Welcome to the USAID-funded Health Policy Plus (HP+) project website.
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Indonesia’s Minister of Health approved a regulation for public-private partnerships (PPPs) in the health sector in mid-February 2022. HP+ supported the ministry’s Center for Health Financing and Decentralization Policy in spearheading the development, adoption, and sensitization process for the regulation. PPPs are helpful in mobilizing the private sector to address gaps in health services within the public health sector. This regulation, which focuses on non-infrastructure needs within the health sector, will allow private companies and organizations to address government health priorities through various contracting and partnership mechanisms. This is expected to contribute to sustainable and equitable scale-up of those services. Read our report on Building the Foundation for Public-Private Partnerships for Indonesia’s Health Sector.
The Indonesian government launched its first health-related public-private partnership (PPP) to support a maternity waiting home in South Sulawesi in November, 2021. The move is a pilot of a new regulation by the country's Ministry of Health on non-infrastructure PPPs for health. The partnership, which includes the government, a private company, and three local nongovernmental organizations, was facilitated by the Gowa district government and the USAID-funded Health Policy Plus project. The PPP and resulting maternity home, aimed at addressing Gowa’s high rates of maternal deaths, will serve as a model for other districts in South Sulawesi and throughout the country for how to engage the private sector in improving maternal health. Speaking ahead of the event, USAID/Indonesia's Deputy Director of Health, Daryl Martyris, reflected that these types of initiatives are proof that collaboration between the two sectors is a good way to address local problems with local solutions.
On November 30, 2021, HP+ hosted a thought-provoking webinar discussion on the challenges and opportunities in catalyzing the private sector’s investment in health, including for family planning commodities. The speakers, including Denise Harrison from USAID’s Commercial, Security and Logistics division of PRH and Monisha Ashok of the Center for Innovation and Impact joined with Palladium and Salient Advisory representatives and Caspian, an Indian venture debt company investing in health, to discuss findings of recent studies of commercial engagement in the family planning and health products space in India and four countries in Africa. The studies found challenges to attracting commercial sector investment in each region were similar and include financing, regulatory, and pricing constraints. However, discussions highlighted innovations that could be applied and supported by patient and risk tolerant capital provided by donors to mitigate risk for investors such as development impact bonds, credit funds, and multistakeholder grant-making mechanisms to support innovation and scale up. The speakers noted that rapid advances of digital innovations necessitated by the COVID-19 pandemic are demonstrating that capacity and opportunities exist. Speakers challenged listeners and one another to be bold and risk-averse in pursuing and financing innovations as this field of blended financing advances.
On November 9, 2021, Liberia’s Ministry of Health launched a new private sector engagement strategy, which HP+ helped develop, moving the country’s health system a step closer toward achieving universal health coverage. At the launch, representatives from the Ministry of Health, county health team, USAID/Liberia, and the private sector praised the government’s commitment to engaging the private health sector to tackle some of the country’s most pressing challenges, referring to the day as a historic moment. The strategy provides a framework for transparent, informed, and effective engagement between the public and private health sectors. It highlights four goals to be implemented collaboratively between public and private stakeholders that focus on expanding access, quality of care, and financial protection for clients. To implement the strategy, the Ministry of Health will establish a multisectoral private sector engagement technical working group, roll out the strategy at the county level, and train key focal persons on private sector engagement. With this strategy, the Ministry of Health is committing to ongoing, deliberate engagement with the private health sector to tackle some of the country’s most pressing needs in the coming years.
In a new policy brief posted in October 2021, HP+ explores important donor considerations for evaluating potential blended finance opportunities. The brief describes blended finance as the strategic use of public and philanthropic resources to mobilize private capital for development outcomes, which can be used to jump-start and advance solutions to address challenges in family planning financing. Topics covered include types of investors to target for partnership, types of blended structures, and the donor financing required to catalyze private investment. The brief also weighs the pros and cons of investing in health funds and highlights several investment opportunities with potential to expand the use of family planning and primary healthcare in low- and middle-income countries, while generating a viable market return for investors.
Sessions on presenting evidence and ideas on public financial management, the health impacts of COVID-19, and health insurance financing were among those delivered by HP+ researchers at this year’s International Health Economics Association (iHEA) online congress. Representatives from HP+ Kenya, Malawi, and Nigeria hosted an organized session on the need for a strong public financial management system and the challenges faced by many countries in delivering better spending in their journeys toward universal health coverage. HP+’s Rebecca Ross collaborated with the London School of Hygiene and Tropical Medicine to convene an organized session, presenting results from a mixed method study on the impact of Indonesia’s national health insurance scheme on the competitive landscape of public and private healthcare providers. View HP+’s sessions.
Family planning is a key part of Liberia’s first private sector engagement strategy, advanced during a recent workshop in Monrovia supported by USAID and HP+. “The Ministry of Health has recognized the need to engage effectively with the private sector if we are to succeed in our mission,” Assistant Minister George Jacobs told the assembled Ministry of Health staff and representatives from professional associations, federation and regulatory bodies, nonprofit organizations, and the private health sector. The strategy for 2021–23 calls for private facilities offering family planning services to have regularly trained providers, consistent with the ministry’s family planning costed implementation plan. Government approval of the strategy is expected by fall 2021. Following that, the Ministry of Health will begin implementation with a multisectoral technical working group led by the ministry’s newly designated focal point for private for private sector engagement. The group will bring together public and private sector actors, begin rollout of the strategy at county level, and undertake a master training for key ministry focal persons.
Community health stakeholders have developed a roadmap for digitization of community health information in Burkina Faso to improve data management and health service delivery at the community level. The roadmap, which describes digitization interventions in all of the country’s 13 regions, grew out of a workshop supported by HP+ and organized by the Ministry of Health. The workshop aligned technical and financial partners involved in the digitization of community health data and was chaired by Burkina Faso Health Minister Prof. Charlemagne Ouedraogo. Also participating were USAID and partners Digital Square, the U.S. Centers for Disease Control and Prevention, Living Goods, the Bill & Melinda Gates Foundation, the World Bank, UNICEF, Terre des Hommes, the Malaria Consortium, Abba’s International Healing Center, and the Red Cross. The alignment workshop explored the use of CommCare, a platform for building and deploying data applications in low-resource settings. Following the workshop, USAID announced it will contribute $1 million to the digitization effort, to include a coordination role for HP+. A task force will be established to oversee and coordinate implementation of the roadmap.
Indonesia’s public and private sectors have come together to endorse a policy that will provide a legal framework, institutional arrangements, and reporting requirements to catalyze health public-private partnerships. Representatives from both sectors endorsed the Public-Private Partnership Policy for Health Services in early May, following a series of HP+-supported workshops on the topic. The policy is now considered final, and the Ministry of Health is charged with its administration and implementation. In a preliminary example of how the partnerships can play out, a new partnership was created to address early-childhood immunization. It involves a vaccine manufacturer, a health technology provider, a consumer goods company, and district-level government. The new policy is expected to open up similar opportunities for partnerships between public and private actors to expand access to healthcare. For additional background, listen to our webinar covering this topic.
HP+ Indonesia hosted a webinar on June 4, Advancing Indonesia's Equitable Health Policy through Strategic Capacity Strengthening Partnerships, to highlight a nearly a six-year collaboration with the government of Indonesia to support its ambitious health reform agenda and improve the policy, financing, and regulatory environment to promote positive outcomes in primary healthcare, maternal and child health, and HIV. The discussion, with special guest speakers from the Ministry of Health’s Institute for Health Research and Development, the Center for Health Financing and Insurance, and the Ministry of National Development Planning explored advances made in creating fiscal space for health, data analysis, and private sector engagement with an emphasis on capacity strengthening and addressing challenges of decentralization. Pamela Foster and Jack Langenbrunner from USAID’s Indonesia Mission joined the discussion on the collaboration and the need to sustain health sector gains in a post-COVID-19 era.
Tanzania has taken some steps to broaden financing for family planning. During a two-day workshop convened last month by HP+, Tanzanian stakeholders discussed options for sustainable financing for family planning services, focusing on segmentation of the family planning consumer market and integration of family planning into the county’s national health insurance scheme. HP+ will model several policy scenarios for financing the scale-up of family planning services to reach the modern contraceptive prevalence rate outlined in the Tanzania National Costed Implementation Plan. The modeling will quantify costs to the government and to women under scenarios in which family planning is offered for free to all users, is incorporated into the health insurance benefits package, and is expanded through commercial products. The findings will be used to advocate for a sustainable option to finance family planning scale-up, with the intent of increasing domestic resource mobilization for family planning, increasing private sector engagement in the delivery of family planning services, and improving access to family planning for the underserved and vulnerable in Tanzania.
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 November 12, HP+, in conjunction with USAID and Indonesia’s Ministry of Health’s Centre for Health Financing and Insurance (PPJK), hosted a global practice webinar. “Public-Private Partnerships (PPPs) for Health: Nuts and Bolts from Policy to Practice—Highlights from India” is the fourth webinar in a series focused on strengthening health sector stakeholders’ understanding of global best practices in scaling up high-quality health services through PPPs. With over 100 participants hailing from government, academia, and the private sector, the webinar explored the rationale and benefits for creating PPPs, approaches to identifying opportunities for collaboration, and the tools, resources, and institutions necessary to design and implement partnership approaches. Examples were taken from India’s experience in expanding private sector engagement and blended financing mechanisms in pursuit of better health outcomes, including the Utkrisht Development Impact Bond model applied to maternal and newborn health programs. Speakers, who included representatives from PPJK, the Gates Foundation, USAID/Washington, and USAID/Indonesia, inspired the audience to think beyond traditional corporate social responsibility, toward innovative ways to harness new collaborations between the public and private sectors.
An HP+ webinar on July 8 featured a discussion on Liberia's private sector response to COVID-19 and the Healthcare Federation of Liberia’s efforts to stimulate coordinated private sector engagement in health following a private sector assessment undertaken by HP+ in 2019. Dr. Cuallau Jabbeh-Howe of Liberia’s Ministry of Health, Dr. Nicole Cooper of the Healthcare Federation of Liberia, and Dr. Amit Thakker of Africa Health Business shared reflections on opportunities and challenges of private sector engagement in health and discussed possibilities for collaboration between the public and private health sectors in Liberia. Listen to the webinar here.
Indonesia’s Secretary General of the Ministry of Health expressed support for the swift adoption of new technical guidelines on public-private partnerships (PPPs) and encouraged national and subnational stakeholders to engage in implementation and budgeting for the new guidelines. HP+ has been working with the Indonesian government to develop a blueprint for how to engage in PPPs in non-infrastructure endeavors, such as the training of healthcare workers, management of healthcare facilities, and community-based prevention and promotion activities. The guidelines, which apply to the whole health sector, will soon be finalized and presented to Ministry of Health leadership for adoption.
HP+ recently conducted an analysis of available equipment and supplies required to fight COVID-19 in Niger’s capital, Niamey. The analysis pointed to the need for an increase in hygiene supplies to effectively combat the pandemic. As a result, the Bank of Africa Foundation provided handwashing kits to 20 health facilities in the city. The handwashing kits, which are valued at more than one million CFA (approximately US$1,700), are in addition to the 373 million CFA (approximately US$640,000) already granted by the Association of Banks and other financial establishments to the Nigerien government to aid in its pandemic response.
HP+ supported Cambodia’s National AIDS Authority to conduct a legal and regulatory assessment of private sector provision of HIV services. The assessment concluded that, while the private sector can legally provide HIV services, these services are insufficiently regulated and reported. Findings informed private sector engagement strategies for the five-year National Health Sector Strategic Plan for HIV. If these strategies are adopted, Cambodia can expect to see higher-quality HIV services provided by the private sector, and the government will be able to use more reliable data to program resources.
In March, HP+ conducted a strategic planning and business viability assessment for SijariEMAS Teknologi Inovasi (PT STI)—an information and communication technology private sector start-up focused on improving health sector referrals for pregnant mothers and newborns in Indonesia—using an adaptation of Palladium’s Strategy Execution Bootcamp. As a result of the assessment, the start-up was able to successfully identify key areas to strengthen. HP+ will continue to support PT STI to make strategic adjustments regarding scale-up and expansion of the referral network to new districts, improve marketing and pricing strategies, streamline procurement and contracting processes, and diversify resources.
In February, the newly launched Healthcare Federation of Liberia (HFL) elected its inaugural board of directors, who also participated in their first Ministerial Stakeholder Forum. The association was launched following an HP+ assessment of the private health sector that identified the need for a unifying body as well as opportunities to improve the private health system, create a framework for collaboration with the government, and better leverage private sector actors for improved health outcomes. With HP+ support, the HFL will offer financial management skills-building courses to health small- and medium-sized enterprises and partner with Access Bank to support the development of loan products tailored to the health sector.
In December 2019, Madagascar integrated a tax exemption for contraceptives into the country’s finance law. The exemption, which will remove the 20% value-added tax applied at customs, followed HP+ support to the Ministry of Public Health’s Family Health Directorate to write advocacy messages encouraging key decisionmakers to make contraceptives tax-exempt. This exemption will reduce purchase costs, contributing to operationalization of the new Reproductive Health and Family Planning Law (2018) that promises access to contraceptives for all, and encourage private sector engagement in family planning service delivery.
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.
FDH Bank of Malawi was awarded the first-ever Positive Youth Development Award at the annual Marketing Excellence Awards by Malawi’s only association of professional marketers. The award, recognizing the bank for excellence in developmental and social services targeting young people ages 10-35, was recently introduced as a new award by Chartered Institute of Marketing (CIM Malawi). The award aims at mobilizing the private sector to support implementation of the country’s National Youth Friendly Health Services Strategy in order to improve youth empowerment and access to health services through strengthened public-private partnerships. At the awarding ceremony, private sector attendees expressed enthusiasm about the introduction of the youth award category, which is expected to stimulate the private sector to invest more in youth related interventions as the companies compete to win in coming years. This all comes as a result of HP+ support to the Ministry of Health to prioritize and promote youth friendly health services.
Across two USAID priority states—Lagos and Kano—and at the national level, HP+ is supporting the implementation of a series of activities aimed at achieving sustainable financing for HIV and tuberculosis (TB) programs in Nigeria. At a workshop on September 3, organized by the Kano State Ministry of Health in collaboration with HP+, the Kano State TB Domestic resource mobilization (Domestic resource mobilization) Committee was reactivated following a gap in donor funding and HIV/AIDS programming integrated into the committee’s mandate. The Domestic resource mobilization Committee’s aim is to improve local domestic resource funding for TB and HIV/AIDS control programs in the state, promote public-private partnerships, and ensure effective and efficient appropriation, release, utilization, and management of funds for TB and HIV. The workshop was attended by members of the Kano State Domestic resource mobilization Committee for TB/HIV, including representatives of development partners such as USAID’s Sustaining Health Outcomes through the Private Sector (SHOPS) Plus project, KNCV Tuberculosis Foundation, and FHI360. The workshop resulted in commitments made to develop a roadmap for integration of TB/HIV into national programs, advocacy kits for stakeholder engagement, and improved awareness efforts.
After many months of consultation with leading corporations and NGOs on boosting women’s health and empowerment in the workplace, the United Nations Foundation publicly released the Framework for Corporate Action on Workplace Women’s Health and Empowerment at a UN General Assembly side event on September 23. The framework, which offers a roadmap for gender-responsive policies, practices, and programs with health as the centerpiece of women’s empowerment, was developed by Meridian International—a non-profit, public diplomacy organization supported by HP+. In addition to providing concrete action steps for corporations and global supply chains to support these initiatives, the framework features publicly available tools and resources that can help companies to implement workplace interventions. At a consultation workshop during the Women Deliver conference in June, Meridian’s David Wofford presented the framework’s policy and systems change component that included information drawn from the HP+ Family Planning-Sustainable Development Goals (FP-SDGs) model. The final framework addresses workplace women’s health, gender-based violence, and professional advancement, with a priority placed on expanding access to services.
In recent weeks, Guatemala’s Ministry of Education (MINEDUC) officially established the National Workforce Training System (SINAFOL) for school and extracurricular education systems. SINAFOL—a system that has been supported by HEP+ for over a year—is the structure that manages and coordinates the government, private sector, and social agents to define and implement policies and strategies that guide education and technical occupational training in the country. It incorporates standardization processes, training, evaluation and certification of labor skills, entrepreneurship, and citizenship in a permanent learning context. In addition to establishing the system in early November by ministerial degree, on January 3, MINEDUC published two additional decrees to (1) support the creation of six new careers in order to expand opportunities for young people in the education system, and (2) create a system of skill certification. HEP+ will continue to support the operation of SINAFOL and the skill certification system in coming months. Read the press coverage.
In 2017 and 2018, HP+ began developing tools and approaches to advance public financing for non-governmental organizations working in HIV and other health related areas. HP+ supported the Global Fund for AIDS, Tuberculosis and Malaria (the Global Fund) efforts to prioritize public financing to civil society organizations (CSOs) and non-governmental organizations (NGOs) as a critical factor in all countries’ paths to sustaining and financing their HIV, TB and Malaria programs. This included support to develop the social contracting diagnostic tool, and setting standards for analyzing the legal/regulatory factors inhibiting or enabling this government health system reform. The tools and approaches are now being used around the world by the Global Fund, HP+, and other technical assistance providers to support the uptake of social contracting. HP+ developed a policy brief to summarize the importance of advancing public financing for NGOs/CSOs/private sector as critical to HIV services and epidemic control. The brief outlines the key competencies and capacities needed to advance social contracting into government health systems. In Guyana, HP+ worked with government and other country stakeholders to identify the legal and regulatory barriers for public financing of CSO-led HIV services. In Kyrgyzstan, HP+ supported the Ministry of Health to develop regulations and protocols to implement public financing contracts to non-governmental organizations. In 2018, the government allocated funding to the mechanism.
In December, USAID, through the Health Policy Plus (HP+) project convened a special plenary at the 5th Nigeria Family Planning Conference in Abuja. The session, “Financing Family Planning in Nigeria within the Context of the Basic Health Care Provision Fund and State Health Insurance,” featured panelists from USAID and Palladium—the prime implementer of the HP+ project—and discussants from the private sector and government. Dr. Kolade Oluwatosin, director of the private-sector firm Health Systems Consult Ltd., said during the meeting, “Best practices from countries like Kenya [another HP+-supported country] have shown that insurance can be used to address issues in family planning, but stakeholders—from donors, insurance bodies, civil society organizations, and government—must come together to agree on robust benefit packages.” From the meeting, a list of recommendations was generated for how Nigeria’s government could improve access to family planning while strengthening standards of care.
Under the leadership of Senegal’s Ministry of Health and Social Action, HP+ West Africa organized an unprecedented family planning advocacy workshop in Dakar in August to secure support and financial commitments from the private sector. The workshop resulted in more than US$630,000 pledged for family planning funding. The International Management Group (IMG), a private company from Cote d'Ivoire that took part in the Dakar meeting disbursed funds for family planning advocacy and clinic services in December 2018. Their contribution provided access to contraceptive pills, injectables, implants and IUDs to 121 additional women on voluntary contraception. This is just a start. IMG expressed a commitment to sustain its engagement moving forward.
Under the leadership of the Senegal’s Ministry of Health and Social Action, USAID-funded HP + West Africa organized an unprecedented reproductive health and family planning advocacy workshop August 30 and 31, 2018, in Dakar to secure support and financial commitments from the private sector resulting in more than approximately USD 630,000 pledged for family planning funding. Participants, including representatives of Banque of Africa, Nantou Mining SA, Mata Holding and other private sector groups, signed a collective declaration in support of reproductive health and family planning policies and programs in their respective countries. USAID Senegal representative, Omar Sanga, the senior government-to-government financing advisor, said of the workshop: "It is exceptional what I saw, such a success with the Private Sector of the sub-region. It is thanks to the expertise of HP+." Follow-up will be done by HP+ at the country level to ensure that the commitments made by the private sector will be implemented.