This session includes two presentations each on three topics: large-scale evidence of access effects; complexity in implementing insurance programmes; and user experiences of access to insurance and care.

The Alliance for Health Policy and Systems Research 2014 report applies a systems approach in illustrating major challenges and advances in the access, affordability and appropriate use of medicines in low- and middle-income countries, using country case-studies. Following a description of how the access-to-medicines field has evolved since the 1970s, the report explores specific links between medicines and universal health coverage,  considers the role of innovation in developing and delivering medicines, and addresses the pluralistic health system around medicines, with a particular focus on health market systems. It concludes with recommendations for decision-makers to inform, monitor and evaluate the reforms required.

A system dynamics (SD) simulation model will be used as a tool to evaluate, inform and communicate a pharmaceutical firm’s social business initiative to improve medicines access in a low-income country. By discussing baseline and alternative scenarios, participants will gain experience with a SD computer model designed to simulate current conditions and system changes following the initiative. Results of simulations will be reviewed. The discussion will conclude with suggestions for improving policy and programme choices and the model used to communicate and evaluate them. 

The session presents a conceptual framework addressing primary health care governance, a realist synthesis on social accountability and considers the role of district managers and partnerships with faith-based providers in people-centred health systems.

This panel highlights the experiences of UN Innovations Working Group mHealth Catalytic Grant Mechanism grantee projects focused on scaling, making sustainable and institutionalizing their maternal and child health mHealth innovations. The panel will showcase three mature projects (IRD, MAMA, mTRAC) to detail elements critical for scaling and institutionalizing mHealth within the health system. Specific tools, emerging findings as well as concepts and metrics relevant for monitoring and assessing mHealth progress toward scale, sustainability, and institutionalization will be presented and discussed.

Strategic purchasing can make health services more equitable and responsive to patient needs. This session will share the results of recent research on purchasing arrangements in 10 African and Asian settings, conducted by the RESYST consortium and the Asia Pacific Observatory on Health Systems. An overview of some of the key findings will be followed by an interactive panel discussion highlighting opportunities for citizen participation in purchasing decisions and monitoring the performance of purchasers and providers.

This session includes presentations addressing African and Asian experiences around pathways to universal health coverage, including civil society involvement and potential impacts on fairness in financing and impoverishment. 

Informal healthcare providers are the first point of care for a majority of rural and urban poor populations in many countries, but marginalized by the formal health sector. With severe shortages of health human resources, informal providers represent a valuable untapped resource for universal health coverage. However, they present both challenges and opportunities in provision of accessible, affordable and good quality primary care. The panel will highlight current controversies, policies and workable approaches for engaging with informal providers, followed by an audience debate and a final vote for or against informal providers.

This session focuses on methods for conducting whole systems’ assessments including composite measures of universal health coverage, holistic assessment of health markets, combining cost effectiveness with health system assessments, and cross-country comparative studies of health and social systems for ageing populations. 

Moderator: Amanda Glassman, Director of Global Health Policy, Centre for Global Development, USA

Within a focus on people-centred health systems, community-based health insurance  might seem a useful way to ensure inclusion of community and patient perspectives toward the development of universal health coverage. However, popular wisdom has focused on conflicts between community-based and national insurance approaches. This panel presents data from the successful case of Rwanda, experience of China’s  rural health insurance development and a case-study of how Ghana weighed options to decide on an alternative model.