Ghana, India, Indonesia, Kenya, Malaysia Mali, Nigeria, The Philippines and Vietnam -----------------------------------------------------------------------------------------

www.jointlearningnetwork.org

jln@resultsfordevelopment.org

Workshop Proceedings

JLN Population Coverage Technical Initiative Workshop

Manila, Philippines

December 8-10, 2014

1. Executive Summary

2. Background on JLN Population Coverage Technical Initiative Workshop

3. Workshop Sessions and Outputs

4. Next Steps

Annex 1: Participant Feedback on Workshop

Annex 2: JLN Population Coverage Technical Initiative Next Steps - Potential Options for New Work

Annex 3: Philippine’s Department of Social Welfare and Development Assessment Form

Workshop participants visit the Rizal Medical Center as part of the site visit organized by PhilHealth.

2

1. Executive Summary

The Joint Learning Network for Universal Health Coverage (JLN) Population Coverage Technical Initiative organized

a three-day workshop in Manila, Philippines from December 8-10, 2014. The workshop convened representatives

from nine JLN member countries to share experiences and lessons in defining, identifying, and enrolling poor and

vulnerable populations in health coverage and to plan for future jointly produced work. The workshop, hosted by

PhilHealth and the World Bank, built on earlier engagement between JLN Initiative members who exchanged

background information about their experiences through virtual presentations and discussions via a Google Group.

The first day of the workshop focused on targeting methodologies, challenges, and innovations. The workshop

kicked off with an introduction to the JLN, participant introductions, and an overview of workshop objectives. Caryn

Bredenkamp, Senior Economist at the World Bank set the stage for the three days by presenting a framework on

targeting methodologies. This was followed by country presentations on innovations in targeting and enrollment of

hard-to-reach populations. Gregorio Rulloda, Vice President for Member Management Group, represented

PhilHealth and presented on the Philippines’ major reforms to target the informal sector, poor, and indigent

populations. Two representatives from Ghana’s National Health Insurance Authority, Ben Kusi, Director of

Membership, Provider Relations and Regional Operations and Collins Akuamoah, Deputy Director of Membership,

shared a presentation on Ghana’s work on defining, targeting, and enrolling disadvantaged populations. In the

afternoon, JLN representatives met in country pairs, and had active discussions about their countries’ challenges

and solutions to in-practice implementation of targeting methodologies. Next, representatives introduced their pair

country and its targeting experience to the broader group.

On the second day of the workshop, PhilHealth hosted site visits to Rizal Medical Center, a health center in Manila,

and a local health insurance office. At the medical center, participants gained an in-depth view of the Onsite Rapid

Enrollment (ORE) system, which directly enrolls critically poor populations seeking care at hospitals in PhilHealth. At

the PhilHealth office participants learned about the scheme’s primary care program, which provides enrollment,

data verification, consultation, and preventive and promotive services to users.

On the last day of the workshop, participants engaged in a fruitful discussion on enrollment from the perspective of

beneficiaries (the user perspective). JLN members met in their country groups to prepare a visualization of the

user’s experience enrolling in health insurance, which documented the trajectory of users, the barriers

encountered, and ways in which the scheme mitigates these challenges. Participants then presented the

visualization to the group to share highlights about their country experiences. The next session of the day focused

on strategic communications, which is a topic that has recently received interest across the JLN. Two JLN members

presented on their experiences: Collins Akuamoah spoke about strategic communications challenges that Ghana

faced when introducing capitation to the Ashanti region and recent solutions; and Dr. Nikka Hao of PhilHealth

presented on PhilHealth’s experience using strategic communications to roll-out the new primary care benefit,

TSeKaP (“check up”) introduced during the site visit to PhilHealth on Day 2.

JLN members closed the workshop by brainstorming and documenting ideas for future Population Coverage joint-

learning work. To follow up on workshop activities, the JLN Population Coverage Technical Initiative facilitators

(R4D) have further developed topics and activities identified by workshop participants on the third day of the

workshop and shared them with the group for feedback and prioritization.

3

2. Background on JLN Population Coverage Technical Initiative Workshop

The Population Coverage Technical Initiative convened the first virtual meeting of representatives of its Technical

Collaboration Team (TCT) on Wednesday, March 26, 2014. One of the outcomes of this meeting was an agreement

to plan an event for representatives to meet in-person to engage on topics related to expansion of health coverage

for poor, informal sector, and other disadvantaged or hard-to-reach groups.

Participants met in-person for a three-day workshop in Manila, Philippines from December 8-10, 2014. The

workshop was organized by the Joint Learning Network (JLN) Population Coverage Technical Initiative in

collaboration with Access Health, and was hosted by PhilHealth and the World Bank office of the Philippines. The

workshop convened representatives from nine JLN member countries and built upon an earlier engagement

between JLN members who exchanged background information on their experiences through virtual presentations

and discussions. This early online engagement among JLN members proved to be instrumental in setting the

foundation for the workshop and enabled workshop participants to have rich in-person exchanges about country

experiences in expanding coverage to target populations.

The workshop emphasized the sharing of country experiences in reaching disadvantaged populations as part of

national efforts to achieve UHC and set out to have participants do the following:

Share JLN country experiences defining, identifying, and enrolling target populations to expand health

insurance coverage, and strategies for improving upon these processes

Understand the user’s experience enrolling in JLN country health insurance schemes, identify user challenges,

and share strategies to facilitate user enrollment

Learn about PhilHealth and its recent experience implementing innovative targeting programs

Identify future areas of focus for the Population Coverage Technical Initiative and collaboration opportunities

across other JLN initiatives

4

3. Workshop Sessions and Outputs

Workshop Day 1

Targeting Methodologies

The workshop kicked off with an introduction to the JLN, introductions among participants, and an overview of

workshop objectives. Caryn Bredenkamp from the World Bank set the stage for the workshop by presenting a

framework on targeting methodologies, which is summarized in the table below.

Box 1: Summary of Presentation: Targeting for UHC- Concepts and Approaches

Presenter: Caryn Bredenkamp, Senior Economist, World Bank

Rationale for targeting: Targeting methods are used to maximize efficiency of resources, as well as efficiency of the overall

program.

Costs of targeting: To develop and implement targeting approaches, programs will incur various types of costs that may

include: administrative costs (time, transportation), incentive costs (will there be an incentive for beneficiaries to change

their behavior?), and social costs (if membership is only available to the poor, will this be stigmatizing?), among others.

Types of errors: Errors in targeting are usually classified as either Type I or Type II errors. Type I errors are referred to as

errors of exclusion, whereby people eligible for benefits are omitted from the program. Type II errors are errors of

inclusion, or leakage, where benefits are provided to those who don’t need them and are not eligible.

Types of targeting methods: The most common targeting methods are described below. Each of these approaches has

strengths and weaknesses that should be considered by decision-makers (see presentation for more information).

Demographic targeting: Based on characteristics of individuals or groups associated with poverty or vulnerability,

particularly vulnerability to illness (e.g. children under 6).

Means testing: Income and asset based testing approaches

Proxy means testing: Approach to assessing income, which considers a broader definition of poverty and usually

considers other household characteristics that can serve as proxies for monetary income

Community-based targeting: Relying on local leaders or organized groups for identification

Self-targeting: Individuals self-select to join a program, which is designed to appeal to those who need its benefits

Guidance on choice of method: Generally, many of the targeting methods presented above are applicable to health

programs, including health insurance schemes. The choice of which targeting method to select is complex and in some

cases it may be most efficient to use a combination of methods. When considering which method to employ, decision-

makers should consider which method is most appropriate given the context and the target population, as well as the costs

and benefits (e.g. error reduction) associated with the design, implementation, and management of the targeting approach.

•Discussion of targeting methodologies

•Presentation on targeting innovations by representatives of PhilHealth and Ghana's National Health Insurance Authority (NHIA)

•Country targeting experiences group work and presentations

•Site visit briefingDay 1

•Site visit to Rizal Medical Center and PhilHealth local health insurance office

Day 2•Site visit debrief

•User experience group work and presentations

•Discussion on strategic communications with presentations by representatives of PhilHealth and Ghana's NHIA

•Brainstorming on JLN Population Coverage Initiative future activities

Day 3

5

Targeting and Enrollment: Country Presentations

The targeting methodologies presentation was followed by country presentations on innovations in targeting and

enrollment of hard-to-reach populations. Gregorio Rulloda, Vice President for Member Management Group,

represented PhilHealth and presented on the Philippines’ major reforms to target the informal sector, poor, and

indigent populations. Two representatives from Ghana’s National Health Insurance Authority, Ben Kusi , Director of

Membership, and Collins Akuamoah, Deputy Director of Membership, shared a presentation on their work on

defining, targeting, and enrolling disadvantaged populations in Ghana.

Box 2: PhilHealth’s Targeting and Enrollment

Defining target populations and membership categories.

PhilHealth redefined its membership categories to ensure

alignment with legal definitions of populations, and to

ensure that key target populations were represented.

Identification. The indigent and the poor are targeted

through the Department of Social Welfare and

Development’s centrally-managed poverty identification

system, the National Household Targeting System for

Poverty Reduction (NHTS-PR). Within the informal sector,

organized groups are identified through the PhilHealth

iGroup program, which engages organized groups in rural

areas to serve as marketing, enrollment, and collection

agents.

Enrollment. Enrollment in PhilHealth is by family. Various

types of enrollment processes are used to capture different

populations.

Poor/indigent: PhilHealth offers in-person enrollment in

scheme offices and enrollment camps in rural areas.

Onsite Enrollment at select hospitals to capture the

indigent at the point-of-care.

Organized groups: iGroup focuses on providing

convenient and easy enrollment and a flexible payment

schedule (quarterly, semi-annual, or annual) for the

informal sector.

Other groups: Individual enrollment at scheme offices.

Formal sector: Automatic enrollment.

Interventions/strategies. Recent strategies to improve

targeting have included:

Inclusion of household help as a category of dependents in formal sector beneficiaries

Removal of documentary requirements for enrollment of indigent and poor

Onsite Rapid Enrollment (ORE) in hospitals; being scaled

up nationally

Box 3: Ghana NHIA’s Targeting and Enrollment

Defining target populations and membership categories.

The NHIA targets all residents for enrollment, including the

poor and vulnerable.

Identification. NHIA enrolls disadvantaged populations in

pro-poor programs, including: those in orphanages, children

in government school feeding programs, and others. NHIA

policy also confers automatic eligibility for premium

exemption for beneficiaries of the Livelihood Empowerment

Against Poverty (LEAP) programme. LEAP uses a community-

based process to identify members and District Social Welfare

officers administer a questionnaire at the household level to

verify eligibility.

Enrollment. Enrollment in the NHIA is by family. Various

types of enrollment processes are used to capture different

populations:

Formal sector workers: Institutional registration.

Indigent, poor, informal sector: Registration agents lead

enrollment via house-to-house visits and office

registration. Members of the informal economy eligible

to pay a premium pay directly to the district office or

through the agents.

Other groups: In-person enrollment at scheme offices. Biometric enrollment was piloted in 2014 in Greater Accra region. Currently, it is implemented in six regions and will be fully rolled out nationally by middle of 2015.

Interventions/strategies. Recent strategies to improve

targeting have included:

Enrollment of existing organized groups of vulnerable populations to bypass stringent definition of the “indigent” and rigid documentary requirements

Improved enrollment form to capture additional data on beneficiaries

Piloting and rolling out biometric enrollment mechanism

6

Targeting and Enrollment: Report-Out by JLN Country Pairs

In the afternoon of Day 1, JLN representatives met in country pairs and had active discussions about their countries’

challenges and solutions to in-practice implementation of targeting methodologies. Representatives then introduced

their pair country and its targeting experience to the broader group, presenting one challenge, strategy, and unexpected

learning they gleaned from discussions with their peer country (summarized in table below).

Table 1: Report-Out by JLN Country Pairs

Malaysia (presented by Nigeria)

Challenge: Ensuring sustainability of funding

Strategy: Foreigners pay more than nationals for services

Unexpected learning: Malaysia is working towards creating

a single payment system. As part of this, Malaysia’s

Ministry of Health is 1) considering how to harmonize

public and private health service provision 2) considering

implementing a social-health-insurance-like scheme

Nigeria (presented by Malaysia)

Challenge: 1) Limited funding for scheme coverage of

beneficiaries 2) Leakages in enrollment

Strategies and solutions: 1) Creating new UHC fund 2)

Biometric registration for new members for the primary

school pupils program

Unexpected learning: Mobile money mechanism used to

collect premium contributions from informal sector

Indonesia (presented by Kenya)

Challenge: Manual enrollment process slower than online

Strategy: BPJS is planning to implement sanctions for the

informal sector to enroll in health insurance. For example,

requiring BPJS membership to obtain and renew a passport

and driver license

Unexpected learning: The major challenge faced by the

scheme with enrollment is administrative capacity to

manage the large number of new member applications

Kenya (presented by Indonesia)

Challenge: Enrollment is compulsory for formal sector, but

voluntary for all other groups. There is a lack of incentive for

the poor, near poor and informal groups to enroll

Strategy: Innovative partnerships between Kenya’s NHIF and

1) mobile network providers to collect premiums via mobile

money; 2) National Registration bureau to require

membership to renew work permits and licenses

Unexpected learning: NHIF is designing a program to provide

refugees with insurance coverage

Mali (presented by India)

Challenge: Local governments are responsible for

identifying indigent populations and contributing funds for

their coverage in the RAMED program. Mayors don’t report

the indigent to avoid paying for their RAMED coverage

Strategy: Mali is implementing a major information and

awareness campaign at national scale

Unexpected learning: Central government is delegating

responsibility to local governments

India (presented by Mali)

Challenge: Lack of incentive for HMOs to enroll populations in

rural areas

Strategy: Scheme managers place informal pressure on HMOs

to encourage enrollment of rural groups

Unexpected learning: Biometric enrollment camps have been

very successful.

Vietnam (presented by Ghana)

Challenge: Corruption leads to errors of inclusion in

targeting; commune leaders responsible for identifying the

poor according to defined poverty line sometimes

incorrectly report individuals as “poor” to provide them with

benefits and premium exemption

Strategy: Individuals identified as poor have their names

placed on a list, which is published in a public area (reduces

the risk of leakages)

Ghana (presented by Vietnam)

Challenge: Registration Agents occasionally enroll new

members incorrectly as indigents members to offer them

premium exemption.

Strategy: Use of biometric enrollment technologies

Unexpected learning: Ghana allocates 17.5% of the funding

from the VAT towards its national health insurance scheme

7

Unexpected learning: Strong political will to extend health

coverage to poor and near-poor populations

Workshop Day 2

Site Visit

PhilHealth, in its role as workshop hosts, planned a site visit to Rizal Medical Center and to a PhilHealth local health

insurance office. The visit to the medical center provided participants with an in-depth view of the Onsite Rapid

Enrollment (ORE) system, described in the box below, which enrolls critically poor populations seeking care at

hospitals into PhilHealth. At the PhilHealth office, participants also learned about the implementation of the

Philippines Anti-Red Tape Act, which requires government agencies (including PhilHealth) to display a Citizen’s

Charter that outlines the standards of services to individuals. PhilHealth also presented on the scheme’s primary

care benefit, TsEkAp (“Check-Up”), which provides enrollment, data verification, consultation, and preventive and

promotive services to users. The site visit provided participants with a rich understanding of PhilHealth programs,

including both the processes used by the scheme for targeting and enrolling beneficiaries (discussed on workshop

day 1) and the experience of users (discussed on workshop day 3).

Box 4: Philippines Onsite Rapid Enrollment (ORE) system

According to the Philippines’ No Balance Billing policy, Filipino citizens who are “critically poor” (defined as in the poorest 25%)

are exempt from paying medical cost and are eligible for free health coverage under PhilHealth’s Sponsored Program. In April

2013, PhilHealth launched a pilot in select hospitals of its Onsite Rapid Enrollment (ORE) system to capture and expedite

enrollment for the critically poor eligible for scheme coverage into the PhilHealth Sponsored Program. The ORE Program was

developed in response to a mandate from the government (Joint Order No 2013-0031, ‘Enrollment of the Critically Poor under

the Sponsored Program of the national health Insurance program at Point-of-Service”), as part of efforts by President Aquino’s

administration to expand health coverage to the poorest Filipino citizens.

ORE: step-by-step process

ORE database is used to determine the patient’s membership status within PhilHealth (whether they are already a

member, dependent, other).

If the patient is unenrolled in PhilHealth, a Medical Social Welfare Assistance Officer (MSWAO) conducts an interview and

completes an assessment form (form included in Annex 3) to determine their need for assistance, taking into account both

financial status and other factors, such as the severity of illness.

If eligible, the new member is enrolled to PhilHealth on-site using the ORE system. The data is sent to the MSWAO, who

transmits the information to the Department of Social Welfare and Development (DSWD).

The premium and medical costs for the visit are covered by the health facility. After the patient receives care, the hospital

submits a claim to PhilHealth, which is paid to the health facility within 30 days (expedited claims reimbursement). The

patient is not billed for any healthcare costs, even those beyond the amount reimbursable by PhilHealth.

DSWD conducts follow-up household visits and interviews to validate the eligibility of the new enrollee. Once validated,

the enrollee’s information is kept on file to ensure continued premium sponsorship. If the enrollee is not deemed to

qualify for the Sponsored program during this process, they will be asked to pay the requisite premium amount in the

following year.

8

9

Box 5: PhilHealth Presentation: 10 things to know about the implementation of the 2007 Anti-Red Tape Act

In April 2013, the Philippines passed the Anti-Red Tape Act (Republic Act No. 9485), which requires government

agencies (including PhilHealth) to set up and display a Citizen’s Charter that states the standards of service to

individuals. The Citizen’s Charter is mandated to be displayed in the office entrance/ the most conspicuous space to

be viewed by all.

1. Applies to all government offices that provide frontline services

2. Limits number of signatures of officials to a maximum of 5

3. Requires government offices to draw Citizen’s Charter which identifies the

services offered, procedures, fees, and complaint/feedback mechanisms

4. Citizen’s Charter must be posted at main entrance/most conspicuous place

and in published materials

5. Public assistance and complaints desk should be attended even during

breaks. All officers interacting with public should wear an ID

6. All applications/requests for frontline services shall be acted upon within 5-

10 working days

7. Denial of request for access shall be fully explained

8. Disciplinary action for violating act, based on the severity of the violation

9. Head of agency is primarily responsible and accountable for implementation of

the rule

10. CSC shall conduct Report Card Survey of Citizen’s Charter

Box 5: TSeKaP: “Tamang Serbisyo para su Kalusugan ng Pamily”

In 2014, PhilHealth re-introduced its Primary Care Benefits Package under a new brand, Tamang Serbisyong

Kalusugang Pampamliya (TSeKaP – or “check-up”). The purpose of redesigning this package creating the new

brand was to make it more attractive to PhilHealth users in order to encourage them to seek preventive health

care services.

Beneficiaries: TSeKaP was first piloted for members of the Department of Education. It is now available to

PhilHealth beneficiaries and their dependents in the following membership categories: Indigent, Sponsored

Members, Organized Groups, and Overseas Workers. There are plans to scale up TSeKaP to other PhilHealth

member categories in the future.

Benefits: Covers primary preventive services, diagnostic examinations, drugs and medicines for specified

diseases.

Providers: All public and private facilities providing primary care services can provide TseKap; Participating

facilities are required to meet accreditation standards.

More information available online.

10

Workshop Day 3

Site Visit Debrief

Evalyne Khamasi and Richard Sigei, representing Kenya’s National Hospital Insurance Fund, kicked off the third day

of the workshop by reviewing takeaways from the site visit from the previous day. They highlighted PhilHealth’s

Onsite Rapid Enrollment process and the No Balance Billing Policy, and discussed their relevance to the Kenyan

context. Richard commented that Kenya uses a means test to target orphans, but that there is no process to target

Kenya’s indigent. Evelyne noted that there remains some ambiguity on how to define the poor and indigent in

Kenya in general and within the context of the NHIF Sponsored Program, and that they could learn from PhilHealth

in this regard.

User Perspective

Workshop participants then had fruitful exchanges about enrollment from the

perspective of scheme beneficiaries (the user perspective). JLN members met in

their country groups to prepare a visualization of the user experience enrolling

in health insurance, which documented the trajectory of users, the barriers

encountered, and ways in which the scheme addresses these challenges.

Participants then reported out to the group to share highlights about their

country experiences, and identified some common barriers to enrollment,

which are summarized in the table below.

Table 2: Common Barriers to Enrollment in Health Insurance from

the Perspective of the Users

Evalyne Khamasi and Richard Sigei create a diagram of the enrollment user experience for Kenya’s NHIF

Outreach

“I’m in a remote location – I didn’t hear the message”

“I don’t speak the language and didn’t understand the message”

“I heard the message but it didn’t tell me what to do next”

“I heard the message but it was wrong” (distortion)

Enrollment

“Which program am I enrolled in?”

“I don’t have an ID card”

“I have to wait to access care”

“There are too many people at enrollment center – I got sick of waiting

and left / I couldn’t wait”

“It’s unfair how they classified me and they were unfriendly”

Access to care

“There is no center in my area”

“I’m at the health facility, I have insurance, but I still have to pay”

“I’m stigmatized and have to wait longer to get service”

“I can’t access/get the care I need”

Sudarto, Iwan Gani, and Widiyarti from Indonesia create a user experience map

Aiché Diarra and N’Tji Diarra discuss user experience of scheme beneficiaries in Mali’s various health insurance programs

11

Strategic Communications

The next session of the workshop focused on strategic communications, which is a topic that has recently gained

interest across the JLN. Within the context of the “targeting and enrollment” theme of this workshop, strategic

communications is important for programs defining, identifying, and enrolling target populations in order to

educate and reach users, provide transparency, and build buy-in among stakeholders. The workshop facilitators

noted that the success of a strategic communications approach is contextual, and they provided a general

framework along with a set of framing questions for programs to consider:

Is the right message being communicated?

Is the right channel being used, and is it appropriate for the target audience?

Is this the right time to convey these messages? What is the best timing?

How will success be measured against programmatic and communication goals?

Following this introduction, two JLN members presented experiences from their countries to demonstrate how

strategic communications can be used within UHC reforms, and to exemplify how they are carried out in practice.

Collins Akuamoah spoke about strategic communications challenges that Ghana faced when introducing capitation

to the Ashanti region and recent solutions. Dr. Nikka Hao of PhilHealth presented on PhilHealth’s experience using

strategic communications to roll-out a new primary care benefit, TSeKaP (“check up”). The presenters shared that

both experiences started with failures, which they were able to learn from and ultimately overcome.

Box 6: Strategic Communications- Key Lessons from Ghana’s NHIA Capitation Reform

Adapt communication strategy and approach based on local context. The NHIA tailored their communication

approach and messages based on characteristics of individual districts, such as the local political context and

leadership, cultural norms, and demographics of the population (e.g. age, socio-economic status, other) and

the local health priorities.

Engage key groups and ensure buy-in and local ownership to support program implementation. The NHIA

central office staff increased the involvement of NHIA district office staff to ensure they were fully engaged in

the implementation of the capitation program

Tailor communication strategies and tools for each group of stakeholders: To reach communities, the NHIA

organized visits to each districts across the region and met with traditional leaders, opinion leaders, and

community members to inform them about the capitation program. NHIA also visited local meeting places to

spread awareness about the program and created educational dramas to inform populations about capitation.

During this process, NHIA realized the need to use common terminology (“Family Doctor”) rather than technical

jargon (“capitation”). NHIA also did targeted outreach to health providers and met with health provider groups

across the Ashanti Region to educate them on capitation and provide them with resources for effective

communication with their constituency members.

Adjust reform based on feedback from key stakeholders. Based on feedback from health providers, the NHIA

adjusted the package of services included in the capitation reform by removing maternal care services and

medicines. The NHIA also increased the capitated rate to ensure provider satisfaction.

12

Box 7: Strategic Communications- Key Lessons from PhilHealth TSeKaP Program

Dr. Razel Nikka Hao, from the PhilHealth Primary Care Benefit Team, presented on the experience of “TSeKaP”

(pronounced “check-up”) and shared three lessons learned from PhilHealth:

Developing the message: PhilHealth sub-contracted a

communications firm, with support from the World Health

Organization, to conduct focused group discussions with

health users across all PhilHealth membership categories.

Based on their findings, the firm created a logo, a

“superhero” for TSeKaP communications, and a digital

communications plan.

Involving stakeholders: PhilHealth formed a technical

working group with key stakeholders involved in the TSeKaP

program, as well as with international partner organizations

(World Bank, World Health Organization, and UNICEF) to

garner external support for the program. The technical

working group conducted stakeholder interviews with

different health providers, which included the PhilHealth

Regional offices, existing primary health care providers in the

public and private sector, as well as drug outlets to identify

possible drug providers for TSeKaP. Findings from these

consultations with other groups proved to be instrumental in

defining 1) what audiences to reach 2) what messages to

convey 3) what communication channels to use to reach to deliver them.

Developing targeted information campaigns: The PhilHealth Primary Benefits Team planned a nation-wide

targeted information campaign, which included a combination of in-person orientation trainings, the

production of written materials, and also a digital information campaign. In-person orientation trainings were

held for local government units, groups of private health providers, and with local chiefs. PhilHealth worked

closely with Union of Local Authorities (ULAP) and the Department of Interior and Local Government (DILG) of

the Philippines to plan the orientation sessions with local chiefs. The following elements were critical to the

success of these orientations:

They were conducted prior to the release of the TSeKaP program and related policies

They were interactive sessions, using a “world café” format aimed at getting feedback from stakeholders

PhilHealth compiled feedback from stakeholders into a “Favorite Asked Questions” document, which was

widely disseminated as part of the information campaigns

PhilHealth also developed a TSeKaP digital communication strategy because of the popularity of Facebook and

other social media websites in the Philippines. They identified key information platforms and sent out tailored

social media messages on a daily basis.

13

Best Practices for Joint-Learning

To end the day, Stefan Nachuk, Associate Director at the Rockefeller Foundation, presented on best practices for

peer-to-peer learning based on past successes within the JLN. Stefan shared examples of past JLN work and

synthesized some key lessons learned about the process of JLN peer-exchanges:

Joint-learning is best achieved within the network when a group of committed JLN members collaboratively

develop a product/output with the aim of collectively addressing a common problem

Contributors should be a group of technical experts, practitioners, and/or policy-makers from JLN member

countries who share common objectives and face a common set of challenges

The technical topic should be narrowly defined and aligned with short-term policy priorities of multiple

countries

The product should draw from and build upon the deep expertise and practical knowledge of JLN members on

implementing UHC reforms to create a useful resource for countries within and beyond the JLN

Future Activities

This presentation framed the closing session for the workshop, during which participants brainstormed and

discussed possible topics and activities for future joint learning work related to targeting and enrolling hard-to-

reach populations. Participants identified the following three products as possibilities for future work (more

information about each product provided in Annex 2):

1. Annotated compendium of country target population definitions

2. Compilation of identification tools with case studies & comments

3. Manual on strategic communications for outreach to users

4. Next Steps

To follow up on workshop activities, the JLN Population Coverage Technical Initiative facilitators (R4D) are obtaining

feedback from workshop participants on the ideas for future activities and their prioritization, and on their personal

interest in assuming a leadership role to take forward the work. Workshop participants will decide, as a group,

which product(s) to develop collaboratively.