Momentum Toward UHC:
Implications and Opportunities for small-to-medium Private Practices

(Meaghan Smith, Jeanne Holtz, etc)

Reporter: Shita Dewi

Sesi ini adalah sesi satelit yang berupa talkshow, dimana para narasumber 'diwawancarai' oleh moderator. Sesi ini khususnya berbicara mengenai pengalaman Strengthening Health Outcomes through Private Sector (SHOPS) Plus, sebuah inisiatif untuk meningkatkan hasil kesehatan melalui kerja sama dengan pihak swasta yang didanai oleh USAID.

http://www.shopsproject.org/ 

Sesi diawali dengan menceritakan pengalaman Kenya dalam melibatkan sektor swasta dalam upayanya mencapai UHC (cakupan kesehatan semesta). Konteks Kenya hampir sama dengan Indonesia: anggaran untuk kesehatan relatif rendah, belanja kesehatan hampir berimbang antara pengeluaran publik (34%) dengan pengeluaran out-of-pocket (32%), sistem kesehatan didominasi sektor publik (46%) tetapi proporsi sektor swasta sangat besar (40%) dan khususnya apabila memperhitungkan small-to-medium private practices/SMPP (klinik pratama, praktek pribadi atau praktek kelompok). Sistem asuransi kesehatan nasional Kenya baru mencakup 16% dari populasi, dan baru sedikit sekali sektor swasta yang memiliki kontrak dengan sektor swasta. Namun, mengingat Kenya berupaya mencapai cakupan kesehatan semesta, sementara mayoritas masyarakat lebih banyak mengakses sektor swasta, maka kerja sama asuransi kesehatan nasional dengan SMPP menjadi salah satu strategi utama.

Tantangannya, hampir sama seperti di Indonesia, SMPP di Kenya tidak terdata secara tepat berapa jumlahnya, walaupun terindikasi bahwa mereka lebih banyak berkembang di daerah-daerah urban dibandingkan di daerah pedesaan atau perbatasan. Tantangan lainnya adalah SMPP sebagian besar kurang terorganisasi, memiliki keterbatasan manajerial, memiliki range kualitas yang cukup besar, dan dihadapkan pada aturan-aturan yang menghalangi mereka untuk mengakses dana publik (misalnya tuntutan untuk terakreditasi, persyaratan administratif, dll). Ada pula hambatan yang tidak langsung, yaitu sering terlambatnya pembayaran asuransi kesehatan nasional ke SMPP, padahal SMPP biasanya tidak memiliki sumber daya keuangan yang cukup untuk belanja obat, dan lain-lain, apabila cashflow mereka terganggu oleh keterlambatan pembayaran.

Reformasi yang dilakukan di Kenya adalah upaya menggunakan social franchising untuk dapat dimanfaatkan oleh SMPP untuk mengakses dana publik (mendapat kontrak dengan asuransi kesehatan nasional). Dengan cara ini, asuransi kesehatan nasional dapat memperluas cakupan layanan yang tersedia bagi pesertanya. Terdapat banyak keuntungan bagi SMPP untuk tergabung ke dalam social franchise. Social franchising membantu SMPP untuk meningkatkan kualitas mereka melalui 13 langkah stratejik sehingga dapat memenuhi tuntutan untuk terakreditasi. Franchise memfasilitasi self-regulatory. Selain itu tergabungnya mereka ke dalam franchise ini memungkinkan SMPP untuk menegosiasikan harga yang lebih baik dalam pembelian obat, alkes dan BMHP. Franchise juga memungkinkan mereka untuk negosiasi kontrak dengan asuransi kesehatan nasional. Kapitasi yang diterima sebagai anggota franchise lebih besar dibanding kapitasi sebagai SMPP yang berdiri sendiri.

  Take Home Message

UHC (cakupan kesehatan semesta) merupakan aspirasi, dan pertanyaannya bukan "Apakah untuk mencapainya diperlukan kerjasama dengan pihak swasta?", melainkan "Bagaimana dapat mencapainya dengan bekerjasama dengan pihak swasta?"

Social franchise bisa jadi salah satu solusi untuk lebih mengorganisir sektor swasta yang selama ini kurang terorganisir dan kurang terdata dengan baik sehingga seringkali "terabaikan" sebagai mitra potensial dalam mencapai cakupan kesehatan semesta. Namun, ini mengandung implikasi kerja besar untuk memiliki data yang lebih baik mengenai SMPP: siapa mereka, dimana mereka berada, bagaimana merancang kebijakan untuk menarik mereka untuk tergabung ke dalam social franchise? Pengalaman Kenya menunjukkan bahwa hal-hal ini dapat diatasi selama pemerintah memiliki komitmen yang cukup kuat untuk mengambil inisiatif.

Reportase Terkait

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Welcome Plenary:
Resilient People, Responsive Health System?

Malam ini diselenggarakan acara penyambutan acara Simposium Global ke-empat Penelitian Sistem Kesehatan.
Acara penyambutan diawali dengan sambutan dan doa dari tetua suku Indian yang merupakan penduduk asli Vancouver. Acara dilanjutkan oleh tari-tarian tradisional Indian yang bersifat sangat interaktif karena melibatkan para peserta simposium yang tertarik untuk ikut menari.

Tema dari acara penyambutan adalah Resilient People, Responsive Health System? yang berupaya menyoroti perspektif holistik mengenai well being yang dimiliki oleh masyarakat asli suatu wilayah dan bagaimana hal itu seharusnya dipertimbangkan dalam memahami sistem kesehatan secara keseluruhan di suatu negara (yang khususnya memiliki penduduk asli).

Pesan utama yang hendak disampaikan oleh pembicara adalah bahwa pasien dan masyarakat jauh lebih penting daripada data dan statistik. Peneliti dan pembuat kebijakan perlu melihat melampaui angka, rasio dan proporsi, karena di balik setiap angka dalam statistik adalah seseorang yang memiliki cerita hidupnya sendiri, yang status kesehatannya sangat dipengaruhi oleh determinan sosial, yang hidup di dalam konteks yang berbeda yang terkadang membatasi pilihan-pilihan yang dapat dibuatnya.

Sistem kesehatan seharusnya melakukan transformasi dengan menghormati pula kearifan lokal terkait perspektif kesehatan yang lebih holistik. Sistem kesehatan pada umumnya lebih terfokus pada pengobatan orang sakit: sistem ini membelanjakan begitu banyak uang untuk tenaga kesehatan, obat dan peralatan diagnostik dan treatment setelah orang tersebut sakit; namun kurang membelanjakan untuk mencapai dan menjaga well being.

Reportase Terkait

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There are many academics who have embraced social media as a tool for research dissemination and engagement, and these resources show how to make the most of social media.

  Using Instagram

Additional Resources

• Using Instagram for research communication – Research to Action explains why Instagram could be a powerful tool to generate an interested and engaged following for researchers and charities
• How academics can get more out of social media – Harvard Business Review uses a case study to show how social media can work for academics
• A guide to using Twitter @ academic conferences – RMM, a digital business consultancy, provide some top tips for tweeting at a conference

http://healthsystemsresearch.org/hsr2016/training-resources/

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Engaging with the media is an important way to communicate your research to external audiences. It can help to disseminate your knowledge and ideas, stimulate debate, influence policy makers and practitioners and raise your profile as an expert in your field. This guide provides an overview of the main principles of media engagement for researchers, particularly for researchers who do not have access to support from a communications specialist.

  Media Engagement Guide

Additional Content:

• Welcome to the media – these are the rules. – Media and Public Affairs Manager at the Overseas Development Institute delves into the complex rules when it comes to navigating the world of media.
• Media engagement for policy advocacy: A short introduction – In this short video, Aditi Kapoor, from the Public Affairs Centre, discusses how to use media for policy advocacy.
• How to pitch to the media – A simple guide by KnowHow NonProfit on the top ten rules on how to pitch story ideas to journalists and get your organisation's good work recognised in the press.
• The dos and don'ts of successful media engagement – Research Media outline their top tips for avoiding common pitfalls when communicating research and discuss how to optimize reach and engagement on Research to Action.
• Engaging with the media – Explore the Sustainable Development 2015 Advocacy Toolkit Mini-Site for useful tips on getting your message across to a broad audience.
• Has twitter killed the media star? (or How I stopped worrying and learned to love social media) – Head of Communications and Impact at the Institute of Development Studies, James Georgalakis, discusses the change in engaging media since the rapid growth of Twitter.

http://healthsystemsresearch.org/hsr2016/training-resources/

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With demands on researchers to demonstrate the impact of their work ever increasing, the ability to successfully identify and engage with policy audiences is critical. There is an extensive body of literature that already exists around impact, policy influence and engagement and the research policy nexus which can be overwhelming. This short guide aims to provide some practical advice and guidance on some of the most commonly used approaches, tools and tactics for effective policy engagement and some examples of how they can be applied in a health context.

  HSG Policy Engagement Guide

Additional content:

• Policy engagement – The Think Tank Initiative explores how policy influence really works in different countries
• Developing a strategic approach to policy engagement and communication – This is a presentation from the Institute of Development Studies delivered as part of a two day workshop held in Nepal in 2014 aimed at communications professionals or the point person for communication within fifteen South Asian think tanks.
• Why engage with policymakers? – Dr Anna Krzywoszynska from Durham University reflects on the workshop session she ran on 'Policy engagement and the nexus' in the afternoon of the Nexus Network Annual Conference in November 2015.
• How proximity and trust are key factors in getting research to feed into policymaking – Jo Maybin, The Kings Fund, outlines how research most likely has an impact as a result of personal interactions between individual researchers and policymakers in this blog post.

http://healthsystemsresearch.org/hsr2016/training-resources/

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A good presentation can be the difference between getting an idea shared and understood, to it not going anywhere. This short film provides an overview of why we need to put more thought into how we present our ideas and work; and some starting points to achieving that.

  Presentation Matters accompanying handout

Handouts:

These short and snappy resources listed here were originally written and provided by Understanding ModernGov: Speaking with Impact.

• Breaking the fear barrier – Everyone gets nervous before speaking in public. Here are a few tips to help you break that fear barrier.
• Delivering the opening – A powerful opening will capture your audiences attention and make them want to listen to the rest of your presentation. This handout outlines a simple way to deliver a eye catching opening.
• Powerful presentations – Your presentation should leave a lasting and positive impression on your audience. In this document you can learn some exercises to improve your voice and speech that will help you to achieve this.
• Structure for Presenting – A well-structured presentation will help you to get your key messages across to your audience. This handout outlines some key questions you should consider when structuring a presentation.

Additional content:

• 6 speaking tips for scientists and engineers – In this TED blog post, Kate Torgovnick May, outlines six tips on presenting for scientists and engineers – taken initially from a great TED talk by Communications expert Melissa Marshall.
• Hans Rosling: the best stats you've ever seen – Hans Rosling is famous for the way he presents data on global health trends in a memorable and eye catching way. This TED talk is a perfect example of this.
• 8 Classic storytelling techniques for engaging presentations – This blog and handy drawings by Ffion Lindsay describes eight storytelling techniques you could use to structure your presentation.

http://healthsystemsresearch.org/hsr2016/training-resources/

 Back

Blogging is now an established channel for sharing and engaging ideas, especially for academics. Writing blog posts can be a great way to diarise your experiences, turn that report into something bite-size and participate in global conversations. Understanding how to write and share your blog posts will be integral to it's success. This is a step-by-step guide to structuring and promoting your blogs.

  Writing a Blog Post

Additional content:

• Why academics and students should take blogging seriously – In this blog post for LSE Impact Blog, Duncan Green, Oxfam, outlines the major arguments for academics to take blogging and social media seriously.
• How to write a blogpost from your journal article – Patrick Dunleavy, London School of Economics, argues that if you've devoted months to writing the paper, dealing with comments, doing rewrites and hacking through the publishing process, why would you not spend the extra couple of hours crafting an accessible blogpost?
• Fortunate developments: a personal reflection – This blog post by Ben Ramalingam, Institute of Development Studies, is a great example of taking a personal lens and narrative, to a much larger discussion.

http://healthsystemsresearch.org/hsr2016/training-resources/

 Back

A clear and concise research poster can be a great way to present your work to your peers. Research posters are primarily presented at conferences and other events to communicate your research to the audience.

An effective research poster should:

• Present a summary of your work. It can be helpful to think of the poster as telling a story to the audience.
• Be a complete story. If the poster is viewed without a presentation does it still get the point across without explanation?
• Be visually attractive and eye catching to generate feedback and discussion.

There are many research poster templates online and numerous websites providing the do's and don't's of poster presentation. However the key thing to keep in mind is that the design and presentation of the poster should be right for the content.

Resources

This infographic, designed by Natalia Rodriguez (Communications Coordinator at Research4Life) includes some really useful tips and tricks to make your poster effective and stand out from the rest.

Dr Rosemary Morgan from Johns Hopkins Bloomberg School of Public Health and Research Fellow with the RinGs consortium has shared this useful set of slides on preparing poster presentations for health systems research.

Additional Resources

• Designing Conference Posters – A blog written by Colin Purrington that outlines how to design the different elements that make up a research poster.
• Better Posters: A Resource for Improving Poster Presentations – This is a collection of articles (that are part of DoctorZen.net) on research design which features some handy tips and tricks for creating great posters.

http://healthsystemsresearch.org/hsr2016/training-resources/