Welcome to the USAID-funded Health Policy Plus (HP+) project website.
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President Uhuru Kenyatta launched the 2020–2030 Kenya Health Financing Strategy during the Annual Universal Healthcare Conference on February 7, 2022. The launch signals the government’s commitment to reform the health sector and achieve sustainable, high-quality services for all Kenyans. Among other priorities, the strategy recommends instituting mandatory pre-payment revenue generation from health insurance premiums, replacing out-of-pocket payment at the point of service, guided by fairness and affordability for different income levels. (This recommendation was adopted in a 2022 amendment to the National Health Insurance Fund Act, which has made membership in the fund mandatory for all Kenyans 18 years of age and above.) HP+ provided technical assistance to the Ministry of Health to develop and finalize the strategy, including facilitating stakeholder engagement and advocacy, generating evidence to inform policy priorities, and assisting with drafting the document. HP+ also supported the ministry to develop a communications and advocacy plan, an abridged version of the strategy, frequently asked questions, and a poster to facilitate dissemination. Read more about HP+’s support, lessons learned, and recommendations, including an interview with HP+ Kenya staff Stephen Muchiri and David Khaoya.
The Guatemalan Congress approved a Vaccination Law on February 1, 2022, that will guarantee immunization against vaccine-preventable diseases for the country’s population. The Reproductive Health Watchdog (OSAR), which HEP+ has supported since 2017 in the areas of advocacy and networking, contributed to the law’s review and expanded its contents, providing expertise in health budget monitoring and processes to promote transparency and accountability. The law’s decree provides an allocation in the federal budget for the Ministry of Health’s Immunization Program, ensuring the necessary resources to purchase vaccines, supplies, and promote vaccination programs. It also establishes a technical body to ensure effective vaccination as well as mechanisms for transparency, citizen monitoring, compliance with the federal vaccination scheme, and joint accountability for the distribution of resources for these initiatives. HEP+ will continue to support OSAR in the coming months to spread community awareness about the new law.
HP+ Madagascar has been supporting the Ministry of Public Health to draft a national health financing strategy to advance universal health coverage in the country. In December 2021, the ministry’s Secretary General led a workshop to validate the strategy with participants from technical and financial partners, civil society organizations, and the private sector. Throughout the strategy development process, HP+ supported staff to assess the country’s existing health financing mechanisms, develop national health financing goals, and define the strategy’s vision, objectives, and strategic axes. HP+ also played a role in supporting government partners to understand the purpose and importance of the strategy while facilitating dialogue between government actors, parliamentarians, donors, partners, and civil society representatives to ensure collective ownership of the strategy through a participatory, collaborative, and inclusive process. HP+ will now integrate stakeholder input into the strategy, coordinate finalization and dissemination, and support the development of an implementation plan and monitoring, evaluation, and governance frameworks.
HP+ and Mali’s National Health Insurance Fund (CANAM) co-facilitated a workshop in December 2021 for government and parastatal agencies on HP+’s analysis of CANAM’s provider payment system. At the workshop HP+ shared its recommendations, which included improving efficiency through new communications processes, reducing inefficient healthcare provision practices, and adopting performance-based management practices. The workshop included facilitated discussions and sought input from participants representing the National Federation of Community Health Associations, the Union of Community-Based Insurance in Mali, the Malian social mutuality agency, the World Health Organization, USAID, and UNICEF. A representative from USAID/Mali praised the efforts being made to strengthen Mali’s health system and increase health coverage. CANAM’s Director General noted that HP+’s recommendations will significantly improve the provider payment system, which will strengthen CANAM’s provision of health insurance for Malian citizens. HP+ is working with CANAM to prepare its team to implement the recommendations.
Leading up to UHC Day, a new piece on “The Elusive Goal of Universal Health Coverage” by HP+’s health financing lead, Eduardo Gonzalez-Pier, was published by New Security Beat on December 10, 2021. In the article, he argues that the COVID-19 “pandemic has been a stark reminder of the human and economic costs of not having made larger and smarter investments in health" and that "we should not let a health crisis of this magnitude go to waste." The article closes with important lessons learned, with a leading takeaway being the need to invest in health system strengthening, which not only saves lives but also delivers high rates of economic returns.
A significant policy win was achieved as HP+ Madagascar supported the development of the Public Financial Protection Law, which is intended to create a more favorable legal environment in support of universal health coverage. At a meeting with parliamentarians that HP+ helped organize in May 2021—a rare collaboration between the Ministry of Health and parliamentarians—the parliamentarians accepted the importance of the law and proposed to be part of the process of carrying it forward to advance equitable healthcare access. The president of the National Assembly’s Public Health Commission was particularly engaged and volunteered to personally carry forward the Public Financial Protection Law. The law includes the creation of a new National Health Solidarity Fund, which will be financed through direct transfers from the national budget, private donations, and external funding and will cover contributions for poor and vulnerable populations. Now that the parliament has bought in, they are developing both the law and the national strategy for health financing alongside partners such as the Ministry of Finance and Budget and Ministry of Decentralization. Next steps include establishing a coordination mechanism between the National Assembly and the Ministry of Health and conducting further advocacy in favor of increasing the state budget for the health sector.
The Kenya government officially adopted in July the 2020—2030 Kenya Health Financing Strategy, which provides direction on how the nation will mobilize resources to finance health services to improve access for all. HP+ supported the Ministry of Health this year in revising a draft of the strategy to accommodate new government policies and reflect new research evidence on healthcare financing since the previous version was developed in 2015/16. The strategy outlines how the country aims to achieve universal health coverage and increase access to services for all through strengthened health systems. When fully implemented, the strategy will help Kenya deliver quality care for all and increase the proportion of the total population covered under mandatory prepayment schemes to 85 percent. The strategy also calls for the government to increase its spending on health to 13 percent of total government spending. A national launch of the strategy is planned in the coming months followed by rollout of the interventions, including development of legal and structural instruments and other supportive systems for implementation of the KHFS. HP+ will provide technical assistance to the MOH to organize the launch, design communication and advocacy activities, and support stakeholder engagement on proposed health financing reforms.
The Mali Ministry of Health has approved plans for reorganizing the country’s health infrastructure, including the creation of a National Center for Immunization. The plans, developed with technical assistance from HP+, are intended to accelerate implementation of Mali’s foundational reform documents, the Health and Social Development Plan and the Strategic Framework for Economic Recovery and Sustainable Development. The Ministry of Health plans describe the restructuring of the General Directorate of Health and Public Hygiene and provide authority for the National Center for Immunization to organize and operate the national immunization program. The next step is the passage of the revised policies by several committees and adoption by the Council of Ministers.
In the first collaboration of its kind, Mali’s workers’ unions and civil society came together recently to support Universal Health Coverage Day December 22. The event in the capital city of Bamako was supported by technical assistance from HP+. It brought together various stakeholders to demand government action on its universal health coverage (UHC) strategy. The Council of Ministers endorsed the universal health insurance plan and national fund for universal health insurance in 2018 as part of Mali’s UHC strategy, but implementation remains slow. To ignite implementation of the plan in 2021, HP+ partnered with the Civil Society Platform for UHC, a civil society group under the Global Financing Facility, to mobilize key stakeholders to push the government to adopt the necessary regulations to fully operationalize the insurance coverage. With support from HP+, the Civil Society Platform developed a UHC call to action and the workers’ unions agreed to sign. Full implementation of plan will contribute to improved health outcomes for Malians.
Senegal’s Ministry of Health and Social Action used HP+ supported resources to raise the visibility of and consensus around the need for domestic resources for family planning, helping lead to an increase in the government’s budget allocation to contraceptives. In 2019, HP+ worked with the MSAS and other family planning stakeholders to identify and evaluate opportunities to catalyze domestic resources for family planning, based on an HP+ framework. HP+ also led a budget advocacy training, supporting stakeholders to develop an action plan to influence the next budget cycle. In a recent news article, MSAS Cabinet Director Alphonse Ousmane Thiaw discusses a consultation on mobilizing domestic resources for family planning. He quotes a report supported by HP+ that suggested a focus on national and subnational government advocacy and strengthening support for family planning under Senegal’s Agency for Universal Health Coverage. Thiaw reaffirms the government’s commitment to financing family planning and announces an increased allocation for contraceptives in 2021. This allocation of CFA 500 million (US$926,000) aligns with the country’s FP2020 commitment, reverses the trend of decline in this allocation between 2016 (CFA 300 million) and 2019 and 2020 (CFA 117 million) and will support the annual contraceptive needs of approximately 160,000 family planning users.
In the lead up to Universal Health Coverage (UHC) Day on December 12, HP+ published two new blogs in our series that highlight multisectoral actions critical to strengthening the health systems through which UHC is achieved. HP+ Nigeria Country Director Frances Ilika shows how multisectoral actions in Nigeria are prioritizing the health sector and removing obstacles to financing to increase enrollment in social health insurance at the state level. A second entry, co-authored by Sachi Jani, Daniel Cotlear, and Sayaka Koseki, discusses the need for the public sector to collaborate with the private sector as a key player in the health market to reach UHC. “The public sector can also improve access to services by leveraging existing private sector networks to expand or improve the efficiency of public health services,” they write. “For example, to improve commodity distribution in Kenya, Palladium used a total market approach to integrate the Kenyan government’s family planning program and contraception distribution with the private sector provider network.”
On October 7, HP+ and the Lagos State Health Management Agency (LASHMA) engaged key ministries, departments, and agencies to discuss and reach consensus around modalities of the state’s health insurance scheme’s regulation policy to enable its effective implementation. Discussions helped to determine practical steps for supporting implementation of the scheme at the local level to expand coverage, increase access to HIV services, and reduce out-of-pocket expenditure on health within rural and poor communities and among people living with HIV. To-date, HP+ has supported LASHMA to expand enrollment in the health insurance scheme to over 200,000 people.
In Cambodia, General Secretariat for the National Social Protection Council (GS-NSPC) leadership reached consensus on five actionable policy recommendations to ensure high-quality health services are delivered under national Universal Health Coverage schemes. The recommendations, which include adoption and optimization of a strategic purchasing approach as well as the integration of monitoring and key progress indicators into the annual performance-based budgeting process, were documented in a peer-reviewed article developed with HP+ input, Improving Health Service Quality in the Kingdom of Cambodia: A Policy Perspective, published in the Asia Pacific Journal of Public Health in September 2020.
Since July, over 129,000 new households have been enrolled in Cambodia’s largest social health protection scheme, the Health Equity Fund, which entitles families to receive free healthcare—including family planning services. This accelerated rollout follows publication of a secondary analysis, conducted by HP+, which found that 36 percent of Cambodians living under the national poverty line do not hold an equity card, making them ineligible to benefit from the fund. The study was cited by a Deputy Secretary of State of the Ministry of Economy and Finance in the rationale to accelerate national rollout of the system, which will benefit an additional 47,785 households.
HP+ Cambodia organized a meeting of eight Ministry of Economy and Finance Secretaries and Undersecretaries of State to discuss an internal policy note aimed at expanding social health protection coverage and enhancing financial risk protection to financially vulnerable lower-income families. As a result, the Deputy Prime Minister officially established the Ministry of Economy and Finance high-level technical working group on strategic planning to achieve universal health coverage. If the policy note recommendations are adopted, it would potentially increase population coverage of social health protection to over six million financially vulnerable Cambodians.
HP+ has been supporting the Cambodian government to generate analytics on key universal health coverage (UHC) dimensions, including population coverage and cost modeling; coverage potential, gaps, and social equity; and healthcare seeking and financial risk protection, underpinning an evidence-to-action agenda to accelerate UHC achievement. This work, which catalyzed the formulation and alignment of policy recommendations among key health development partners and within the Cambodian government, was featured in an August 27 webinar, “Evidence to Action- Advancing UHC in Cambodia.” Moving forward, HP+ is facilitating government action to accelerate implementation of the recommendations and support the country on its journey to achieve UHC.
A webinar on June 25 highlighted Nigeria’s successes in achieving health reform, advanced over two years with support from USAID through HP+. Presenters, including HP+ Project Director Suneeta Sharma, HP+ Nigeria Country Director Frances Ilika, and Osun State Health Insurance Scheme Executive Secretary Adeniyi Oginni, discussed domestic resource mobilization, capacity development of primary healthcare management, and health insurance coverage expansion in the Federal Capital Territory and Abia, Ebonyi, and Osun States. Advancements include the unlocking of US$58 million for health to aid advocacy and policy reform and the enrollment of 345,000 individuals in health insurance schemes in Osun State and the Federal Capital Territory.
An original article authored by HP+ in coordination with a research team at Cambodia’s Ministry of Economy and Finance’s General Secretariat for the National Social Protection Council was published in the International Social Security Review. The research, which assesses current coverage potential, gaps, and social equity considerations with regard to the expansion of social health protection in Cambodia, is being used to inform a comprehensive policy proposal to expand coverage to about 5.7 million financially vulnerable people, improve healthcare quality, and strengthen institutional systems within Cambodia.
Representatives from HP+ Cambodia and Indonesia teams participated in the Prince Mahidol Award Conference 2020, adding to discussions on universal health coverage with case studies on HIV financing, social protection, and private sector engagement. HP+ collaborated with USAID to host a well-attended satellite session entitled Harnessing the Private Sector for UHC through Smart Policy, with participation by Elaine Menotti and Pellavi Sharma of the Office of Population and Reproductive Health.
“No other organization supports [the National Health Insurance Scheme] like HP+.” That was the first reaction of Professor Muhammed Sambo, Executive Secretary of Nigeria’s National Health Insurance Scheme last week when reviewing recent results that come in part from technical and financial support given to establish state-level insurance agencies in four Nigerian states. The health reform goal is to reach women and children under five, and to date, Osun state has enrolled over 200,000 participants into their insurance scheme. In the Federal Capital Territory health insurance coverage has been extended to 85,000 formal sector workers and $2.19 million was released to pay for nine months of capitation and fee-for-service. Likewise, in November 2019, Nigeria’s National Primary Health Care Development Agency presented HP+ with an award in recognition of the project’s technical contribution to strengthening the country’s primary healthcare system, specifically for their work in helping states implement Nigeria’s Primary Health Care Under One Roof policy, aimed at improving the quality of and access to care at the community level. More information about efforts in Osun State
In Nigeria, HP+ has been working to support implementation of the Basic Health Care Provision Fund (BHCPF)—a critical health reform aimed at improving and expanding high-quality, affordable, accessible primary healthcare services to all Nigerians. This month, the first-ever BHCPF scorecard, intended to showcase state-level readiness and initial implementation of one of the key sources of federal-level funding for the BHCPF, was rolled out. The evaluation revealed that, of all 24 states assessed, only three (Abia, Osun, and the Federal Capital Territory)—all of which were supported by HP+—met all of the requirements. A fourth HP+-supported state (Ebonyi) met all but one requirement. The scorecard assessed whether proper structures were put in place to accept federal-level funds for implementation, facility baseline assessments were conducted, and a significant cascade of facility-level trainings on BHCPF implementation were completed. HP+ support to this effort is critical, as the project has worked to improve institutional capacity and facility-level readiness to implement a ground-breaking health reform, that if successful, could significantly move the needle towards achieving universal health coverage goals in Nigeria.
A blog published by Health Policy Plus in the lead up to Universal Health Coverage Day December 12th, considers a governance angle on Universal Health Coverage and identifies three areas that are particularly critical: 1) politically aware and savvy champions committed to inclusive processes; 2) leadership and management that fosters a culture of accountability; and 3) more data on the costs of effective management and administration of UHC programs. The authors, Jay Gribble, the deputy director for family planning and reproductive health and Alyson Lipsky, the project’s lead on governance and stewardship, draw on results from HP+ Nigeria and other case studies as they argue that these governance, stewardship, and accountability elements will be key to reaching UHC goals.
Abia State hosted a Legislatures Day Event on September 26, 2019, which featured a special session in the general chamber of the House of Assembly, an orientation focused on state health systems strengthening, and a launch among legislatures and HP+ visitors. The first-time special parliamentary session on universal health coverage at the House of Assembly coincided with the launch of the State Social Health Insurance Scheme and was designed to advance state government understanding and commitment for financing and oversight of the primary health care system. HP+ project director Suneeta Sharma addressed the legislature, where members of the Health & Women, Appropriations, and Public Private Partnership (PPP) committees as well as the speaker of the House expressed their commitment to universal health coverage and the strengthening of the state’s primary health service delivery. The PPP Committee chairman said: “The House will support the primary health care initiative, which will improve the economy of the State because when people are healthy, they can work.” The Abia Legislatures Day Event was an innovative way for HP+ to engage collectively with the House of Assembly on this important topic and to set a model approach for engagement with government leaders in other priority States. Get more background details.
Nigeria’s Abia State launched its social health insurance scheme on September 26, 2019, taking a major step forward in ensuring its citizens gain access to equitable, affordable, and quality health services. The launch comes after a year’s long engagement by Health Policy Plus (HP+), which provided technical support to the health insurance scheme that includes defining and costing of health benefit package, developing the mechanism for claims management and provider payments, and strengthening of the organizational capacity of the agency’s governing board, management, and staff. The launch event was attended by HP+ project director Suneeta Sharma and HP+ Nigeria deputy country director Gani Alabi and several high-level government officials, including the deputy Governor of Abia state, Dr Udeh Oko Chukwu and representative of Senator Orji Uzor Kalu, former governor of Abia state, who committed to enrolling vulnerable populations from his constituency through his eponymous foundation. The chairman of the House of Assembly’s committee on health also demonstrated political will reinforcing the legislatures’ commitment to policies and frameworks for universal access. The governor’s representative announced that disbursement of funds through the Basic Health Care Provision Fund would begin on October 1, flowing to the 292 accredited ward-level primary health centers. The event demonstrated community leadership and the importance of traditional leaders in overseeing the success of the health scheme at the local level. Moving forward, payroll deductions of formal sector employees will begin in October.
Read additional background from local reporting
On May 3, Osun State—one of three states supported by HP+ in Nigeria—became the first state in the country to begin enrollment of clients into the national Basic Health Care Provision Fund (BHCPF), the federal government’s initiative to provide the rural poor with a basic package of health services. Along with the achievement of this milestone, the state will receive approximately US$2.5 million over the next nine months—delivered directly to selected primary healthcare facilities to support the delivery of high-quality health services. HP+ has supported Osun State to pilot the BHCPF for the last three months in preparation for the scheme’s statewide roll-out. “The learning from the pilot program will influence what will happen moving forward,” said HP+ Nigeria Country Director Onoriode Ezire to government officials at the launch. “We hope that, beyond the launch, access will be improved, and we will continue to address maternal and infant mortality in the state,” he added.
On May 22, 2019, two key health reform bills secured concurrence by Nigeria’s House of Representatives, the final step before the bills move forward for presidential authorization. The Federal Capital Territory’s (FCT’s) State Health Insurance and Primary Health Care Board bills, which were passed last month by Nigeria’s Senate, promise to improve access to primary healthcare and relieve financial barriers, particularly among the poor. Once signed into law, the bills will allow the FCT to access the country’s Basic Health Care Provision Fund—a national- and state-level mechanism that aims to extend health insurance coverage and provide a range of free services to the country’s most vulnerable groups.
Nigeria’s Federal Capitol Territory (FCT) is a major step closer to accessing resources for primary health care with the passage of a previously stymied law. Bolstered with evidence gathered with support from USAID through the Health Policy Plus project and capacity development of advocates and FCT leadership, the FCT secured sponsorship of the health insurance and primary health care board bills at the National Assembly and have been able to advance the bills through the stages of the legislative process. Concurrence and presidential assent, the final stages of the process, will open the door for the FCT to access the Basic Health Care Provision Fund (BHCPF), a national and state-level mechanism that will extend health insurance coverage, and a range of free services, not only to those in the public and formal private sector, but also to the vulnerable – pregnant women, children under 5-years old, persons with disabilities, and the elderly – and those in the informal sector, for whom access and the ability to pay for primary health care was a barrier. State-by-state health reform has been advancing to secure the systems and legal backing needed to access the BHCPF, while the FCT had been delayed until now. With this advancement, access to the fund is expected to reduce maternal and under-5 mortality rates and reduce financial hardship resulting from medical costs. Momentum around the BHCPF in Nigeria increased significantly last year with approved funding under the 2018 national budget. HP+ supported FCT leadership through each step of the legislative process, which it will continue to provide as the bill moves forward for concurrence and authorization by the President of Nigeria.
On January 17, two Nigerian states, Ebonyi and Abia, inaugurated the governing boards of their respective state health insurance agencies—an important step in making quality healthcare available and accessible to all Nigerians. This milestone follows an advocacy visit paid the previous day to the State Commissioner of Health, Hon. Dr. Daniel Umezurike, by HP+ Nigeria Country Director Onoriode Ezire, alongside officials from the country’s National Health Insurance Scheme (NHIS). The group discussed the need to establish state health insurance agencies and comply with the requirements of the Primary Health Care Under One Roof policy, prerequisites for accessing the Basic Health Care Provision Fund meant to improve access to quality and affordable healthcare for the poor. Moving forward, HP+ will continue to support efforts to increase quality and reduce the cost of healthcare services throughout the country.
Madagascar’s National Universal Health Coverage (UHC) strategy includes a vision to develop a comprehensive health financing mechanism that will extend the reach of a high-quality essential package of services to more people, especially the poor. As part of this effort, the government is now piloting the National Health Solidarity Fund, a candidate mechanism, to advance the health system towards universal health coverage. To inform health reform decision-making, the USAID-funded Health Policy Plus project conducted an assessment of Madagascar’s current health financing arrangements. Findings from the assessment suggest that Madagascar has a low revenue base, and the health sector relies heavily on donors and out-of-pocket payments to fund key programs and health facility costs. Like many other low-income countries, use of health services is low, health financing pools are fragmented, and financing mechanisms cannot guarantee an essential package of services for most citizens. The assessment also identified opportunities to increase efficiency in budgetary allocation and execution. As the country pilots the National Health Solidarity Fund, this landmark assessment comes at a critical time to inform policies aimed at maximizing financial protection for the poor and vulnerable.
A new journal article published in Global Health: Science and Practice examines the intersection of universal health coverage (UHC) and family planning efforts to understand to what extent selected countries in Latin America and the Caribbean have been successful in integrating family planning services and UHC-oriented schemes. Adopting a family planning lens, the Health Policy Plus authors examine access along the three dimensions of UHC: coverage, range of services (i.e., contraceptive methods), and financial protection. In addition to identifying barriers to access, this analysis takes a first step toward understanding the causal relationship between insurance coverage and family planning access.
The USAID-funded Health Policy Project (HPP), the Health Policy Plus (HP+) project’s predecessor, provided extensive technical assistance to Kenya’s Ministry of Health to develop the KenyaHealth Act, 2017, which was introduced into law last month (July 2017). The act obliges Kenya to provide access to health services to vulnerable groups, mandates the provision of emergency and specialized care, and ensures the provision of free maternity care, vaccinations for children under age five, and workplace breastfeeding facilities. The Health Act also formalizes collaboration between national and county governments with the legalization of the Health Sector Inter-governmental Consultative Forum—a positive step in the country’s continued devolution. Read the full story.
Madagascar's government council passed a decree in April 2017 establishing a national health solidarity fund as part of its universal health coverage (UHC) efforts. The solidarity fund, called Caisse Nationale de Solidarité en Santé(CNSS), aims to cover the cost of preventive, curative, and rehabilitation care for its affiliates, which will be provided nationally via a third-party payment system. The USAID-funded Health Policy Plus (HP+) project provided technical and financial support to the Ministry of Health's universal health coverage division to develop the decree with a broad group of public and private stakeholders. This is an important step for Madagascar following the launch of the UHC strategy, but there is still a long road ahead. HP+ Madagascar will continue to work with the government on next steps, including establishing a clear benefits package and determining the payment structure.
Progress toward universal health coverage that reaches marginalized groups requires a multi-pronged approach that includes health insurance as well as demand-side interventions to improve service utilization; empowered communities demanding accountability; and, mechanisms to identify, reach, cover, and empower neglected or stigmatized populations. These recommendations were made at a USAID-hosted meeting - Extending Coverage to Marginalized Groups - at the Prince Mahidol Award Conference, in Bangkok, Thailand, on January 29th, which featured dynamic conversations among health economists and health reform experts. USAID representatives included Jennifer Adams, acting assistant administrator in the Bureau for Global Health; Margaret Reeves, senior family planning policy advisor; Jodi Charles, senior health systems advisor; and Josef Tayag, senior private sector financing advisor. The meeting was organized in collaboration with USAID-funded projects Health Policy Plus (HP+), Health Finance and Governance (HFG), and Sustaining Health Outcomes through the Private Sector Plus (SHOPS+).
In recent decades many Latin America and Caribbean (LAC) countries have lowered fertility rates and increased contraceptive prevalence. This progress is due in part to broad social reforms, including the adoption of universal health coverage (UHC) policies. To extract lessons for countries—both within LAC and beyond—who are in the early stages of implementing UHC programs, USAID through the Health Policy Plus project examined the interplay between UHC and family planning (FP) in nine countries. They found that, while LAC’s progress in moving toward UHC and expanding FP access has been positive, systematic inequalities persist. Most social health insurance schemes cover FP, but method choice is not always guaranteed and there are disparities in access and coverage between ethnic, geographical, and wealth groups. The briefs are available for download from the HP+ website.
Madagascar’s current family planning (FP) law was adopted around 1920, and restricts contraceptive access to young people. HP+ co-facilitated a workshop on Advanced Family Planning SMART to train stakeholders on FP advocacy techniques and develop a plan of action to assure that the country’s newly revised family planning and reproductive health law—created with drafting and technical review support from HP+—is reviewed and passed by parliament this year. The project is also active in the development and advancement of universal health coverage (UHC) and is represented on the UHC technical working group. The project has collaborated with the World Bank to introduce the RMNCAH (reproductive, maternal, newborn, child, and adolescent health) investment case to the MOH, and will support the ministry in its development.
Supported by USAID's Health Policy Plus project, Kenya's parliamentary health committee adopted an amendment bill to the National Hospital Insurance Fund (NHIF) act. The proposed reforms impact delivery and financing of the mandated benefits package (inclusive of FP and HIV), supporting Kenya's efforts to achieve universal health coverage (UHC). The amendment will facilitate an increase in the number of individuals with health insurance, reducing out-of-pocket expenditure and ultimately reducing catastrophic health expenditure. If adopted, the bill will streamline administration at the NHIF, freeing up resources to be used for service delivery, contributing to domestic resource mobilization for health, and increasing access to essential health services. The bill now moves to the National Assembly for discussion and full adoption by September 2016.