Expanding health insurance coverage for the population of Lao PDR

Expanding health insurance coverage for the population of Lao PDR

Activities under the project which focused on social health protection coverage and improving financial management at facility level provided a valuable contribution to the Ministry of Health's efforts in the implementation of the Health Sector Reform.

Dr. Kotsaythoune Phimmasone, Deputy Director, Department of Finance, Ministry of Health Lao PDR

CONTEXT

Reducing the financial burden of accessing health care for Lao people is part of the Government’s commitment to reaching universal health coverage by 2025. Effective social health protection and efficient allocation of funding to the health sector are key to ensure the necessary resources to deliver services. Different health insurance schemes following different modalities increased the administrative burden on the government and health facilities. Weak financial management and reporting led to delays in fund transfers at all levels resulting in funding gaps within health facilities.

OBJECTIVES

  • Increased access to quality basic health care, including increased coverage of population by merging social health protection schemes.
  • Improved financial reporting and management of health budgets and technical revenues at national, provincial, district and health facility level.

RESULTS

  • National Health Insurance Strategy 2017 – 2020 has been developed.
  • Staff from national, 2 provincial and 4 district Health Insurance Bureaus are able and feel confident in managing the implementation of health insurance schemes.
  • Increased engagement of all stakeholders including vice governors, health officials, health insurance officers, hospital representatives, through quarterly health insurance management committee meetings.
  • The 4 target districts provide monthly summaries of financial reports in the online District Health Information System 2.
  • Department of Finance staff at national level, in 2 provinces and 4 districts has been trained on advanced excel reporting.

FACTS AND FIGURES

  • 6 health insurance offices have been refurbished and provided with equipment such as computers and internet access
  • 24 quarterly health insurance management meetings supported in the target area
  • Over 70 persons received repeated training on financial reporting

TESTIMONY

Strengthening of health insurance management in Vientiane Province

The EU-MOH-WHO funded project aimed to improve the capacity of health insurance staff in Vientiane Province including two districts: Phonehong and Vangvieng. Thanks to the project we could implement many activities which facilitate the management and the operation of the health insurance schemes. The project supported the refurbishment of our provincial office and provided necessary equipment including furniture, computers and internet access.

Our staff from the Provincial Health Insurance Bureau, staff from the Health Insurance Bureau in the two target districts and staff from health facilities were trained on the concepts of health insurance and the management of health insurance schemes. Specific training on very practical aspects of health insurance management such as the use of the electronic reporting system on service utilisation by insured members, calculation of premiums, and processing of claims were very useful.

We also had discussions on the mandate of the Provincial Health Insurance Bureau. The revision of the mandate made the roles and responsibilities of our staff very clear and allowed us to work more efficiently. The project also provided financial support for organizing the quarterly meetings of the health insurance management committee at provincial and district levels. The meetings are very useful to discuss the progress and bottlenecks of the implementation of health insurance schemes with all stakeholders including the provincial and district vice-governors, the heads of the health departments and representatives from hospitals.

During the three years of this project, and as a result of capacity building for all staff, the management of health insurance has improved a lot. Staff who have been trained are able to manage implementation and reporting in a timely manner and are also able to coach newly recruited staff. They understand the issues and difficulties related to the implementation of health insurance schemes and are well prepared to carry out the roll out of the new integrated National Health Insurance scheme which has been launched in September 2017 in Vientiane Province.