Over the past decade, a number of national or state-level reforms have been implemented by governments that are committed to expanding health coverage through “demand-side” (third-party) financing models, to reach the poorest and informal sectors of their populations. These reforms are ambitious in their goals, but challenging to implement successfully. Many organizations and initiatives currently provide helpful policy assistance for and generate valuable information on these new and innovative reforms. To complement these existing activities, there is increasing demand for cross-learning and joint problem-solving among countries pursuing similar reforms. Cross-learning activities are specifically desired by implementing practitioners who feel they can work with peer countries to identify strategies and tactics to overcome the many challenges to successful implementation.
To meet this demand for cross-learning, a group of initiating countries, in collaboration with several development partners, is developing a plan to establish a multi-country cross-learning platform for countries implementing demand-side financing reforms. This effort would result in a network of country-level implementers, ongoing activities designed for cross-country learning and problem-solving, a repository of existing and new tools that could be used by implementers, better documentation and dissemination of existing reform efforts and a practical research agenda around core implementation questions.
As a first step toward the development of an ongoing, multi-country cross-learning platform, several countries and their development partners convened a joint learning workshop in Delhi, India on February 3 – 5, 2010. The workshop brought together practitioners from six countries – Ghana, India, Indonesia, Philippines, Thailand and Vietnam – to share learning around the successes and problem-solve around the challenges of implementing demand-side health financing reforms to expand health coverage.
The broad objectives of the joint learning workshop were to:
- Provide a forum for knowledge transfer and joint problem-solving across countries on a variety of policy and technical issues
- Enable participants to gain a deeper understanding of at least one issue of technical significance and problem-solve jointly with other participants on the issue
- Develop stronger informal ties among champions of health financing reforms across countries and with the international community, and create a platform for continued collaboration
- Strengthen the case for continued reform among participant countries, creating momentum to act and fostering a sense of community among countries facing similar challenges to achieving reforms
- Highlight specific needs (e.g., funding, technical assistance, monitoring/evaluation, research, etc.) of participant countries that might be met by external assistance
- Identify mechanisms for ongoing joint learning that facilitate collaboration to address existing and upcoming challenges, and develop a series of next steps for continued joint learning
The workshop spanned 3 days and provided participants from six countries the opportunity to share and learn from one other and engage in in-depth learning around a handful of specific technical issues. The workshop leveraged a range of learning modalities (e.g., from large group presentations and discussion to small working group issue-focused problem solving sessions) to maximize participant engagement and learning.
Key partners for this initial workshop included the Indian School of Business, the ACCESS Health Initiative, Atlantic Philanthropies, the Government of India, GTZ, ILO, P4H, the Results for Development Institute, the Rockefeller Foundation, the Bill and Melinda Gates Foundation, and the World Bank. Representatives from each of the participating countries – Ghana, India, Indonesia, the Philippines, Thailand and Vietnam – also participated heavily in the development of the workshop objectives, agenda structure, and specific activities.
The objective of this workshop was to serve as a “pilot” for additional workshops and meetings still to be scheduled. With active participation from country delegations, as well as a continued commitment from development partners, the Delhi workshop may serve as the starting point for the broader Joint Learning Network.