1. Ministry of Healthcare & Nutrition Broader Approaches to Health Strategic Frame Work for Health Development

2.  Peoples’ Needs  Changing /developing world  Continuing /emerging /evolving problems  Available resources

4. Challenges Health Services Human Resources for Health Health Sector Management and Stewardship Tsunami and Conflict-affected Areas Optimizing the Private Sector Contribution Focusing on Vulnerable Groups Inter-sectoral Collaboration Demographic and Epidemiological Transition Health Financing and Resource Allocation

5. * MOH Health Expenditure combines Recurrent & Capital Expenditures, 2003 is based on Estimates Figure 01 Health Financing and Resource Allocation 1939 to 2003

6. Health financing and resource allocation 20052006200720082009 Total government expenditure on health (Rs bn) 47637588103 As a percentage of GDP1.92.22.32.42.5 As a percentage of total government expenditure 5.7 5.86.27.2 Recurrent expenditure as a % of total govt. health expenditure 8074766966 Per Capita Exp (Rs)2,3113,228 (30 US$) 3,8244,4695,231 Source: MOFP

7. Investment in 2006 National levelRs. Mn% of Total Curative services28,02278.0 Preventive services 2,75808.0 Nutrition 87002.0 Health sector training 2,15406.0 Health Research 118 0.6 Estate health 55 0.2 General health services 1,174 3.0 Budget proposals 2,027 Provincial level Provincial Councils 19,777 Source: MOFP

8. CapitalRecurrent % Foreign Aid 5,63615.0 Foreign Aid Related Domestic Funding 1,6204.4 Domestic Funding 5,15124,81180.6 Total 12,35724,811100.0 Method of financing-2006 Source: MOFP

9. Government Policy “I consider it my responsibility to preserve the free health service and safeguard the right of every citizen for the benefits there under. In this regard immediate action will be taken to enhance these services both qualitatively and quantitatively through increased budgetary provisions.” ENSURING GOOD HEALTH

10. Strategic Framework for Health Development Strengthen Individual, Household and Community Actions for Health Improve Health Services Delivery and Health Actions Improve Human Resource Development & Management Improve Health Financing, Resource Allocation & Utilization Strengthen Stewardship & Management Functions Inter-relationships among the Five Strategic Objectives

11. STRATEGIC OBJECTIVE 1 :TO IMPROVE COMPREHENSIVE HEALTH SERVICES DELIVERY AND HEALTH ACTIONS, WHICH REDUCE THE DISEASE BURDEN AND PROMOTE HEALTH Immediate Objectives: To rationalize and strengthen the network of health facilities and services (that includes allopathic and indigenous as well as public and private services) To introduce technology assessment at the central MoH and access appropriate technologies To ensure adequate drugs, other medical supplies and equipment are in place To enhance the quality of service delivery (assuring responsiveness to needs) To reduce priority diseases/conditions through strategic interventions To improve the health status of vulnerable populations (including marginalized and underprivileged groups) To promote inter-sectoral coordination for disease control and prevention To increase public confidence and patient/client satisfaction in the health services.

12. STRATEGIC OBJECTIVE 2 : TO EMPOWER COMMUNITY TOWARDS MORE ACTIVE PARTICIPATION IN MAINTAINING AND PROMOTING THEIR HEALTH Immediate Objectives: To monitor public perception of their needs and of the health system towards serving as input for improvement. To improve participation of civil society and non- governmental organizations in promoting behavioural and lifestyle changes. To improve public awareness of their rights, responsibilities and options for care as well as to establish an ombudsman system.

13. STRATEGIC OBJECTIVE 3: TO IMPROVE THE MANAGEMENT OF HUMAN RESOURCES FOR HEALTH Immediate Objectives: To improve the technical and managerial competencies of health staff in both curative and preventive sectors. To rationalize the development and management of human resources for health. To improve the performance of human resources in the health sector.

14. STRATEGIC OBJECTIVE 4 : TO IMPROVE HEALTH FINANCE MOBILIZATION, ALLOCATION AND UTILIZATION Immediate Objectives: To increase government financial support at all levels to strengthen the financial sustainability of the health sector To improve allocative efficiency and equity To identify and test alternative financing mechanisms (including various forms of health insurance, possible fees, co-payment, earmarked taxes and others) with a view towards national implementation. Adopt best option. To make optimal use of financial resources (through cost-effective strategies that will be identified, adopted and re-evaluated for the management of priority diseases/conditions). To optimise private sector contribution, initially establishing an information- sharing mechanism to include reporting on service use and quality as well as financing. To strengthen financial management (including capacity, authority, autonomy, monitoring and supervision, and use of available resources).

15. STRATEGIC OBJECTIVE 5 : TO STRENGTHEN STEWARDSHIP AND MANAGEMENT FUNCTIONS OF THE HEALTH SYSTEM Immediate Objectives: To institutionalise effective mechanisms for policy development within existing units. To enhance efficiency, effectiveness and accountability of the MoH and decentralised units, autonomy in management To strengthen managerial performance at national and decentralised levels.

16. STRATEGIC OBJECTIVE 5 :contd… TO STRENGTHEN STEWARDSHIP AND MANAGEMENT FUNCTIONS OF THE HEALTH SYSTEM Immediate Objectives: To strengthen and introduce monitoring and evaluation of performance, which are related to health outcomes, in all health institutions. To strengthen the system for regulating the services of public and private providers. To strengthen health information system. To strengthen capacity in health research.