From 10-12 December, several researchers from the Future Health Systems consortium will be presenting at the Health System Reform in Asia conference hosted by Elsevier at Hong Kong University. Barun Kanjilal of IIHMR has summarized the proceedings in a recent blog 'Health dragons or health hydras? The challenges of regulation in Asian health systems'.
Over the last five years, FHS work in Asia has focused on:
- Health markets and the role of informal providers: For many rural poor, informal providers are the first port of call when seeking health services, especially in Bangladesh and India. However, these providers have little training and often over-prescribe unnecessary – and occasionally harmful – medications to make a living. The FHS Bangladesh team has established a social franchise of informal providers called ShastyaSena, or Health Soldiers, to train the providers and to create a recognized brand of higher quality services.
- Health financing for the poor: As a core health systems building block, FHS focuses on improving health financing mechanisms. In China, this involved research contributing to the merger of two insurance schemes, the New Rural Cooperative Medical Scheme (NCMS) and the Medical Financial Assistance Scheme (MFA). In Afghanistan, our research contributed to the removal of user fees to access health services.
In the future, we will be undertaking cutting edge research in Asia into:
- Health service delivery innovations: Training informal providers has been an important but not sufficient intervention to improve rural health services. Establishing links to the formal sector is also key. FHS Bangladesh, in partnership with the Telemedicine Reference Centre, are exploring innovative mHealth approaches to delivering health services in hard-to-reach areas.
- Unlocking community capabilities: In Afghanistan, health services are mainly contracted to NGO providers through the Basic Package of Health Services (BPHS). Overall these services have been improving since 2003, but communities have had little say in how they can be better tailored to meet their needs. FHS Afghanistan is piloting a community-based scorecard to encourage dialog and improve services.
- Intervening in complex adaptive systems (CAS): One priority on China's health reform agenda is to build a national essential drug system that ensures the rational use and effective delivery of essential drugs. But different combinations of approaches are being trialled in different counties. In the Sundarbans, a range of stakeholders, including the government, NGOs and private sector (mainly informal) actors deliver health services in an uncoordinated manner. Working across countries we will use a CAS approach to plan better interventions and understand how this approach can be used more effectively in other contexts.
- Understanding the links between climatic shocks, health and wellbeing: The Sundarbans are a geographically isolated delta region in West Bengal, India, which are highly susceptible to climate events. Cyclone Aila only left informal providers of health services in her wake when she passed through the area in 2009. We will explore how we can establish resilient and effective health systems in such adverse conditions.
During the conference, we will be participating in a number of panels, presentations and posters, many of which are available as audio 'slidecats' on the FHS website (see links below).
Plenaries, sub-plenaries and symposia
- Meeting new regulatory challenges: Markets, information and citizen, 10 Dec., 16:30-18:00, Rayson Huang Theatre
- Building institutions for health and health systems in contexts of rapid change, 11 Dec., 09:00-10:30, Rayson Huang Theatre
- Strategies for improving the performance of poorly regulated health markets, 11 Dec., 13:30-15:10, Rayson Huang Theatre
- A semi-professional workforce in a growing market: The implications for health care regulation, X. Pei, 10 Dec., 11:30-11:50, Rayson Huang Theatre
- Trust matters: Villagers’ trust in providers and insurers and their demand for community-based health insurance in Cambodia, S. Ozawa and D.G. Walker, 10 Dec., 14:10-14:30, Meng Wah Complex T5
- Food safety regulation in the context of rapid change: The case of melamine contamination of milk in China, Y. Xiao and G. Bloom, 10 Dec., 14:10-14:30, Meng Wah Complex T4
- Coming home: The return of migrant workers with work injury in Hubei & Sichuan, C. Chen, S. Ding, H. Lucas & G. Bloom, 11 Dec. 16:30-16:50, Meng Wah Complex T4
- How donors add value to private sector health care in Myanmar: Tracking the flow of funds in a social franchise, D. Bishai et al., 11 Dec.
- Evaluating the costs & sustainability of improved vaccination coverage in slums in Dhaka, Bangladesh, K. Hayford et al., 11 Dec.