[Subgroup-health] Rép. : RE: 1st discussion of the CGAP Health sub-group -Mission statement

Tue Apr 15 18:50:39 CEST 2008

What I meant by Appropriate Treatment Protocols (ATP) is the research on
what is the most cost efficient quality medical treatment for a particular
disease. For example Oral Rehydration Solution (ORS) is the best solution
for diarrhea for the majority of cases, yet both clients and medical
personnel would like to administer a drip. The cost difference in these two
treatments is in the region of half a days wage for a BPL person for ORS and
20 days wages for a drip. The medical outcome, I’m told by a physician, is
superior for ORS compared to a drip.  A recent study in the USA on cardiac
surgery found that by developing best practices among cardiac surgeons they
where able to achieve improved health outcomes and reduced cost.   When we
talk about “health insurance” most of us are talking about throwing money at
providers, there is little research on the other side of the coin, which is
what is necessary and appropriate. Without ATP, we would be looking at one
tiny aspect of reducing cost and improving outcomes. To do ATP you would
require an agreement with the health provider, which should include the
charge for the service.

For question 2, I would agree that the proposed subject is of interest to
the micro health insurance, that is relating to the provider and the role of
MHI in clear government policy (There are few examples of this, save Rwanda)

Warm regards,

Denis Garand

denis at garandnet.net

(306) 591-0783, Toll free\sans frais (866) 591-0783 , Canada

-----Original Message-----
From: Valérie Schmitt-Diabate [mailto:schmitt-diabate at ilo.org] 
Sent: April 15, 2008 9:29 AM
To: Denis Garand; subgroup-health at microfinance.lu
Subject: Rép. : RE: [Subgroup-health] 1st discussion of the CGAP Health
sub-group -Mission statement

Thanks Denis for your inputs !

I have 2 questions:

Question 1:

Could you explain a little bit what do you mean by "possible research into
appropriate treatment protocols"? do you have any examples?

Does it include for instance:

- the agreement between CBHIs and accredited hospitals on specific
administrative procedures (e.g., specific desk; cash less system ...) for
CBHI members (for instance in Yeshasvini there is a special desk for the
members)?

- the agreement between CBHIs and accredited hospitals on a list of medical
procedures (including the diagnosis and examination parts and the list of
possible (i.e. covered) treatments for each disease / case)?

- the joint definition of a rational and "affordable" minimum health benefit
package that should be provided to all citizens in the country. The
definition process should involve the MoH, Min of Finance, representatives
from the oublic and private health sectors, federations of CBHIs, etc. This
package should be affordable to the CBHI members or for the country as a
whole in case of a universal national social health insurance programme.

...

Question 2:

Does it make sense if we include your proposal as a subchapter of following
issue : " The relationship with health care sector (contracting) and more
broadly linking MHI with national health systems including the financial
aspects --> The role of MHI in the better use of global funds (diagonal
approach)"?"

Thanks in advance

Valerie

>>> "Denis Garand" <denis at garandnet.net> 04/05/08 4:02 pm >>>

Dear Valerie

Thank you for this initial contribution. Additional questions that should be
included in the health subgroup would be

* Understanding how to use health promotion and prevention strategies 

* Possible research into appropriate treatment protocols 

Best regards,

Denis Garand

denis at garandnet.net

(306) 591-0783, Toll free\sans frais (866) 591-0783 , Canada

-----Original Message-----
From: subgroup-health-bounces at microfinance.lu
[mailto:subgroup-health-bounces at microfinance.lu] On Behalf Of Valérie
Schmitt-Diabate
Sent: April 4, 2008 7:17 AM
To: subgroup-health at microfinance.lu
Subject: [Subgroup-health] 1st discussion of the CGAP Health sub-group
-Mission statement

Dear members of the CGAP health sub-group,

We, Harrie and I, discussed the best way of starting activities within the
health subgroup

In order to have some clarity about the role of the sub-group (what do we
stand for? what is our purpose? what is our strategy?) and to facilitate the
development of a work plan, we came to the conclusion that it was necessary
to produce first a mission statement (including a strategy) of the subgroup.

We have put our ideas on paper ; here is a proposal that we would like to
share with you (attached document).

Could you please comment it by the 18th April ? You may send your comments
by answering to the present e-mail. We will then be able to produce a
consolidated and revised version of the document.

Once the mission statement has been clearly defined, we will be in a
position to work on:

1. the definition of a clear focus of the subgroup for the next 12 months
(leading to one or more activities).

2. the subgroup's contribution to the 2008 microinsurance conference, in
Cartagena.

Best regards,

Valerie Schmitt Diabaté (ILO / STEP, Geneva) 

& Harrie Oostingh (Oxfam Novib, Netherlands)

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