Over the last few years with the support from WHO the National Health Insurance Company

(CNAM) has been engaged into a process of strengthening its institutional capacities to manage
the internal processes and organization with better efficiency and performance, but also to be
well equipped in supporting the implementation of the health financing and system reforms
planned by the Ministry of Health in the strategic documents. Many organizational development
initiatives have been started in CNAM and positive changes have occurred. An institutional
Development Strategy has been developed in 2012 with new ones revised in 2013 and 2014, the
organizational structure has been changed in early 2014, processes and key performance
indicators for staff developed and approved, also a performance remuneration system for staff
introduced in second half of 2014. WHOs support has been provided along this process and
expert knowledge has been made available to support the development and implementation of:
processes - competency assessment, quarterly strategic planning meetings; and instruments -
scorecards for central and territorial agencies; also mentoring to key staff was provided
throughout the process. A stronger institution would be able to better respond to the health
reforms in the health sector, but more importantly as a state insurer that has obligations in front
of the population that contributes to the mandatory insurance system the institution should be
able to protect the rights of the insured, to guarantee equal and affordable access to care, as well
as to continuously improve the quality of care it purchases on behalf of the population. Thus the
CNAM Institutional Development Strategy has an objective to regularly measure the satisfaction
of the population with the services delivered in the public health system, as well as the
satisfaction of patients with the way the CNAM is servicing the population as an institution
itself. For this purpose MoH has requested WHO support to initiate a population satisfaction
survey that would be country representative and would become a regular process within CNAM.
Considering that CNAM has already conducted a similar survey but a less extensive and less
representative in December 2014, but also considering its legal mandate to protect the rights of
insured and having the structure in place with people working at 7 Territorial Agencies across the
whole country that would collect data, and also considering the analytical capacities at the
central level that would provide data analysis and interpretation, it was decided to delegate the
coordination and implementation role for the population satisfaction survey to the National
Health Insurance Company 2. Objectives, outputs, and indicators of the work assignment,
including technical report.
To conduct a representative population satisfaction survey about the national health system. To
produce evidence based data and analysis to support the National Health Insurance Company in
developing policies and making decisions about improving quality of care and satisfaction of p
To strengthen the capacities of the National Health Insurance Company and its substructures in
providing necessary data and analysis on regular basis for decision makers. To develop
additional evidence of patient satisfaction of the health care system, to be added to the existing
studies conducted on ad-hoc basis, to be used for right decision making.