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| Health Financing Reform in Ukraine
RECOMMENDATIONS Short term • Create a CabMin committee to act as an oversight committee for the NHSU and to facilitate better interagency coordination among the MoF, MoH, NHSU, and other ministries in setting the strategic directions for the NHSU and reaching consensus on issues such as health financing strategy, PMG packages, budget proposals, and tariffs. • Pilot a mechanism through which the MoH would organize NHSU accountability to the CabMin for relevant aspects of the sector policy implementation, clearly defining responsibilities for agreeing on and reviewing performance objectives. This can form part of Ukraine’s new developments in performance-based oversight of policy implementation by the CabMin. • Develop an NHSU organizational strategy, which should be aligned with the health financing strategy and with the performance objectives and indicators previously proposed in this report by which the NHSU can be held accountable to the CabMin. • Establish a small, permanent unit in the MoH with technical expertise in health financing policy to enable the MoH to better perform its stewardship and governance roles with respect to the NHSU and its role in the CabMin committee overseeing the NHSU. • Specify the role and procedures of the PCC with respect to NHSU governance in a CabMin order, including the information and reports the NHSU should share with the PCC; formalize a mechanism by which the PCC can share its findings and recommendations with the MoH and the CabMin proposed committee. • Provide briefing materials and regular opportunities for policy dialogue for new ministers, senior MoH and MoF officials who have new responsibilities in health financing policy and NHSU governance, and members of the PCC to enhance understanding of their respective roles and responsibilities. • Implement a medium-term process for planning, priority setting, and budgeting the PMG to complement and guide the current annual process. • Develop and implement a systematic, evidence-based methodology for defining the PMG and AMP priorities, benefit package, and tariff, together with a clear delineation of the roles of the NHSU, MoH, and MoF at each stage of development and approval. • Develop and improve the contract specification for various services to improve quality and efficiency of services; clarify the roles of the NHSU and other parties in the process. • Develop a framework to govern consultations over the PMG, AMP, and contract specifications that prevents conflicts of interest, promotes transparency, and ensures participation of all stakeholders, including citizens.
Long term • Provide regular training opportunities in health financing and purchasing for the MoH and MoF staff who work with the NHSU.
