Brining Universal Health

Coverage Closer to Reality: The

Joint Learning Network
Asian Development Bank
May 8th 2017
Manila. Philippines
Vera Siesjo, Country Director
ACCESS Health International
Disclaimer: The views expressed in this paper/presentation
are the views of the author and do not necessarily reflect the
views or policies of the Asian Development Bank (ADB), or its
Board of Governors, or the governments they represent. ADB
does not guarantee the accuracy of the data included in this
paper and accepts no responsibility for any consequence of
their use. Terminology used may not necessarily be consistent
with ADB official terms.
 What is the JLN and how do
countries engage with the network?
Country-Led: The priorities of the JLN are set by country members at the forefront of UHC
reform efforts.

Demand-Driven: Technical work is done in response to the priorities of country members,

not based primarily on development partner priorities.

Flexible: The JLN does not compete with other global organizations, but is a flexible
network of support that contributes to ongoing in-country activities and global UHC
initiatives.

Global Platform: The JLN regularly produces innovative, practical experience-based tools
and products for countries throughout the world to use in the pursuit of universal health
coverage.

Sustainable: The JLN seeks to exist without question about its long-term financial viability
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Member Countries
Full Members
Bangladesh
Ethiopia
Ghana
Indonesia
India
Kenya
Liberia
Malaysia
Mali
Mexico
Mongolia
Nigeria
Philippines
Senegal
South Korea
Sudan
Vietnam
Associate Countries
Bahrain
Colombia
Egypt
Japan
Kosovo
Moldova
Morocco
Namibia
Peru 4
Yemen
The End Goal of the JLN

Goal 2: Increase
access to essential
health services,
especially primary Goal 3: Improve
health care services. quality of care and
patient safety

Goal 1: Expand
health coverage to Goal 4: Promote
reach target financial
populations, sustainability of
especially the poor End Goal: Extend UHC systems
and informal sector. coverage to more
than 3 billion
people and ensure
financial
protection

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The JLN seeks to accelerate the progress of demand-
side financing reforms in countries moving towards UHC
by:

Enabling
Country
Progress
Translating evidence into
actionable reforms at the policy
and operational level.

Increasing Knowledge
Increasing the understanding of policies and
operational techniques that work best for reaching
universal health coverage.
Improving Implementation
Testing innovative methods for
improving the implementation
Creating Community
of UHC within member
Fostering community and increasing shared learning among countries
countries
pursuing universal health coverage.

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Technical Issues Prioritized within the JLN

Goals
Equitably expand Increased access to Improve quality of Sustainably and
coverage to target services, especially care and patient effectively finance
populations primary care safety services

Costing and pricing of services

Targeted functions

Utilization review/Quality audits

Targeting policy and design of
mechanisms
Delivery system/provider network
design
Licensing/accreditation

Provider Payment
Information technology
X-cutting functions

Strategic communication
Benefits design/Health Technology Cross-cutting functions support all goals
Assessment
Monitoring progress/M&E

Human Resources

Institutional Roles & Governance

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The Joint Learning Approach

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Current Technical Initiatives and Collaboratives

Primary
Population Provider Information Health
Health Quality
Coverage Payment Technology Financing
Care

Mobilizing
Engaging the Medical Domestic
Costing
Private Sector Audits Financing

Measurement Data Analytics Leveraging

for Monitoring Governance
for Existing
Provider of Quality
Improvement Resources
Payment
Fiscal Policy
Health
PPM for PHC Instruments
Benefits
for Health
Policy
Outcomes
People
Centered
Integrated
Care

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The Joint Learning Approach
Collaborative learning among practitioners to co-develop global
knowledge on the practical how-tos of achieving UHC

1. Common
Problem
Identification 2. Collective
Problem Solving 3. Synthesis of
New Knowledge 4. Knowledge
Adapted Within
JLN Countries

Key Benefits of the JLN Approach: 5. Knowledge

Disseminated to
Strong country ownership Other Countries
Relevance to country priorities
Space to analyze root causes
Builds trust, safe space, and community
Results in practical tools/knowledge products that can be
used & shared
Creates opportunities for responsive follow-up by partners

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Co-produced Tools and Guides
JLN members co-produce new knowledge products by blending theory and
tacit knowledge. Below are a few of our publications:

Costing Manual for Provider Payment

Comparative Database of Country Reforms
Data Analytics for Monitoring Provider Payment Systems Toolkit
IT Requirements of Provider a Payment Mechanisms
OpenHDD (Health Data Dictionary)
Expanding Coverage Information Dashboard Prototype
Quality Self-Assessment Tools and Measurement Framework
Knowledge Products in Progress
e-Health Standards for UHC
M&E for Provider Payment
Primary Health Care Self-Assessment Tool
Engaging the Private Sector in Primary Health Care to Achieve
Universal Health Coverage: Advice from Implementers to Implementers

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Joint Learning Fund
JLF has flexible funds to support JLN member countries in their efforts to gain
knowledge of UHC reforms in other countries, and to gain practical experiences in
technical areas together with other countries
JLF is coordinated with leads of technical initiatives
As a basic criteria to apply for JLF, it requires more than one member country
benefiting from the proposed activity
JLN Governance Structure

Steering Group
Country
Country Core
Core
Group
Country
Country Core Core
GroupGroup
Groups
Network Coordinator

Technical Initiatives

Collaboratives and Learning Exchanges

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Results of Mathematica Review

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Results of Mathematic Review
- JLN is a vibrant, highly-valued global network comprising members
who tackle common challenges to achieve UHC

- The governance structure is country-led and responsive to country

priorities

- Effective facilitation requires both technical knowledge and the

ability to listen and learn to co-produce practical knowledge
products

- Technical initiatives are most effective with continuous

engagement and steady, long-term funding

- Strong country engagement requires the buy-in of senior officials

and robust CCGs supported by the network

- The JLF has yet to be leveraged to its full potential 15

Through the JLN, countries have been able to challenge each other, which
has resulted in new ways of thinking about difficult topics

Balance of focus on primary care v. in-patient & tertiary systems

Balance of focus on financing vs. delivery
Use of fee-for-service vs. capitation payment methods
Sequencing of coverage for formal and informal sectors
Institutional architecture for quality
Optimal roles for private insurers
Information systems, biometrics, mobile money, national ID systems
Poverty targeting, leveraging community groups for enrollment
Benefits design -- the advantages and disadvantages of positive and negative
lists
Trade-offs between voluntary enrollment & premium-collection vs.
mandatory enrollment & fully-subsidized premiums for certain populations
Joint Learning Fund Achievements in Indonesia
 Thank you

Vera Siesjo
Country Director ACCESS Health Philippines
vera.siesjo@accessh.org
http://jointlearningnetwork.org