Positive feedback on the health financing course on universal health coverage

The sixth WHO Barcelona Course on Health Financing took place on 14–18 March 2016 in Barcelona, Spain. Built on the theme of universal health coverage, the course reviewed ways to improve health systems' performance through better policy on health financing.

It was designed and delivered by the WHO Barcelona Office for Health Systems Strengthening in collaboration with WHO headquarters' health financing policy team.

The course brought together 56 participants from 25 countries in the WHO European Region. Participants included government officials, managers and experts of health insurance funds, and representatives of public health institutions, academe and international donor organizations.

About the course

The interactive course combines comprehensive thinking about health systems and financing with helpful tools for analysis, policy design and implementation. Participants encounter examples from countries throughout the course, engage in solving real-life cases and develop lasting professional relationships.

As a challenge, the participants had the chance to engineer real structural reform in one country. In addition, the course addressed a number of key issues in health financing policy with which Member States grapple in their efforts to move towards universal health coverage and to find ways to maintain it in times of economic and financial hardship.

It was organized around key policy issues relating to revenue collection, pooling, purchasing and benefit design, and systematically outlined policy instruments and their impact on financial protection, equity, efficiency, the quality of care and transparency.

Dmitrii Parfentiev, General Director of the National Health Insurance Company of the Republic of Moldova, said, "I really appreciated the country case. What I found most helpful about it was not only the group work, but also the poster viewing, because we could compare what we produced with what other groups produced. That enabled us to learn from each other's approach."

Implementation challenges and the political economy of reform

A highlight of the course was the keynote session, which featured two renowned speakers. The session focused on implementation challenges and the political economy of complex health system and health financing reforms in Portugal and Turkey.

Pedro Pita Barros, Professor of Economics at Universidade Nova de Lisboa in Portugal, addressed the effects of the financial crisis on the health sector. His presentation showed that, even under major fiscal stress, the Portuguese health system continued to protect people from the impoverishing effects of health care payments and ensured access through clever policies and efficiency gains. Professor Pita Barros showed a range of evidence in this regard. Overall, the session emphasized the critical role of politics and communication in reform implementation and provided a fascinating counterpoint to the technical discussions.

Recep Akdağ, Member of the Grand National Assembly of Turkey and Former Minister of Health, gave an overview of the health transformation programme in Turkey, which has brought about a reduction in out-of-pocket payments and an improvement in financial protection, among other achievements. Professor Akdağ underlined that a key strategic approach of the programme was to make tangible improvements visible to the population in the early stages of the reform process. This has created a supportive political mass and has allowed the programme to win over opponents one by one.

Ian Forde, Senior Policy Analyst at the Organisation for Economic Co-operation and Development, said, "In the course, there is something for everybody. So if you are fairly new to the topic of health financing, you can find a lot of introductory materials around the key concepts. But if you know a bit more, then you can also find a lot of data, a lot of country examples and also a summary of the latest evidence on how different policy options perform. No matter what level you are at, you will find something helpful."

Feedback from participants

"We learned that there is no black and white: all policy options have pros and cons that we must consider. In addition, the course has provided me with a number of reference readings that I will always be able to go back to," said Regina Amaya Sauto, Policy Officer at the European Commission.

"I am working for the Federal Ministry of Health of Germany, designing reform legislation, so this course enabled me to reflect on our goals and also on the tools that we have at our disposal to achieve these goals," added Sabine Troppens, Subject Specialist at the Federal Ministry of Health.

 "Both the materials and the lectures were great. You can learn in one week all the financial aspects of health systems, which was perfect," pointed out Yair Asraf, Deputy Director-General of Planning, Budgeting and Pricing at the Ministry of Health of Israel.

"It is a very well integrated course that covers a wide range of aspects, but if you have a particular interest, you have the instruments to go deeper into it," observed Paula de Beltrán, Technical Officer at the Ministry of Health, Social Services and Equity of Spain.

"The course has really exceeded my expectations. In Ukraine, we are currently designing a completely new health system. We really need a lot of information about how to do that right and also to learn from other countries' experiences. Thanks to a very structured presentation of good practices across the Region, as well as the informal communication with other participants, the course has really helped me to organize and deepen my knowledge," said Kateryna Maynzyuk, Fiscal Decentralization Adviser at the Ministry of Finance of Ukraine.