1.
Ghana
Joint Learning Workshop:
Moving Toward Universal Health Coverage
India
Overview and Workshop Agenda
Heritage Village Manesar
Gurgaon, Delhi, India
Indonesia February 3-5, 2010
The Philippines
Thailand
Vietnam

2. Joint Learning Workshop:
Moving Toward Universal Health Coverage
Overview and Workshop Agenda
Logistical information
The Joint Learning Workshop will take place at the Heritage Village Manesar Hotel in Gurgaon,
near Delhi, India. The hotel is located approximately 30 minutes from the Delhi International
Airport.
Heritage Manesar ‐ Select Holiday Resorts
NH 8, Manesar, Gurgaon ‐ 122050
Tel: +91 (0)124 287 1500
Participants of the Joint Learning workshop will be staying in either the Heritage Village Manesar
or the nearby Ramada Hotel. For those staying at the Ramada hotel, transportation to the
Heritage Village will be available at the beginning and end of the day, and can be arranged as
needed at other times.
Hotel Ramada Gurgaon, BMK
Adjacent To Rajiv Chowk, Civil Line, Gurgaon
Tel: +91 (0)124 471 7000
Airport transfers to the hotels are being arranged for each participant based on the flight
information provided during the online registration process.
The Joint Learning Workshop will officially begin the morning of February 3 and conclude on the
afternoon of February 5. Optional site visits and presentations will take place on the afternoon of
February 2 for international participants and others who are arriving early. Each day will begin
with breakfast at 7:30 AM. For those not staying at either the Heritage Village or the Ramada,
please plan to arrive at the Heritage Village in time for the first session at 8:30 AM each day.
Should you encounter any questions or concerns before or during the workshop, please contact
the following members of the workshop secretariat:
For questions regarding logistics:
Rahul Reddy | ACCESS Health Initiative | +91 955 004 8581 | joint.learning@accessh.org
Any other inquiries:
Sofi Bergkvist | ACCESS Health Initiative | +91 970 405 1113 | sofi.bergkvist@accessh.org
Brian Latko | Results for Development | +1 216 509 4907 | blatko@resultsfordevelopment.org
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3. Joint Learning Workshop:
Moving Toward Universal Health Coverage
Overview and Workshop Agenda
Introduction and context
Over the past decade, a number of national or state‐level reforms have been implemented
by governments that are committed to expanding health coverage through “demand‐side”
(third‐party) financing models, to reach the poorest and informal sectors of their
populations. These reforms – undertaken by countries as varied as Chile, Colombia,
Estonia, Ghana, India, Indonesia, Kenya, the Kyrgyz Republic and Vietnam – are ambitious
in their goals, but challenging to implement successfully. Specific challenges often facing
these types of reform efforts can include establishing effective mechanisms for claims
processing and reimbursement, and provider payment and contracting.
Many organizations and initiatives currently provide helpful policy assistance for and
generate valuable information on these new and innovative reforms (e.g., ILO, CGAP, GTZ,
USAID, the World Bank, the Health Insurance Fund, P4H, etc.). To complement these
existing activities, there is increasing demand for cross‐learning and joint problem‐solving
among countries pursuing similar reforms. Cross‐learning activities are specifically desired
by implementing practitioners who feel they can work with peer countries to identify
strategies and tactics to overcome the many challenges of successful implementation.
To meet this demand for cross‐learning, a group of initiating countries, in collaboration
with several development partners, is developing a plan to establish a multi‐country cross‐
learning platform for countries implementing demand‐side financing reforms. This effort
would result in a network of country‐level implementers, ongoing activities designed for
cross‐country learning and problem‐solving, a repository of existing and new tools that
could be used by implementers, better documentation and dissemination of existing
reform efforts and a practical research agenda around core implementation questions.
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4. Joint Learning Workshop:
Moving Toward Universal Health Coverage
Overview and Workshop Agenda
Workshop objectives
As a first step toward the development of an ongoing, multi‐country cross‐learning
platform, several countries and their development partners have convened a joint learning
workshop in Delhi, India on February 3 – 5, 2010. The workshop brings together
practitioners from six countries to share learning around the successes and problem‐solve
around the challenges of implementing demand‐side health financing reforms to expand
health coverage. The focus of the workshop is on practitioner‐to‐practitioner learning,
rather than teaching or training by certain countries or technical experts. In this regard, the
workshop serves as a pilot for the practitioner‐to‐practitioner learning model that may be
used in subsequent meetings or workshops.
The broad objectives of the joint learning workshop are to:
• Provide a forum for knowledge transfer and joint problem‐solving across countries
on a variety of policy and technical issues
• Enable participants to gain a deeper understanding of at least one issue of technical
significance and problem‐solve jointly with other participants on the issue
• Develop stronger informal ties among champions of health financing reforms across
countries and with the international community, and create a platform for continued
collaboration
• Strengthen the case for continued reform among participant countries, creating
momentum to act and fostering a sense of community among countries facing
similar challenges to achieving reforms
• Highlight specific needs (e.g., funding, technical assistance, monitoring/ evaluation,
research, etc.) of participant countries that might be met by external assistance
• Identify mechanisms for ongoing joint learning that facilitate collaboration to address
existing and upcoming challenges, and develop a series of next steps for continued
joint learning
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5. Joint Learning Workshop:
Moving Toward Universal Health Coverage
Overview and Workshop Agenda
Participants and partners
Target countries: For this initial workshop, participant countries are low/middle‐income
countries that have made a political commitment to pursue universal health coverage
through implementation of reforms that utilize demand‐side financing, and that have
begun implementation of such reforms. Within this broad definition, the countries are at
various stages of implementation, and have chosen different methods for financing these
reforms. The six countries at this initial workshop include Ghana, India (with delegations
from several states currently implementing reforms), Indonesia, the Philippines, Thailand
and Vietnam.
Target participants: The primary target audience of the joint learning workshop is the
practitioners and implementers from reform countries – those not only responsible for
advising political leaders on health financing scheme policy and design, but also responsible
for the implementation of reforms.
The secondary audience for this workshop consists of global development partners,
technical experts and individuals from the academic and research communities. These
partners will act primarily as observers, participating in sessions on technical and policy
issues where they bring particular knowledge or expertise. They will be expected to
observe the workshop, seek feedback from country delegations, and identify specific needs
of the countries that may be met through external assistance. They will be expected to
carefully consider how to best support ongoing joint learning efforts and future models of
collaboration.
Sponsoring partners: Key partners for this initial workshop include the Indian School of
Business, the ACCESS Health Initiative, Atlantic Philanthropies, GTZ, ILO, P4H, the Results
for Development Institute, the Rockefeller Foundation, the Bill and Melinda Gates
Foundation, and the World Bank. Representatives from each of the participating countries
– Ghana, India, Indonesia, the Philippines, Thailand and Vietnam – have also participated
heavily in the development of the workshop objectives, agenda structure, and specific
activities.
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6. Joint Learning Workshop:
Moving Toward Universal Health Coverage
Overview and Workshop Agenda
Program agenda subject to change. Final agenda will be provided upon arrival in Delhi.
(Optional) Day 0: February 2, 2010 – Program/provider site visits and presentations
Time Activity Location
Site visits (off‐site) Meet in lobby of the
• Option 1: RSBY Enrollment Station in the Mewat Heritage at 1 PM for
1:00 PM – 5:00 PM
District of Haryana departure
• Option 2: RSBY Hospital Visit
Presentation (on‐site) Utsav 3
• Health Management and Research Institute
6:30 PM – 7:00 PM (HMRI)
See page 10 for detailed site visit and presentation
descriptions
Dinner in country delegations with informal Restaurant
7:00 PM – 9:00 PM
welcome from workshop organizers
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7. Joint Learning Workshop:
Moving Toward Universal Health Coverage
Overview and Workshop Agenda
Day I: February 3, 2010 – Introduction to country reform efforts and policy discussions
Time Activity Location
7:30 AM – 8:30 AM Breakfast Restaurant
Welcome and opening session Darbar
Mr. Stefan Nachuk – Rockefeller Foundation
Ms. Sofi Bergkvist – ACCESS Health Initiative
8:30 AM – 10:30 AM Mr. Anil Swarup – Ministry of Labor and
Employment, Government of India
Mr. Prabhat Chaudhary – Ministry of Labor and
Employment, Government of India
10:30 AM – 11:00 AM Coffee/Tea Break Outside Darbar
Health reform trivia competition Darbar
11:00 AM – 12:00 PM Ms. Gina Lagomarsino – Results for Development
Ms. Sofi Bergkvist – ACCESS Health Initiative
Country panel discussion – Scope of Coverage Darbar
See page 11 for detailed panel descriptions
12:00 AM – 1:15 PM
Dr. Eduardo Banzon – The World Bank
Country delegation representatives
1:15 PM – 2:15 PM Lunch Restaurant
Country panel discussion – Financing Darbar
2:15 PM –3:30 PM Dr. David de Ferranti – Results for Development
Country delegation representatives
3:30 PM – 4:00 PM Coffee/Tea Break Outside Darbar
Country panel discussion – Institutional Structure Darbar
Ms. Cheryl Scott – The Bill and Melinda Gates
4:00 PM – 5:15 PM
Foundation
Country delegation representatives
Closing Session Darbar
5:15 PM – 6:00 PM
Dr. Ariel Pablos Mendez – Rockefeller Foundation
7:00 PM – 9:00 PM Dinner with cultural presentation or performance Restaurant
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8. Joint Learning Workshop:
Moving Toward Universal Health Coverage
Overview and Workshop Agenda
Day II: February 4, 2010 – Technical workshops
Time Activity Location
7:30 AM – 9:00 AM Breakfast Restaurant
Introduction to technical tracks and logistics Darbar
9:00 AM – 9:30 AM Ms. Sapna Kundra – Results for Development
Mr. Brian Latko – Results for Development
Technical tracks (parallel breakout sessions)
See page 13 for detailed track descriptions
Quality – Using a health financing platform to Utsav 1
promote quality of care improvements
Dr. Jerry La Forgia – The World Bank
Dr. Rob Janett – Senior Medical Director of
Network Health, Cambridge Health Alliance
Provider management – Establishing a robust Utsav 2
provider network through contracting and payment
Dr. Somil Nagpal – The World Bank (Formerly
with IRDA, Government of India)
9:30 AM –1:00 PM Dr. Jack Langenbrunner – The World Bank
Coverage – Strategies for enrolling target Utsav 3
populations and for extending coverage over time
Dr. Peter Berman – The World Bank
Dr. Maria‐Luisa Escobar – The World Bank
(Formerly with Government of Colombia)
Technology – Using technology to support effective Utsav 4
implementation, management, and evaluation
Ms. Gina Lagomarsino – Results for
Development
Mr. Nishant Jain – GTZ India
(Coffee/tea break included during this time)
1:00 PM – 2:00 PM Lunch Restaurant
Technical tracks (continued)
2:00 PM – 5:00 PM
(Coffee/tea break included during this time)
5:00 PM – 6:00 PM Country/state regroups Various (TBD)
Dinner offsite including group activity TBD
7:30 PM – 9: 30 PM
Donor and development partner dinner TBD
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9. Joint Learning Workshop:
Moving Toward Universal Health Coverage
Overview and Workshop Agenda
Day III: February 5, 2010 – Debrief and discussion of future opportunities
Time Activity Location
7:30 AM – 8:30 AM Breakfast Restaurant
Plenary report back from technical tracks Utsav
8:30 AM – 10:30 AM Dr. Robert Hecht – Results for Development
Technical track representatives
10:30 AM – 11:00 AM Coffee/Tea Break Outside Utsav
Country delegation panel on workshop concept, Utsav
methodology and next steps
11:00 AM – 1:00 PM Mr. Nishant Jain – GTZ India
Mr. Stefan Nachuk – Rockefeller Foundation
Country delegation representatives
1:00 PM – 2:00 PM Lunch Restaurant
Joint Learning Network discussion Utsav
2:00 PM – 3:30 PM
Mr. Stefan Nachuk – Rockefeller Foundation
3:30 PM – 4:00 PM Closing session Utsav
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10. Joint Learning Workshop:
Moving Toward Universal Health Coverage
Overview and Workshop Agenda
Session descriptions
(Optional) Day 0 – Site visits and presentations:
Site Visit Option 1 – RSBY Enrollment Station in the Mewat District of Haryana: This site
visit will provide you with an opportunity to visit an enrollment station of RSBY. The
scheme has received significant attention due to its on‐site technique of issuing smart cards
for beneficiaries. At the enrollment station, visitors can see how biometric data and
photographs of each family are collected in the villages, the smart card is printed and
biometrically verified by the Government officer and then handed over to the beneficiary.
The process is simple and takes less than 10 minutes but the back office effort including the
logistics is challenging.
Site Visit Option 2 – RSBY Hospital Visit: A beneficiary enrolled in RSBY is free to go to any
empanelled hospital across India to receive treatment. This is made possible because of
the use of smart card and biometric technology. This site visit provides you with a chance
to see how beneficiaries receive treatment in hospitals that are enrolled in the RSBY
scheme. You will be able to observe the process where beneficiaries are identified and
treated and you will get a chance to interact with beneficiaries about their experiences
using the scheme.
Presentation – Health Management and Research Institute (HMRI): A pubic‐private
partnership has enabled this large scale and innovative model to improve access to
healthcare. The mobile medical outreach program has currently more than 10 million
patient records and provides fixed‐day healthcare services in remote areas. HMRI
furthermore has telemedicine solutions and a well utilized toll‐free number for medical
advice.
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11. Joint Learning Workshop:
Moving Toward Universal Health Coverage
Overview and Workshop Agenda
Session descriptions
Day I – Country panel policy discussions: Policy panel discussions are intended to increase
the audience’s understanding of each country’s health insurance scheme through
discussion of various policy and design issues that are faced by all countries. The sessions
will focus on comparative analysis across countries, and are designed to highlight important
choices and the tradeoffs that exist when considering different options. Each panel will
consist of a moderator as well as a representative from each health insurance scheme
represented at the workshop.
Scope of Coverage: This session will focus on two major design choices related to
population coverage faced by all country or state level health insurance schemes:
1. Segmenting the population and choosing a target population or a set of target
populations to enroll in the scheme (e.g., the poor, informal sector employees, etc.)
2. Deciding on a benefits package that provides an optimal level of both financial
protection and healthcare interventions (e.g., inpatient, outpatient or
comprehensive).
Moderator: Dr. Eduardo Banzon – The World Bank
Panelists:
Ms. Nancy Ampah – Ghana TBD – India (Aarogyasri)
Mr. Anil Swarup – India (RSBY) Dr. Ali Ghufron Mukti – Indonesia
Mr. Oscar Abadu – The Philippines Dr. Viroj Tangcharoensathien – Thailand
Dr. Tran Van Tien– Vietnam
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12. Joint Learning Workshop:
Moving Toward Universal Health Coverage
Overview and Workshop Agenda
Financing: This session will focus on the choices required when deciding on how to fund a
national or state level health insurance scheme, and the tradeoffs that often exist between
beneficiary affordability, political viability and financial solvency. The two major design
choices covered will be:
1. Major sources of revenue put towards health insurance scheme financing (e.g.,
general government revenues, payroll contributions, etc.)
2. The level of beneficiary contributions required and the mechanisms used for
collection (e.g., registration fees, monthly premiums, co‐pays, etc.)
Moderator: Dr. David de Ferranti – Results for Development Institute
Panelists:
Dr. Sam Adjei – Ghana TBD – India (Aarogyasri)
Mr. Nishant Jain – India (RSBY) Dr. Ascobat Gani – Indonesia
Dr. Eduardo Banzon – The Philippines Dr. Samrit Srithamrongsawat – Thailand
Dr. Tran Van Tien – Vietnam
Institutional Structure: This session will discuss the various options for structuring the
administrative operations of a national or state‐level health insurance scheme, including
the key actors involved and the delegation of roles and activities across different actors.
Design choices to be discussed include:
1. Distribution of insurance administration responsibilities (e.g., centralized at
national/state level, decentralized at district or local level)
2. The use of private/commercial insurers or TPAs, the delegation of responsibilities to
those organizations, and required oversight activities
Moderator: Ms. Cheryl Scott – The Bill and Melinda Gates Foundation
Panelists:
Mr. Nathaniel Otoo – Ghana TBD – India (Aarogyasri)
TBD – India (RSBY) Dr. Setiana Adang – Indonesia
Dr. Eduardo Banzon – The Philippines Dr Pongpisut Jongudomsuk – Thailand
Dr. Tran Van Tien – Vietnam
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13. Joint Learning Workshop:
Moving Toward Universal Health Coverage
Overview and Workshop Agenda
Session descriptions
Day II – Technical tracks: Technical track discussions are intended to serve as a platform
for joint learning and problem‐solving across country delegations on implementation‐
related topics that are of mutual interest to multiple countries. Topics were selected based
on a survey as well as a series of interviews with country representatives. Each session will
be 6‐7 hours in length, providing ample time for meaningful interaction and discussion
between country delegates and with participating members of the international
community. Each session will be moderated by international and in‐country participants
with particular interest and specialized knowledge on the topic. Each session will also
consist of several short country case studies designed to spark conversations on the topic.
Quality: Participants will discuss various options available for health insurers and
purchasers for incentivizing quality of care improvements in a demand‐side health
financing (i.e., health insurance) environment. Participants will discuss the major design
elements, trade offs associated with the different design elements, implementation
challenges, and lessons learned. Participants will learn from and discuss successful pay‐for‐
quality schemes and problem solve to determine the steps for implementing similar
schemes within their institutional contexts.
Moderators: Dr. Jerry La Forgia – The World Bank
Presenters: Dr. Robert Janett (US/Massachusetts) – Senior Medical Director of Network
Health, Cambridge Health Alliance
Dr. Paulo Borem (Brazil) – Commercial Director, UNIMED, Belo Horizonte
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14. Joint Learning Workshop:
Moving Toward Universal Health Coverage
Overview and Workshop Agenda
Provider management: In this session, participants will discuss their schemes’ approaches
to provider contracting and payment and the associated tradeoffs and challenges.
Participants will learn from and discuss the experiences of Thailand and other schemes
which have employed innovative approaches to provider payment. Participants will discuss
the range of options available and jointly problem‐solving on how to overcome the typical
challenges associated with establishing a robust provider management mechanism.
Moderators: Dr. Somil Nagpal – The World Bank (Formerly with Indian Insurance
Regulatory and Development Authority)
Dr. Jack Langenbrunner – The World Bank
Presenters: Dr. Jadej Thammatacharee (Thailand) – National Health Security Office,
Government of Thailand
Coverage: Participants will discuss effective strategies for increasing awareness and
coverage levels among the populations targeted by their countries’ schemes. Participants
will discuss mechanisms for identifying and targeting members of the formal and informal
sectors, share challenges associated with expanding coverage in their countries’ health
insurance schemes, and problem‐solve potential solutions to those challenges.
Moderators: Dr. Peter Berman – The World Bank
Presenters: Dr. Maria‐Luisa Escobar (Colombia) – The World Bank (Formerly with the
Government of Colombia)
Mr. Anil Swarup (India/RSBY) – Ministry of Labor and Employment,
Government of India
Mr. Prasad Rao Pasam (India/Aarogyasri) – General Manager of Human
Resources, Star Health
Dr. Eduardo Banzon (The Philippines) – The World Bank
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15. Joint Learning Workshop:
Moving Toward Universal Health Coverage
Overview and Workshop Agenda
Technology: In this session, participants will discuss unique technology solutions that have
been implemented across health insurance schemes, and share the current uses and future
aspirations for technology within their country. Participants will discuss challenges in
health insurance implementation that can addressed through technology. Participants will
also discuss the barriers they face to identifying, selecting, procuring and implementing
new technologies and problem‐solve with one another on the possible solutions.
Moderators: Ms. Gina Lagomarsino – Results for Development
Mr. Nishant Jain – GTZ India
Presenters: Dr. Sun‐Hau Chen (Taiwan) – Information Management Division, Bureau of
National Health Insurance, Government of Taiwan
Ms. Rangsima Preechachard (Thailand) – Social Security Office, Government
of Thailand
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16. Joint Learning Workshop:
Moving Toward Universal Health Coverage
Overview and Workshop Agenda
Post‐workshop Activities
Country implementers, in connection with the workshop secretariat and other
development partners, plan to utilize the joint learning workshop in Delhi as a starting
point for additional collaboration and joint learning activities based on the outcomes of the
workshop and the discussions that ensue. Next steps from the Delhi workshop may
include:
1. Follow‐up meetings and subsequent workshops: The objective of this workshop is
to serve as a “pilot” for additional workshops and meetings still to be scheduled.
With active participation from country delegations, as well as a continued
commitment from development partners, subsequent workshops may be scheduled
with a focus on additional technical topics, or a narrower but more in‐depth focus on
specific technical topics. Additional meetings may also be scheduled to bring
together a broader set of countries, or another group of countries at a different
stage of design or implementation.
2. Establishment of a joint learning network: With the support of country delegations,
the Delhi workshop may serve as the starting point for a broader joint learning
network that can bring together countries and international partners for a variety of
purposes that go beyond workshops. Potential activities of a joint learning network
may include collection and dissemination of information on existing reform efforts,
creation of a repository of existing and new tools that could be used by
implementers, development of a forum for continuous networking and collaboration
across countries, and creation of a platform to connect countries to financial and
technical resources.
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