Biennial Health Conference 2011 - Ministry of Health

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Report of the 1st Biennial Health Conference 7-9 November 2011 HEALTH FINANCING AND 11 TH FYP –Mr. Jayendra Sharma, PPD Mr. Jayendra Sharma, PPD made a presentation on “Financing Healthcare in Bhutan” highlighting the need to have a self reliant system. The forum was apprised on how financing impacts cost control, the different methods of healthcare financing and the national policy. He further elaborated on the key findings from the Bhutan National Health Accounts 2009-2010 and Healthcare costing exercises which were carried out by the Ministry. The need for sustainability initiatives by increasing the pool of resources and the ways to minimize the resource leakages was also discussed. Concerns were raised with regard to the definition of basic and free health care in the National Health Policy. The forum was informed that the definition of free and basic health care was discussed in detail and was intentionally removed due to many reasons, with the key reason being that the term basic is dynamic and subject to change with time and evolution of healthcare. With regard to charging non-Bhutanese, directives from the conference was sought by the participants. It was clarified that non-Bhutanese can be categorized into many categories such as teachers who do not earn high salary, skilled and semi skilled workers hired for Hydro power projects, and tourist who are covered by health insurance. Concerns were raised whether it is possible to compare BHU and referral hospital in terms of health expenditure where the services provided are different. It was also submitted that Indent control should be done at every level. With regard to outsourcing, increasing efficiency and cost saving, it was elucidated that outsourcing will bring in efficiency but will take some time. To make health system sustainable, it was raised that the system should allow mixed players and encourage Public Private Partnership model. Permitting private participation in the provision of specialized services in selected diagnostic services was also discussed.. Ministry should review the current existing guideline for charging non-Bhutanese to make it more convenient and uniform. -8-
Report of the 1st Biennial Health Conference 7-9 November 2011 SCHOOL HEALTH SERVICES- Mrs. Sonam Palden, PO, DoPH The Program Officer informed the forum that Comprehensive School Health Program (CSHP) has been renamed as Adolescent Health Program since October 2010. The forum was also briefed on the key area of focus and objectives of the program which included, among others, early diagnosis and follow up of diseases. Following issues were highlighted by the program: Low coverage of health services in the schools Weak referral system and follow up after the school visits Inadequate health promotion The forum noting the increase in adolescent health issues such as teenage pregnancy, acknowledged the initiative taken by the program by broadening the aspects of the program to cover adolescent issues targeting both formal and informal sectors. Concerns surrounding the coverage and frequency of school health checkups in view of the inadequacy of budget were deliberated. The forum also deliberated on the need to prioritize the schools by focusing on schools located in remote areas away from health facilities rather than covering all the schools. Considering that one third of the Bhutanese population are in school, and further acknowledging the impact of school health program on early diagnosis and timely referral of cases from the very remote schools of the country, the forum committed to uplift the activities currently undertaken. The frequency of visit was however, left to the districts to decide depending on the convenience of the district. The forum also agreed on the need to explore alternatives such as involving NGOs in order to reach the unreached population particularly the informal sector and further to mainstream coverage. The forum was informed that life skill based education program would train all the teachers so that they inculcate the knowledge into the students. -9-
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