Title: Universal Health Coverage (UHC): - Current challenges in Health Sector Reforms
Keywords: Health systems
Health reform
Health Policy (incl. advocacy)
Country: Netherlands
Institution: The Netherlands - Royal Tropical Institute (KIT), Amsterdam
Course coordinator: Y.S. van den Berg, MD, MPH
Date start: 2017-08-14
Date end: 2017-08-25
About duration and dates: 2 weeks
Classification: advanced optional
Mode of delivery: Face to face
ECTS credit points: 3 ECTS credits
SIT: 84 Student Investment Hours
54 contact hours, 6 hours group work, 24 hours self-study
Language: English

At the end of the module the student should be able to:

• Critically discuss the concept, and broad aims of ‘universal health coverage’.
• Appraise the relative importance of financing and funding constraints to organizational, political, human resources, sociocultural and gender-based barriers to universal access.
• Compare and discuss the challenges of the various financing modalities for health systems in LMIC, including those of external aid. Appraise opportunities and feasibility for raising additional resources.
• Identify major sources of inefficiencies within health systems, and formulate strategies to reduce them.
• Discuss positive and negative incentives of provider payment systems and contracting arrangements on performance of health systems and on provider behaviour.
• Appraise a country situation in terms of progress towards the different dimensions of UHC.
Assessment Procedures:
A written open book: assignment to be elaborated in 3 hours, on a case scenario (a country case study of around 10 pages, that will be given one day in advance); a set of questions related to this case study will be given at the start of the exam, and will cover the various challenges in relation to UHC.
(readers and course materials may be used). Resit can be done one month after the course. Participants will receive the material through email and have to send it back within a specific time frame.

The focus of this course is clarifying the paradigm of UHC, linking it to broader health systems strengthening and related health reforms.

Program highlights:
• Introduction to concepts of universal health coverage (UHC), relating it to other health sector reforms and paradigms (PHC, HSS, HiAP/SDOH, HRH, SDG-agenda, etc).
• Comparative (dis)advantages of different modalities to health systems financing: insurance, external aid, general & earmarked taxes interpreting NHA data;
• Demand side barriers to UHC: sociocultural issues, gender relations, perceptions on cost and quality; supply side barriers: service availability and readiness, HRH issues, organizational issues (decentralisation, integration, public and private provision)
• Quality of care and Universal Health Coverage; the role of Basic Benefit Packages and their costing; breadth, depth and height dimensions of UHC;
• Provider payment Mechanisms, contractual arrangements and Results-based Financing (P4P); resource allocation versus purchasing; rationing as an implicit or explicit choice;
• The policy process and UHC; Measuring progress towards UHC, including their equity dimensions; Voice and accountability: how are the people involved in governance issues around UHC?
• Presenting and debating own countries progress and challenges on various dimensions of UHC and Health System Strengthening (not assessed).

Lectures (54 hours), group work (6 hours), self-study (24 hours).

Introductory interactive lectures; exercises and (country) case studies. Critical reading of articles (guided by sets of questions) that discuss various country experiences and challenges.

• Postgraduate course on public health or international health, diploma or MSc level
• Basic health economics
• At least 3 years professional experience, preferably working or going to work at the national level in a developing country on topics mentioned under contents
• Working for MoH, donor agency, international or local NGO or private consultant.
• English level TOEFL 550 or equivalent, or IELTS 6.0 (academic version)
Maximum number of students: 25
Maximum number of tropEd students: 5
See under prerequisites; in case there are more eligible applicants than the maximum number, the principle of ‘first come, first served’ will apply.
Those who have taken the Health Policy and Financing course can benefit as this course is at a more advanced level.
Fees: EUR 2600, tropEd 1570.
Scholarships: Nuffic: www.nuffic.nl
Major changes since initial accreditation:
The learning objectives have been further revised to reflect the particular emphasis on UHC. The title has been adapted. Otherwise the framework of this module has not changed. The programme is updated yearly to reflect recent developments.
Student evaluation:
Over the years the module was evaluated very well with ratings well over 4 on a scale of 1 to 5, with 5 being the most positive score on relevance and presentation. The high level of facilitators and the sharing of experiences of professionals working in higher levels of health care organisations were the basis for the good evaluations. We have run this course for 10 years now, and there has been a continued demand for it.
In 2013, the course has been organised in Ghana, and not in Amsterdam; in 2014 due to internal reasons, the course has been cancelled.
Lessons learned:
Over the years, more emphasis has been given to participants reviewing their own country situation in the light of the various sessions, over the course of the two weeks building up to a comprehensive assessment and finally a presentation on their countries’ situation, progress and challenges on UHC policies and practice.
tropEd accreditation: The Health Sector Reform and Financing course was accredited in Amsterdam in 2003, then reaccredited in Paris in May 2008. In 2013, the course was resubmitted as a revised version of the earlier course, with a particular focus on health reforms and their relation to the current paradigm of Universal Health Coverage (UHC); therefore the title was changed the present submission is a further revision, in which the title also reflects this focus. Re-accreditation in February 2016, Yogyakarta. The accreditation is valid until February 2021.
Remarks: online application
Email Address: F.Maldonado@kit.nl
Date Of Record Creation: 2012-01-14 08:30:57 (W3C-DTF)
Date Of Record Release: 2012-01-14 15:20:08 (W3C-DTF)
Date Record Checked: 2016-07-05 (W3C-DTF)
Date Last Modified: 2018-03-25 07:35:55 (W3C-DTF)

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