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![Page 1: Ministry of Healthcare & Nutrition Broader Approaches to Health Strategic Frame Work for Health Development.](https://reader035.fdocuments.net/reader035/viewer/2022070401/56649f1d5503460f94c339fb/html5/thumbnails/1.jpg)
Ministry of Healthcare & Nutrition
Broader Approaches to Health
Strategic Frame Work for Health Development
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Peoples’ Needs
Changing /developing world
Continuing /emerging /evolving
problems Available resources
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Challenges
• Health Services• Human Resources for Health• Health Sector Management and Stewardship• Tsunami and Conflict-affected Areas• Optimizing the Private Sector Contribution• Focusing on Vulnerable Groups• Inter-sectoral Collaboration• Demographic and Epidemiological Transition • Health Financing and Resource Allocation
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1.5
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1940 1943 1946 1949 1952 1955 1958 1961 1964 1967 1970 1973 1976 1979 1982 1985 1988 1991 1994 1997 2000
Year
% S
har
e o
f G
DP
MOH Health Share of GDP Nominal (R+C) Exp.
* MOH Health Expenditure combines Recurrent & Capital Expenditures , 2003 is based on Estimates
Figure 01
Health Financing and Resource Allocation1939 to 2003
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Health financing and resource allocation
2005 2006 2007 2008 2009
Total government expenditure on health (Rs bn)
47 63 75 88 103
As a percentage of GDP 1.9 2.2 2.3 2.4 2.5
As a percentage of total government expenditure
5.7 5.7 5.8 6.2 7.2
Recurrent expenditure as a % of total govt. health expenditure
80 74 76 69 66
Per Capita Exp (Rs) 2,311 3,228(30 US$)
3,824 4,469 5,231
Source: MOFP
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Investment in 2006National level Rs. Mn % of Total
Curative services 28,022 78.0
Preventive services 2,758 08.0
Nutrition 870 02.0
Health sector training 2,154 06.0
Health Research 118 0.6
Estate health 55 0.2
General health services 1,174 3.0
Budget proposals 2,027
Provincial levelProvincial Councils 19,777
Source: MOFP
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Capital Recurrent %
Foreign Aid 5,636 15.0
Foreign Aid Related Domestic Funding
1,620 4.4
Domestic Funding
5,151 24,811 80.6
Total 12,357 24,811 100.0
Method of financing-2006
Source: MOFP
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Government Policy
“I consider it my responsibility to preserve the freehealth service and safeguard the right of every citizen for the benefits there under. In this regard immediate action will be taken to enhance theseservices both qualitatively and quantitativelythrough increased budgetary provisions.”
ENSURING GOOD HEALTH
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Strategic Framework for Health Development
Strengthen Individual, Household and Community Actions for Health
Improve Health Services Delivery and Health Actions
ImproveHuman Resource
Development &
Management
Improve Health Financing,
Resource Allocation & Utilization
StrengthenStewardship & Management
Functions
Inter-relationships among the Five Strategic Objectives
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STRATEGIC OBJECTIVE 1 : TO IMPROVE COMPREHENSIVE HEALTH SERVICES DELIVERY AND HEALTH ACTIONS, WHICH REDUCE THE DISEASE BURDEN AND PROMOTE HEALTH
Immediate Objectives:
• To rationalize and strengthen the network of health facilities and services (that includes allopathic and indigenous as well as public and private services)
• To introduce technology assessment at the central MoH and access appropriate technologies
• To ensure adequate drugs, other medical supplies and equipment are in place
• To enhance the quality of service delivery (assuring responsiveness to needs)
• To reduce priority diseases/conditions through strategic interventions
• To improve the health status of vulnerable populations (including marginalized and underprivileged groups)
• To promote inter-sectoral coordination for disease control and prevention
• To increase public confidence and patient/client satisfaction in the health services.
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STRATEGIC OBJECTIVE 2 :TO EMPOWER COMMUNITY TOWARDS MORE ACTIVE PARTICIPATION IN MAINTAINING AND PROMOTING THEIR HEALTH
Immediate Objectives:
• To monitor public perception of their needs and of the health system towards serving as input for improvement.
• To improve participation of civil society and non-governmental organizations in promoting behavioural and lifestyle changes.
• To improve public awareness of their rights, responsibilities and options for care as well as to establish an ombudsman system.
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STRATEGIC OBJECTIVE 3:TO IMPROVE THE MANAGEMENT OF HUMAN RESOURCES FOR HEALTH
Immediate Objectives:• To improve the technical and managerial
competencies of health staff in both curative and preventive sectors.
• To rationalize the development and management of human resources for health.
• To improve the performance of human resources in the health sector.
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STRATEGIC OBJECTIVE 4 :TO IMPROVE HEALTH FINANCE MOBILIZATION, ALLOCATION AND UTILIZATION
Immediate Objectives:• To increase government financial support at all levels to strengthen the financial
sustainability of the health sector
• To improve allocative efficiency and equity
• To identify and test alternative financing mechanisms (including various forms of health insurance, possible fees, co-payment, earmarked taxes and others) with a view towards national implementation. Adopt best option.
• To make optimal use of financial resources (through cost-effective strategies that will be identified, adopted and re-evaluated for the management of priority diseases/conditions).
• To optimise private sector contribution, initially establishing an information-sharing mechanism to include reporting on service use and quality as well as financing.
• To strengthen financial management (including capacity, authority, autonomy, monitoring and supervision, and use of available resources).
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STRATEGIC OBJECTIVE 5 :TO STRENGTHEN STEWARDSHIP AND MANAGEMENT FUNCTIONS OF THE HEALTH SYSTEM
Immediate Objectives:
• To institutionalise effective mechanisms for policy development within existing units.
• To enhance efficiency, effectiveness and accountability of the MoH and decentralised units,
autonomy in management • To strengthen managerial performance at national
and decentralised levels.
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STRATEGIC OBJECTIVE 5 : contd…TO STRENGTHEN STEWARDSHIP AND MANAGEMENT FUNCTIONS OF THE HEALTH SYSTEM
Immediate Objectives:
• To strengthen and introduce monitoring and evaluation of performance, which are related to health outcomes, in all health institutions.
• To strengthen the system for regulating the services of public and private providers.
• To strengthen health information system.
• To strengthen capacity in health research.
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