools that allow the MoH tobid and obtain in a timely and cost-effective way all drugs requiredto respond to the health care needs of the Palestinian people.
Introduce & Implement a Comprehensive M& E Approach
•Why: Putting in place a cross cutting system to improve reportingand communicating results guides planning, decision-making andresource allocation.
ID Plan Priority Reform Areas and Interventions
Improve Coordination of Stakeholders
•Why: Strengthening the capacity of the MoH to coordinatestakeholders ensures that long-term health sector prioritizedobjectives are addressed, that the regulatory role of the MoH isstrengthened, and that there is greater predictability of resources tofinance MoH development goals.
Thank you