Presentation shpi kp
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The document discusses healthcare financing in different countries and contexts. In high income countries, most healthcare is financed through government and private insurance pools. In low and middle income countries, healthcare is often paid for through private out-of-pocket spending. Globally, high income countries spend more on healthcare and have lower disease burdens compared to low and middle income countries.
Presentation shpi kp
- 2. PRIVATE OUT OF POCKET PRIVATE POOLED PRIVATE OUT OF POCKET PRIVATE OUT OF POCKET GOVERNMENT PRIVATE POOLED PRIVATE POOLED GOVERNMENT GOVERNMENT LOW INCOME COUNTRIES (GNI 1035 US $ per MIDDLE INCOME COUNTRIES (GNI 1036 -12616 US $ per capita/year HIGH INCOME COUNTRIES (GNI above 12616 - US $ per capita/year) GLOBAL FINANCING OF HEALTH CARE
- 3. HIGH INCOME COUNTRIES LOW AND MIDDLE INCOME COUNTRIES HIGH INCOME COUNTRIES GLOBAL HEALTH SPENDING GLOBAL DISEASE BURDEN LOW AND MIDDLE INCOME COUNTRIES
- 4. Article 38 of the Constitution of Islamic Republic of Pakistan Pakistan is a signatory of SDGs Goal 3 Target 8 of SDGs - Universal Health Coverage Country Vision – To improve the health of all Pakistanis, particularly women and children by providing Universal Access to affordable, quality, essential health services through a responsive health system Health Policy Outcome 5- Enhanced Health Financing for efficient service delivery & Financial Risk Protection for people of KP
- 6. Brand Name of the Programme Slogan Logo Districts of Implementation All districts of the province
- 8. 1 Phase I (KfW assisted) • 16th December 2015 2 Phase II • 31st August 2016 3 Phase III • 30th November 2017 • 12th January 2018 – Inclusion of Transgenders 4 Phase IV • 20th August 2020- Coverage of all population
- 9. PHASE PMT SCORE TARGETED HOUSEHOLDS/FAMILIES % OF POPULATION PHASE I 16.17 100,000 3 % (4 districts only) PHASE II 24.51 1,791,930 (Including Phase I) 51% (All districts) PHASE III 32.50 2,461,114 (3,200,000) (Including Phase I & II) 64% (All districts) PHASE IV NA 3,845,168 (6,059,023) 100% Merged Districts NA 1,211,420 100%
- 10. PHASE I PHASE II PHASE III PHASE IV 3% 51% 64% 100% 97% 49% 36% 0% POPULATION COVERED POPULATION REMAINING
- 11. Goal: To incrementally achieve Universal Health Coverage by enhancing access of the poorest population of the province to quality healthcare services Objectives: Reduction of out of pocket payment Improve the quality of healthcare services Enhance stewardship role of Department of Health
- 12. It is a Health Insurance Programme, implemented by State Life Insurance Corporation of Pakistan. Period of contract is 5 years starting from 1st July 2020. More than 6.5 million families of KP would get free inpatient healthcare services. Annual cost of the programme is approximately 18 billion. Services will be provided through a network of Public and Private Hospitals.
- 14. Oversight of the programme. Payment of premium. Provision of data of beneficiaries. Approval of recommended service providers. Monitoring & Evaluation.
- 15. Establishment of required offices and recruitment of necessary staff. Establishment of Central Management Information System (CMIS). Enrollment of beneficiaries. Assessment and Empanelment of hospitals Service provision through empanelled Hospitals. Awareness of beneficiaries and distribution of necessary documents. Grievance redressal.
- 16. Facilitation Disk In Empaneled Hospitals PATIENT DISCHARGED DIDICATED FILTER CLINIC ADMISSION & TREATMENT SPECIALIST OPD FACILITATION DESK IN HOSPITAL PATIENT DEDUCTION FROM THE ACOUNT OF USER PMU AT PESHAWAR PROVINCIAL OFFICE OF SLIC
- 17. Previously beneficiaries were targeted on the basis of BISP Poverty Score Card. In 2012 BISP conducted door to door survey to determine the poverty status of the people. Based on proxy indicators all the households are given a poverty score which is called Proxy Mean Testing (PMT) score. PMT score starts at zero and reaches to 100. Lowest is the PMT, poorest is the family. There are two cut off lines at PMT 16.17 (poorest of the poor) and PMT 32.49 (poor). Average income of Households at PMT score 16.17 or below is $ 1 per day and at PMT 32.50 or below it is $ 2 per day per household
- 19. Premium Rs. 2849/- (+ Rs. 40) per Family/Yea r Secondary care Package Rs. 200,000/Family (40,000/member) Tertiary care Package Rs. 400,000/Family (+ R. 400,000) 85 % of unutilized premium to be returned
- 20. Maternity Transportati on Rs. 1,000 Tertiary care Transportati on Rs. 2,000 Burial Rs. 10,000
- 21. Secondary Care Services All the secondary health care services normally provided at secondary level private and public sector hospitals including DHQ and THQ hospitals The services may include but not limited to: Accidents and emergencies General Medicine General Surgery Orthopedics Gynae and Obstetrics Paediatrics Ophthalmology and ENT etc.
- 22. Tertiary Care Services Accident and Emergency (All the medical/surgical emergency care which can’t be provided in secondary care hospitals) Cardiovascular problems Complications of Diabetes Management of all type of Cancers Management of Genito-urinary diseases including Dialysis and Transplant Management of Neurosurgical diseases Complications of secondary care diseases/procedures needing referral to tertiary care hospitals Artificial limbs (Prosthetics) Breast Cancer Screening
- 23. DISTRICT NAME TOTAL FAMILIES Peshawar 625,476 Swat 508,008 Mardan 472,733 Mansehra 444,394 Abbottabad 367,977 Swabi 353,145 Charsadda 328,727 Nowshera 270,024 D.I. Khan 268,477 Haripur 261,850 Lower Dir 261,041 Bannu 217,004 Kohat 208,647 DISTRICT NAME TOTAL FAMILIES Upper Dir 184,176 Buner 183,032 Shangla 163,649 Karak 157,698 Lakki Marwat 149,997 Malakand 145,359 Battagram 121,455 Hangu 110,869 Chitral 97,783 Kohistan 69,657 Tank 68,239 Torghar 19,606 TOTAL 6,059,023
- 24. Implementation Capacity Advocacy and Public Information Campaigns Ensuring sustainability of the initiative Outpatient benefit
Editor's Notes
- #3: For the fiscal year 2014, low-income economies are defined as those with a GNI per capita, calculated using the World Bank Atlas method, of $1,035 or less in 2012; middle-income economies are those with a GNI per capita of more than $1,035 but less than $12,616; high-income economies are those with a GNI per capita of $12,616 or more. Lower-middle-income and upper-middle-income economies are separated at a GNI per capita of $4,085.
- #5: 38. Promotion of social and economic well-being of the people - The State shall secure the well-being of the people, irrespective of sex, caste, creed or race, by raising their standard of living, by preventing the concentration of wealth and means of production and distribution in the hands of a few to the detriment of general interest and by ensuring equitable adjustment of rights between employers and employees, and landlords and tenants; provide for all citizens, within the available resources of the country, facilities for work and adequate livelihood with reasonable rest and leisure; provide for all persons employed in the service of Pakistan or otherwise, social security by compulsory social insurance or other means; provide basic necessities of life, such as food, clothing, housing, education and medical relief, for all such citizens, irrespective of sex, caste, creed or race, as are permanently or temporarily unable to earn their livelihood on account of infirmity, sickness or unemployment; reduce disparity in the income and earnings of individuals, including persons in the various classes of the service of Pakistan; eliminate riba as early as possible and ensure that the shares of the Provinces in all Federal services, including autonomous bodies and corporations established by, or under the control of, the Federal Government, shall be secured and any omission in the allocation of the shares of the Provinces in the past shall be rectified.