Monthly Archives: January 2014

Strengthening social health protection schemes and improving client satisfaction with public health services

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17 January 2014

Background

With the aim of advancing social health protection in Cambodia, operators of social health protection schemes across Cambodia joined forces to establish an association that would allow for a collective voice and provide a platform for collaboration. The initiative would also enable access to quality technical support, attracting financial resources; and promote information sharing and policy development within the sector.

Therefore, a number of organisations joined hands and contributed to the establishment of a new capacity development institute for NGOs active in the social health protection sector e.g. as operators for the  Health Equity Funds (HEF), integrated social health protection schemes (extended HEFs through voluntary enrolment programmes), and Micro Health Insurance (MHI). This new institute, the Social Health Protection Association (SHPA), began its operations, with support of GIZ, in May 2012.

SHPA’s mission is to support and promote the quality, sustainability and coverage of voluntary enrolment programmes and other social health protection schemes in Cambodia.

Its main objectives are to support social health protection schemes:

  • To provide a collective voice and platform for collaboration;
  • To establish a high-quality resource centre for all social health protection schemes; and
  • To provide an information and communication platform for all stakeholders.

To fulfill its aims, SHPA developed a work-plan, based on key support needs identified by its members, with additional inputs from the Ministry of Health and other key partners. In line with the plan, SHPA organised various workshops and capacity building trainings.

 

Client Satisfaction and Quality improvement

The majority of the Cambodian population initiates medical treatment in the private sector. Approximately 30% initiates care in public health facilities. The main reason for this is the perceived low quality of care in the public sector.  Many Cambodians prefer private providers because they are seen as friendlier and more responsive to patients’ needs, even if the technical quality of services is inferior to that provided in the public sector.

Improving misperceptions of the quality of public health services, and thus overall client satisfaction, is essential to ensure optimal operations of a social health protection scheme. The Ministry of Health guidelines for SHP schemes require operators to address these issues through specific activities to monitor and respond to clients’ feedback. In response, a client Satisfaction Survey Tools (CSST) was developed by the Quality Assurance Office of the Ministry in 2009 with assistance from GIZ. The intent of the CSST is to provide a standardised survey instrument and data collection methodology for measuring clients’ perspectives on care provided by hospital and health centres.

Social health protection schemes have a strong incentive to improve clients’ perceptions of health services by contracted providers, as enrolment –and service utilization- correlates with the population’s satisfaction with these services. Measuring client satisfaction with feedback on the results to providers to inform quality improvement activities, together with effectively addressing complaints while allowing the communities to voice their opinions, are important tasks of SHP operators. Most SHP schemes conduct satisfaction surveys amongst their members and have mechanisms for dealing with complaints and raising issues with healthcare providers. However, these are not standardized across the schemes.

Workshop on Quality and Client Satisfaction for Integrated Social Health Protection Schemes

Figure 1 and 2: Participants discussed a wide-range of topics from improving client satisfaction to strengthening external feedback.

Figure 1 and 2: Participants discussed a wide-range of topics from improving client satisfaction to strengthening external feedback.

Following a situation analysis of existing tools and approaches SHPA’s member organisations requested the Association to support them by:

1) Improving the use of existing quality and client satisfaction tools and processes; and

2) Initiating a process of standardisation to assist operators and the Ministry of Health to monitor perceived quality and client satisfaction within and between schemes

In response to these requests, SHPA conducted a workshop on Quality and Client Satisfaction for Integrated Social Health Protection Schemes on 17-18 October 2013.

During the workshop the operators, SHPA, and representatives from the MoH, and GIZ focused on client satisfaction surveys and tools, complaints mechanisms, data collection, storage and analysis, internal review of data and feedback, and strengthening external feedback to clients, communities, providers and local authorities.

 

Key issues defined by the operators for further discussion and support included:

  • A clear desire by the MoH to standardize tools for measuring client satisfaction;
  • Development of a standard database for client satisfaction assessment results;
  • Development of standard complaints format and roll-out of an online complaints system together with training to enable staff to effectively handle complaints, to strengthen their interviewing/survey skills and to analyse results of the surveys; and
  • Development of standard operating procedures for all associated processes.

Following the results and recommendations from this workshop, SHPA will continue to advocate for the standardisation of tools and approaches, continue the collaboration with the MoH on the development of a data system, and organise a follow-up workshop in 2014 on interview skills and data entry and analysis for field-level staff.

 

 

Development Partnerships: Experience Exchange

Opening ceremony of the workshop, Development Partnerships in Agriculture: Experience Exchange, organized by the RED-Green Belt programme of GIZ in collaboration with  Provincial Department of Agriculture and the representative office of East West Seed International Ltd

Opening ceremony of the workshop, Development Partnerships in Agriculture: Experience Exchange, organized by the RED-Green Belt programme of GIZ in collaboration with Provincial Department of Agriculture and the representative office of East West Seed International Ltd

 

6 December 2013

SIEM REAP – On 6 December 2013, a workshop on development partnerships was held in Siem Reap. The event was facilitated by GIZ programme for Regional Economic Development (RED) – Green Belt and organised in collaboration with Provincial Department of Agriculture (PDA) and the representative office of East West Seed International Ltd. (EWS).

The workshop brought together over 40 representatives from the public and private sectors as well as development agencies operating in Cambodia. Participants presented and discussed on-going development partnerships, i.e. collaboration agreements between agricultural input companies, on the one hand, and government or development agencies, on the other.

The event built on the experience of RED and its partners in the implementation of development partnerships in Siem Reap province since 2009. The Provincial Department of Agriculture (PDA) Siem Reap, EWS and the NGO Agricultural Development Denmark Asia (ADDA), among others, presented achievements and lessons learned from partnership initiatives that matured in the framework of RED. The representatives of Provincial Departments of Agriculture from Kampong Cham, Kampong Chnang and Kanda shared their perspectives as well.

Participants expressed agreement on the effectiveness of development partnerships as a tool to engage the private sector in the role of a know-how provider in agriculture. Similarly, private sector representatives shared the view that development partnerships can fit in their long-term commercial strategies.

Discussion unfolded on the challenges faced by public and private sector stakeholders and on ways forward. All participants stressed the difficulties involved in the identification of the “right” partner and advocated for a “brokering function” as RED has played in Siem Reap. Secondly, trust, transparency and clear communication procedures were identified as cornerstones of a successful partnership. Finally, participants debated on the contributions and functions that each partner should bear and expect. Lack of clarity on such matter is, in everyone’s opinion, a reason for failure.

Group discussion on benefits and challenges of development partnerships. Participants discuss success factors and limitations of public-private collaboration agreements and their effectiveness as vehicles to deliver services to farmers and producers.

Group discussion on benefits and challenges of development partnerships. Participants discuss success factors and limitations of public-private collaboration agreements and their effectiveness as vehicles to deliver services to farmers and producers.

The need for a policy framework that enables and regulates development partnerships also led to discussion. On this matter, the representative of the Ministry of Agriculture, Forestry and Fisheries (MAFF), Dr. Mak Soeun, emphasised that partnerships with the private sector are already endorsed by government policies, while guidelines for their design and implementation still need formulation.

In conclusion, partnerships with private sector were recognised to play a significant role to promote access to know-how and innovations in agriculture, and increasingly so, as the public sector progressively embraces regulation, facilitation and coordination functions. However, challenges still lay ahead and further experience exchange will be required to establish guidelines and models that will orient development partnerships in the future.

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All activities are implemented by GIZ on behalf of the German Federal Ministry for Economic Cooperation and Development (BMZ).