Steering Role National Health Authority Steering Role

National Health Authority

Priscilla Rivas-Loría, Ph.DAdvisor in Health Sector Reform

Health Systems Strengthening Area, PAHO/WHO, WDC

Priscilla Rivas-Loría, Ph.DAdvisor in Health Sector Reform

Health Systems Strengthening Area, PAHO/WHO, WDC

Monitoring Health Systems Change and Health Reform

English-Speaking Caribbean and Canada

Monitoring Health Systems Change and Health Reform

English-Speaking Caribbean and Canada

Belize City, Belize 30 May - 1 June 2006

Belize City, Belize 30 May - 1 June 2006

WHY IS IT A PRIORITY ISSUE? WHY IS IT A PRIORITY ISSUE?

1. State Reform: reduction size of the State

2. Transfer of functions traditionally performed by public sector to private sector and civil society

3. Globalization: increase in the flow of (a) information, (b) capital, and (c) work force

4. Progressive erosion of the autonomy of the Nation-State leads to a weak governance capacity

5. Insufficient level of institutional development

HSR Regional Trends Influencing

Steering Role Performance HSR Regional Trends Influencing

Steering Role Performance

1. Intensification of decentralization processes.

2. Trend toward the separation of health system functions, such as financing, insurance and health services delivery.

3. Emergence of new public and private actors in the health sector.

4. Growing participation of private health insurance and private pre-payment mechanisms.

PROVIS

ION

ASSU

RANCE

FINANCIN

G

STEERIN

G

ROLE

Trend toward the separation of health system functions, such as financing, insurance and health services

delivery.

HSR Regional Trends Influencing

Steering Role Performance HSR Regional Trends Influencing

Steering Role Performance

1. The exercise of responsibilities inherent to

public policy in health, which take place

within the framework of the new set of

relationships between government and

society in the modern State. It is performed

by the Health Authority.

What is the Steering Role Function in Health?

What is the Steering Role Function in Health?

1. Define and implement public decisions

and actions to fulfill and guarantee the

health needs of all stakeholders within

the framework of the national

development scheme.

Objective

Steering Role Function in Health

Objective

Steering Role Function in Health

RegulateRegulate

HarmonizeProvision

HarmonizeProvision

MonitorFinancingMonitor

Financing

MonitorAssuranceMonitor

AssuranceLeadLead

SteeringRole

SteeringRole

Dimensions of the Steering Role

Dimensions of the Steering Role

Exercise theEPHFs

Exercise theEPHFs

HEALTH AUTHORITY

HEALTH AUTHORITY

FINANCING and ASSUARNCE

FINANCING and ASSUARNCE PROVISION of

HEALTH SERVICES PROVISION of

HEALTH SERVICES

REGULAteREGULAte LeadLead

EXCLUSIVE

Responsibilities

EXCLUSIVE

Responsibilities

Shared Responsabilitie

s

Shared Responsabilitie

s

Responsibilities Responsibilities

Essential Public Health FunctionsEssential Public

Health Functions

HEALTH AUTHORITY HEALTH AUTHORITY

1. Is the custodian of the public good in health.

2. Its main objective is to safeguard, protect and promote the population’s health.

3. Structural differences in the composition of the Health Authority based on the federal or unitary nature character of the country, as well as the institutional organization of the health sector.

1. Is the custodian of the public good in health.

2. Its main objective is to safeguard, protect and promote the population’s health.

3. Structural differences in the composition of the Health Authority based on the federal or unitary nature character of the country, as well as the institutional organization of the health sector.

HEALTH AUTHORITYHEALTH AUTHORITY

LEAD

FINANCING & assurance

REGULAte

Public health HEALTH SERVICES

PROVISION

Economic

Politics

Social

Exercise State responsibilities in health which cannot be delegated

Health Authority

(CITIZENS RIGHTS)

(Power, Governance)

(Economic power)

Why do Mapping?Why do Mapping?

• Diversity of Stakeholders and Institutions

• Scope of Activities

• Separation of Functions

• Context

• Diversity of Stakeholders and Institutions

• Scope of Activities

• Separation of Functions

• Context

identify identify sspecific pecific

stakeholdes stakeholdes and scope of and scope of

action action of of Health Health

AuthorityAuthority

identify identify sspecific pecific

stakeholdes stakeholdes and scope of and scope of

action action of of Health Health

AuthorityAuthority

¿WHO DOES WHAT? ¿WHO DOES WHAT?

LEADLEAD

Capacity to guide the sector’s

institutions and mobilize social institutions and

groups in support of National Health

Policy

Capacity to guide the sector’s

institutions and mobilize social institutions and

groups in support of National Health

Policy

REGULATIONREGULATION

Design normative framework to protect and

promote population’s health and

guarantee its enforcement

Design normative framework to protect and

promote population’s health and

guarantee its enforcement