ZdravPlus supports development of favorable policy environments for improving health services and builds local capacity to plan and manage reforms more effectively by:
These strategies are designed to build local capacity, so counterparts can better manage the policy process as well as improve the content of policies, laws and regulations governing health sector. Moreover, the strategies will reduce policy barriers in other technical areas, increasing the likelihood of success and results.
To develop and implement a comprehensive, integrated health care reform model requires extensive policy dialogue with government and health authorities on all health reform elements. ZdravPlus continues work begun under the ZdravReform Project to encourage policy dialogue and to improve policy processes and data based decision-making. One way ZdravPlus helps strengthen policy processes is by supporting Working Groups. Working Groups are formed by the government or health authorities to enhance policy dialogue and build capacity for broad policy and planning issues, as well as to discuss narrower technical issues. Working Groups can protect the policy process against political instability, as Working Group participants tend to be more stable than political leadership. ZdravPlus continues to encourage the use of Working Groups in the policy process and will build the capacity of Working Group members through technical assistance, training, and the provision of wider access to information. In addition, these working groups continue to be a forum for planning program activities with counterparts. Successful policy dialogue, processes, and advocacy require an inter-sectoral approach and excellent donor and project collaboration. The health systems development process in most of Central Asia has progressed to the extent that many issues no longer fall within the sole jurisdiction of the Ministry of Health. Therefore, ZdravPlus works to ensure that all stakeholders are included in policy dialogue and processes through a consultative, participatory process.
Building on the policy successes achieved under ZdravReform in changing laws and regulations, ZdravPlus continues to provide technical assistance to improve policy content. The possible topics are too many to list here, but are highlighted in the other three technical components. As the policy dialogue and analysis processes generate policy decisions and strategies, ZdravPlus provides technical assistance to convert policy decisions into consistent, transparent, and easy-to-implement laws and regulations. Project specialists and lawyers provide technical assistance to counterparts to draft, amend, revise, and comment on the technical content of health sector laws and regulations.
Health policy analysis, evaluation, and research has not historically been a part of the Ministry of Health. This often results in health policies that are drafted under unrealistic time constraints, and evaluations that are highly subjective and politicized. Large amounts of data are generated, but are used mainly for compiling aggregate statistics rather than feeding information back into the system to improve performance. ZdravPlus provides training to create awareness of the benefits of integrating research and analysis into policy decision-making, and establishing a process for formative health policy evaluation. Clearer processes have now been established for incorporating results from the pilots into the national policy process. To incorporate more rigorous policy analysis, formative evaluation, and research into the health policy development process, ZdravPlus works with policymakers to use the new clinical and financial information systems that accompany new provider payment systems as a source of routine information for policy analysis and evaluation. Linking this information into a system of health policy formulation and evaluation provides timely and useful information for continuous quality improvement of the health system as a whole.
The predecessor project to ZdravPlus contributed to the formation of 22 health sector NGOs, including Family Group Practice Associations, Hospital Associations, and public health NGOs in Uzbekistan. These NGOs have already begun to serve as policy advocates. ZdravPlus builds on past efforts to develop NGOs through technical assistance, training, and grants to enhance their capacity to provide services to members and communicate with the population. In particular, the project focuses on developing a systematic approach to enhance the capabilities of health sector NGOs for advocacy and empower them to harness their natural capacity to contribute to health policy dialogue and processes. With additional assistance and training, these NGOs have the potential to serve as powerful policy advocates and contribute to democratic transition, representing groups that have traditionally had little voice in health policy decision-making.