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Project Summary

Global cervical cancer elimination is achievable by 2030 if sufficient resources can be mobilized, and effectively and equitably used to accelerate implementation and uptake of national programs. The Union for International Cancer Control (UICC) engaged ThinkWell to conduct an assessment and stakeholder interviews to examine the status of health financing for cervical cancer elimination in four project countries: Guatemala, Philippines, Burkina Faso, and Côte d’Ivoire. This work was done within the context of the Scale-Up Cervical Cancer Elimination with Secondary Prevention Strategy (SUCCESS) project, funded by Unitaid, led by Expertise France and implemented together with UICC and Jhpiego.

ThinkWell brings knowledge to the CCE advocacy community on the health financing ecosystem for each of the project countries and how it applies to cervical cancer, including comprehensive and realistic perspectives on what it will take to advocate for sustainable financing approaches for CCE. The profiles outline policy actions for advocates and stakeholders to utilize in addressing the need for CCE financing.

 

Country Context

Why does financing for cervical cancer elimination matter?

Cervical cancer is a leading diagnosis among women in each country profiled. For example, cervical cancer is the second leading cancer diagnosis in Burkina Faso and takes the lives of over 2,000 Burkinabe women each year, but fewer than 1 in 10 Burkinabe women have been screened for cervical cancer, and the HPV vaccine is not currently included in the national immunization program (WHO 2021). Financing cervical cancer services is a vital step to ending these preventable deaths.

Taking Actionable Steps

By reviewing the current health system structures of each country, ThinkWell found that there is ample opportunity to take health financing-related actions towards the elimination of cervical cancer. As shown in the figure below, these actions are part of a continuum that spans the macro and micro contexts of any given country. Additionally, each country assessment includes policy action suggestions tailored to each country’s context.

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Summary

With support from the WHO, ThinkWell conducted a study to develop a primary care competency certification framework and a corresponding tool to certify primary care health workers. As part of the study, we mapped the current state of primary care delivery in the Philippines, developed options for primary care provider models for the Philippines based on global best practices, created and piloted primary care provider competency assessment tools, and designed a primary care provider certification framework. Our study helped ensure that the Department of Health is prepared to certify primary care providers to deliver services in primary care facilities, as mandated under the country’s Universal Health Care (UHC) Law.

Breaking New Ground

Our work consolidated and aligned initiatives that the Health Human Resource Development Bureau of the Philippine Department of Health has led to clarify and re-shape the traditional roles of health care workers in front-line health facilities, particularly in the public sector. More importantly, this work paved the way to ensure that primary health care services be prioritized and institutionalized.

Challenge

ThinkWell helped to ensure that when the UHC Law was implemented in 2020, the Philippines had a certification tool to help identify and certify primary care providers who are equipped to deliver an expanded primary care benefit package for all Filipinos.

Approach

ThinkWell reviewed existing studies and documents that articulate important health care worker competencies. Our work aligned with the goal for primary health care services in the Philippines to be high-quality, efficient, and accessible to all.

Results

Our research uncovered primary care delivery models that are potentially applicable in various settings in the Philippines. In addition, we identified and validated essential competencies for primary care health workers. Finally, we proposed a certification framework and tool that was pilot tested in selected primary care facilities. For a summary of the rationale and proposed design of the certification process of primary care providers, please visit the SP4PHC Philippines page.

Assessment and Strategy to Cover the Informal Sector

Backed by a presidential mandate for universal health coverage, the Philippine Health Insurance Corporation (PhilHealth) has aggressively worked to improve coverage, services, and financial protection. PhilHealth insures an impressive 85 percent of Filipinos, yet 18.5 million informal sector workers such as fishermen and micro-entrepreneurs have remained elusive.

ThinkWell supported PhilHealth’s initiative on provider payment reform for private providers to improve coverage, services, and financial protection. To help PhilHealth reach uninsured informal sector workers, we assessed and identified non-traditional private-sector partners—such as pawn shops and microfinance institutions—that could help expand enrollment. We also proposed strategies to leverage PhilHealth’s growing purchasing power to expand the scheme’s influence in health reform efforts.

Read our analysis and recommendations report.

 

Photo credit: (c) 2014 Phoebe Gullunan, courtesy of Photoshare

Photo credit: (c) 2014 Phoebe Gullunan, courtesy of Photoshare

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