In October 2022, the Strategic Health Purchasing Pilot for Maternal and Newborn Health Services (“the pilot”) launched in Serang District of Indonesia. The pilot is a collaborative effort from the Ministry of Health and Indonesia’s Health Insurance Agency (BPJSK) to improve the way that maternal and newborn health services are paid for under the country’s national health insurance program (JKN). It comes in response to challenges with unpredictable service quality and financial strain on JKN. The innovative design of the pilot seeks to strengthen the benefits package, contracting arrangements, provider payment mechanism, and monitoring of maternal and newborn health services. Ultimately, this will reduce spending inefficiencies and promote better health outcomes for pregnant people and their children.

USAID’s Health Financing Activity (HFA)led by ThinkWell and implemented with Center for Health Economics and Policy Studies at the University of Indonesia, the Center for Health Policy and Management at Gadjah Mada University, and Results for Development (R4D)is providing technical support to the Ministry of Health and BPJSK. HFA’s collaborative and locally led approach has been instrumental to the success this initiative has seen so far. The pilot fosters active engagement and coordination among policymakers, purchasing agencies, and providers to effectively monitor and support maternal and newborn health service deliveryan achievement that has been lauded widely by those participating in this initiative. Portions of the pilot design are also already being adopted at the national level, and the pilot is now being expanded to include more facilities in the implementation region.

The pilot is ongoing and closely evaluated through implementation research. In a blog posted by ThinkWell’s partner, R4D, HFA experts share three main lessons from the process which they believe led to the successful launch the pilot and has set it up for a lasting impact:

  1. Co-creation with local stakeholders has grounded the design in local realities and was fundamental to promoting local ownership of this pilot.
  2. Collaboration and established partnership protocols among national and subnational health agencies built a strong foundation for scale-up.
  3. Placing local voices in the lead improves pilot performance and leaves a lasting impact.

The IHEA congress is an international convention of health systems experts to discuss the latest data, methodologies, findings, and tools in the pursuit of improving health care around the globe. It will take place in both buildings of the Cape Town International Convention Centre (CTICC).

Below you can find an agenda of all of the organized sessions, oral presentations, and poster presentations ThinkWell will be organizing for the main congress. The main IHEA congress will be held July 10-12, 2023. As more details around schedules become available, this page will be updated.

IHEA Congress Agenda

Congress Registration

ThinkWell’s Pre-Congresses

Organized sessions

Florence Tochukwu Sibeudu, Olusola Oresanya, Christina Banks, Annette Ozaltin

Tuesday, July 11, 10:30 AM-12:00 PM

Stephen Muleshe, Angellah Nakyanzi

Monday, July 10, 10:30 AM-12:00 PM

Mursaleena Islam, Nirmala Ravishankar, Najibullah Syed

Wednesday, July 12, 11:00 AM-12:30 PM

Oral presentations

Find all the details for our oral presentations by accessing the IHEA 2023 agenda and searching “ThinkWell.”

Examining the Challenges of Purchasing Primary Health Care Interventions in Urban Settings: Lessons from Kampala and Nairobi

Richard Ssemujju

The Role of National Health Insurance in Reducing Catastrophic Health Spending on Maternal and Neonatal Health Services in Indonesia Year 2018-2021

Mutia Astrini Pratiwi

Increasing the Sustainability and Fairness of the National Health Insurance in Indonesia

Ruli Endepe Al Faizin

Private Primary Healthcare Provider Readiness in Strengthening HIV Care in Indonesia

Diah Evasari Husnul Khotimah

Better access to Emergency Medicines and Health Supplies; Implications of Improved Autonomy in the Context of Performance Based Financing

Eric Tabusibwa

Does the Gratuité User Fee Exemption Policy Make a Difference on Maternal, Newborn and Child Health Service Utilization in Conflict-Affected Regions of Burkina Faso? Evidence from a Pre-Post Analysis

Marie-Jeanne Offosse Ngbesso

The Effect of Districts’ Health Expenditure Towards Maternal Mortality Rate in Indonesia

Nirwan Maulana

Does fiscal capacity at the district level influence vaccination coverage and the infant mortality rate? Findings from Indonesian National Socio-Economic Survey 2019 – 2021

Edward Sutanto

The 15th IHEA World Congress on Health Economics will be held July 9-12, 2023, in Cape Town, South Africa, and our teams are prepping for our biggest attendance yet. Our projects will be featured in five pre-congress sessions all listed below, all of which are available for FREE virtual attendance.

The IHEA Congress is an international convention for health systems experts to discuss the latest data, methodologies, findings, and tools in the pursuit of improving health care around the globe. This year’s theme is “Diversity in Health Economics.” The event will take place in both buildings of the Cape Town International Convention Centre (CTICC). Find more information on ThinkWell’s IHEA pre-congress sessions, how to register, and the agenda below.

As more details around schedules become available, this page will be updated. See you in Cape Town!

Attend Pre-Congresses Virtually

Pre-Congress Registration

Pre-Congress Agenda

Pre-congress sessions will run July 8-9, 2023. ThinkWell will participate in five sessions detailed below.

Saturday, July 8

9 AM-12:30 PM

Organizers: ThinkWell, Center for Global Development, and KEMRI Wellcome Trust Research Programme

There is growing consensus that channeling funds to health facilities and granting them more autonomy will improve the delivery of primary health care services. In this session, we will explore the evidence about the impact of direct financing for facilities on access to health products, especially essential medicines.

People-Centred, Efficient Health Care Services: Rethinking Sustainable Health Care Financing in the Context of the African Union’s ALM Declaration on Domestic Financing for Health

1:30 PM-5 PM

Organizers: ThinkWell, The Global Fund, AUDA-NEPAD, Eastern African Community, ODI, and SADC

In uncertain times, the need to ensure that adequate, effective, and efficient financing for healthcare in Africa remains a political priority has never been clearer.  This is the goal at the heart of the African Unions ALM initiative on domestic financing for health. We hear from the organizations tasked with implementing that ambitious agenda, together with member states implementing their own health financing reform agendas.

9 AM-5 PM

The Immunization Economics Special Interest Group welcomes researchers to join a two-day meeting to take stock of the latest evidence and research projects, exchange research approaches and methods, and to discuss research priorities. Topics on the agenda will include costing, value of vaccines, immunization financing, and the use of economic evidence for policy and programming.

Register for this session here

Sunday, July 9

8:30 AM-12 PM

Organizers: ThinkWell, R4D, and WHO

This bilingual session (English-French) brings together diverse country experiences to discuss the latest research on contributory social health insurance and non-contributory/free healthcare schemes. The session facilitates an exchange between African, Asian, and Latin American speakers, explores the politics behind these reforms and how these schemes can be improved to achieve UHC.

1 PM-4:30 PM

The SDGs push all countries to achieve UHC by 2030; however, UHC will not be achieved unless sustainable health financing is in place. Many countries have inadequate comprehensive analyses of sustainable health financing. This session explores several health financing models and the respective performance of current UHC in four LMICs: Indonesia, the Philippines, India, and Sri Lanka.

8:30 AM-4:30 PM

The main IHEA congress will be held July 10-12, 2023. The detailed agenda for each presentation can be found HERE. Please visit this page to access titles, times, and descriptions for each presentation.

IHEA Congress Information

Congress Registration

Attend Pre-Congresses Virtually

On June 1, 2023, at 9:00 AM-EST, ThinkWell hosted the third installment of the Counterpoint webinar series titled “Financing health facilities directly: What is all the fuss about?”

During this webinar, we explored the topic of financing health facilities directly.

Watch the recording

There is a growing consensus that granting health facilities in the public sector more funds and greater autonomy is critical for improving primary health care (PHC) delivery. This was one of the themes highlighted by the Lancet Global Health Commission on financing primary health care, which found that public sector PHC facilities could retain and manage funds in fewer than 40% of low- and middle-income countries (LMICs). The report noted that direct financing for public facilities will allow them to improve service readiness and responsiveness. It is also a necessary precondition for them to feel incentivized by signals from public purchasing entities attempting to advance health system goals like improved access, equity, quality, and efficiency. There has been a spate of papers on the topic recently, including by the World Health Organization (WHO) and the World Bank.

And yet, giving health facilities greater financial autonomy is not a new idea as such. Many types of management entities to produce goods and services have been around for centuries. More critically, the merits of granting hospitals autonomy have been debated extensively as part of the new public management discourse since the 1980s. Not everyone is convinced. Some feel that local governments are better positioned operationally to manage service delivery instead of expecting each facility—including small health centers and dispensaries—to manage their own affairs.

In this webinar, we had a candid conversation with two leading voices on the topic about why the push for getting more funds and management of service delivery to the frontlines and why some continue to challenge the idea. We discussed why this is an important issue for LMICs to explore as they develop and execute strategies to make progress towards universal health coverage. ThinkWell Senior Fellow, Nirmala Ravishankar hosted the webinar featuring two experts:






Nirmala Ravishankar is a Senior Fellow at ThinkWell.

Sheila O’Dougherty is a health financing and management expert who retired from her position as Vice President at Abt Associates in 2020. Sheila led USAID-funded health systems strengthening project implemented by Abt Associates that supported far-reaching government reforms to enable direct financing for public facilities in Central Asia and Tanzania. She is the lead author of joint WHO-World Bank brief on direct financing for health facilities.

Edwine Barasa is the Director of the Nairobi Program of the KEMRI Wellcome Trust Research Program in Kenya. He was instrumental in documenting how health facilities lost financial autonomy when Kenya devolved key decision-making powers from the central government to newly formed county governments and has published extensively on the question of decentralization and facility autonomy.

Some of questions we posed to these experts are as follows:

  1. What does it mean to directly finance facilities? Why the focus on financial autonomy?
  2. Have countries done this before? What does their experience teach us?
  3. Many countries have pursued devolution of decision-making powers to local governments. Is that the same thing? Is that not enough?
  4. Are there any risks to giving more money and control to public facilities? How can they be mitigated?
  5. Where is this agenda headed? What should health financing analysts be exploring? What should health financing policymakers and practitioners be doing?

Counterpoint is ThinkWell’s signature series of webinars that offers a platform for free and frank debate about questions related to health system strengthening. Through these honest discussions, we strive to both challenge dominant paradigms and scrutinize new trends to ascertain their merit.