1. 2006 Pan American Health Organization.... Capacity of the National Health Authority to Regulate/Enforce Health Systems Strengthening Seminar Monitoring Health Systems Change/Health Reforms Belize City, Belize 30 May-1 June 2006 Capacity of the National Health Authority to Regulate/Enforce Health Systems Strengthening Seminar Monitoring Health Systems Change/Health Reforms Belize City, Belize 30 May-1 June 2006

2. 2006 Pan American Health Organization Regulation and Enforcement Roles Actors Scenarios Expectation on the States responsibility to conduct/lead Roles Actors Scenarios Expectation on the States responsibility to conduct/lead Redistributive justice Equity Transparency The creations of spaces for the effective participation of all sectors including civil society

3. 2006 Pan American Health Organization What is regulation? A manifestation of the States responsibility to order and systematize a reality according to a series of trend prevailing at a given time The regulatory capacity of the NHA is exercised in the preparation and promulgation of the statutory instruments needed to implement laws or health acts A manifestation of the States responsibility to order and systematize a reality according to a series of trend prevailing at a given time The regulatory capacity of the NHA is exercised in the preparation and promulgation of the statutory instruments needed to implement laws or health acts

4. 2006 Pan American Health Organization Why is the regulatory dimension important? Means to create the legal framework needed to protect and promote the health of the population as well as to guarantee its enforcement By of its regulatory prerogative the State distributes social goods in an universe of intense competitiveness among actors and highly fragmented scenarios Incidence of the private sector Empowerment of individuals Means to create the legal framework needed to protect and promote the health of the population as well as to guarantee its enforcement By of its regulatory prerogative the State distributes social goods in an universe of intense competitiveness among actors and highly fragmented scenarios Incidence of the private sector Empowerment of individuals

5. 2006 Pan American Health Organization What are the determinants of the regulatory function? Within the State –Regulatory mandates Constitutions –Rights and duties –Decentralization of functions among levels of government Laws or acts granting regulatory powers In the international context –Commitments entered by States International treaties or conventions (FCTC/IHR) Membership to the WTO Membership to supranational groups Within the State –Regulatory mandates Constitutions –Rights and duties –Decentralization of functions among levels of government Laws or acts granting regulatory powers In the international context –Commitments entered by States International treaties or conventions (FCTC/IHR) Membership to the WTO Membership to supranational groups

6. 2006 Pan American Health Organization What makes the regulatory dimension effective? Recognize the impact of the regulatory function/solid regulatory framework Ensure the regulatory leadership of the NHA Strengthen political will to regulate/create an adequate infrastructure Clear policies and shared principles (equity, quality, universality) Institutional capacity (conduction/ articulation of interests among actors and sectors) Strategic foreseen capacity Monitor, evaluate and upgrade the regulatory framework Coordinate/ articulate with decentralized agencies Capacity to enforce regulations Recognize the impact of the regulatory function/solid regulatory framework Ensure the regulatory leadership of the NHA Strengthen political will to regulate/create an adequate infrastructure Clear policies and shared principles (equity, quality, universality) Institutional capacity (conduction/ articulation of interests among actors and sectors) Strategic foreseen capacity Monitor, evaluate and upgrade the regulatory framework Coordinate/ articulate with decentralized agencies Capacity to enforce regulations

7. 2006 Pan American Health Organization Enforcement Is aimed at assuring timely compliance with the regulatory framework –Enough technical personnel, financial resources and guideline for procedure –Prevention of misuse of authority –Education of the public –Ongoing training/evaluation of training programs –Technical assistance/support to sub-national levels in enforcing regulations Is aimed at assuring timely compliance with the regulatory framework –Enough technical personnel, financial resources and guideline for procedure –Prevention of misuse of authority –Education of the public –Ongoing training/evaluation of training programs –Technical assistance/support to sub-national levels in enforcing regulations