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Health Sector Reform

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Health Sector Reform
← No uniform recipe for change

← Emerging HSR: ← Financing the health care/ services ← Insurance (compulsory and private) ← Separation between providers and regulator ← Promoting the private share in service delivery ← Promoting the family medicine/ gateway practice

← Challenges facing the Governments: ← Lack of policy making and analysis capability ← Lack of research based policy making ← Top-down implementation ← Lack of ownership ← Importing best practices without appraisal and adaptation

Policy is not developed in a vacuum BUT in a comlpex context!!!

How best to formulate policy? ← by comprehensively understanding the policy context ← Failing to understand the context, leads to misconceptions over role, appropriateness, policy process and political feasibility. ← The research focused on observing 7 countries

Policy context
Leichter
1. Situational factors 2. Structural factors 3. Cultural factors 4. Environmental factors

Frenk 1. Political and political regime 2. Ideological 3. Demographic and epidemiological

Walt & Gilson 1. Structural context 2. Policy content 3. Policy actors 4. Processes of decision-making

← Understanding the context is a MUST. Why?? ← Objective of HSR: the context explains why the issue is raised on the agenda now! ← Policy appropriateness: helps in identifying options (most appropriate) ← Policy process: especially how different stakeholders/ players react; differences over time and location ← Policy feasibility: margin of maneuvering; constraints,

Accordingly, it is best to consider the following 6 factors in HSE Policy context 1. Demographic and epidemiological 2. Processes of social and economic change 3. Economic and financial policies
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