Health Transformation and Social Security Reform Project (Phase II) is based on Health Transformation Project (Phase I).
HEALTH TRANSFORMATION AND SOCIAL SECURITY REFORM PROJECT (HTSSRP)
1.1. Project Description:
Health Transformation and Social Security Reform Project (Phase II) is based on Health Transformation Project (Phase I).
For the financing of the project, a new loan agreement was concluded by and between the Republic of Turkey and World Bank on 30 June 2009. This agreement took effect on 29 September 2009. The project, which is based on the strategic plan of our Ministry for the years 2010-2014 and constitutes the second phase of the Health Transformation Program, is made up of 3 main components:
COMPONENT A: SUPPORT FOR MINISTRY OF HEALTH'S STRATEGIC PLAN (2010-2014)
Target:
Target is to increase capacity to make the MoH an efficient guide for the health sector and enable the MoH complete the service provision reforms. This component finances technical assistance, training and material needs for eight out of ten programs of the 2010-2014 Health Sector Strategic Plan of the MoH. This component has eight sub-components:
SUB-COMPONENT A.1: Strengthening Preventive and Primary Health Care Services:
Target:
This component will finance equipment, technical assistance, technical services and training to expand from existing 33 provinces to 81 provinces of Turkey by increasing the scale of the family medicine program and also support the implementation of preventive healthcare services of the MoH for the control of communicable and non-communicable diseases.
Units in Charge:
• Department of Health Promotion and Improvement of the General Directorate of Primary Healthcare Services
• Department of Non-Communicable Diseases and Chronic Conditions of the General Directorate of Primary Healthcare Services
• Department of Family Medicine of the General Directorate of Primary Healthcare Services
• Department of Tuberculosis Control
SUB-COMPONENT A.2: Implementing Public Hospitals Reforms
Target:
This component will finance technical assistance and training to support the implementation of hospital reforms. Primary goal of the hospital reforms under the Health Transformation Program is to carry out the pilot study of the Public Hospital Union model and to implement it throughout the country. Implementation of this model will convert the MoH hospitals in Turkey into public enterprises.
Units in Charge:
• General Directorate of Health Education
• General Directorate of Treatment Services
SUB-COMPONENT A.2: Improving the Quality of Health Services
Target:
Under this component, technical assistance and training will be provided to build capacity at the Department of Performance Management and Quality Improvement of the MoH and to implement performance-based payment systems of this department and to increase its role in regulating the services of the healthcare providers with a goal to achieve quality healthcare services.
Unit in Charge:
• Department of Performance Management and Quality Improvement of the General Directorate of Treatment Services
• PMSU- Department of Monitoring and Evaluation
SUB-COMPONENT A.4: Institutional Restructuring and Capacity Building
Target:
This component will finance equipment, technical service, technical assistance and training activities (including the establishment of National Pharmaceuticals and Medical Devices Agency, National Cancer Institute and an internal audit structure and institutionalization of the Monitoring and Evaluation functions of the MoH). This sub-component will also support the strengthening of strategic management capacity for the implementation of strategic financing methods in the field of performance-based budgeting and ensure the continuity and coordination of in-service training programs.
Unit in Charge:
• Directorate of Refik Saydam Institute
• General Directorate of Pharmaceuticals and Pharmacy
• Department of Cancer Control
• Presidency of Strategy Development
• General Directorate of Health Education
SUB-COMPONENT A.6: Improving Health Information Systems
Target:
This component will finance goods, technical assistance and training to support the expansion of MoH National Health Information System (USBS). Target of the USBS is to identify, improve, and implement the health informatics standards, to enhance the principles of confidentiality, security and privacy of personal and corporate health records, to establish a data warehouse within the scope of decision support system, to initiate data mining practices and to establish tele-pharmacy and tele-health systems.
Units in Charge:
• Department of Administrative and Financial Affairs
SUB-COMPONENT A.7: Supporting Inter-Sectoral Health Responsibility and Aligning Health Policies with World Standards
Target:
Under this component; equipment, technical assistance, technical service and training activities will be supported to strengthen inter-sectoral collaboration and to align the health policies with international standards, European Union principles and standards in particular.
Unit in Charge:
• Project Management and Support Unit
• Department of Public Private Partnership
• RSHMB- Directorate of Refik Saydam Institute
SUB-COMPONENT A.8: Functionalizing the National Public Health Institution
Target:
This component will provide goods, technical assistance and training activities for the Presidency of Refik Saydam Health Center (RSHMB) to convert this institution into the national public health institution, which is responsible for all important health functions within the country.
Unit in Charge:
• Presidency of Refik Saydam Health Center
SUB-COMPONENT A.9: Strengthening Collaboration in Improving Health Policies with Other Countries and International Organizations and sharing country experiences
Target:
Strengthening the institutional capacity of the Department of Foreign Affairs in international relations through equipment, technical assistance, technical services and training activities, enhancing collaboration with other countries and international organizations and sharing the experience gained with Health Transformation and Social Security Reform Project at the international level will be ensured.
Unit in Charge:
• General Directorate of EU and Foreign Affairs
COMPONENT B: PILOTING OUTPUT-BASED FINANCING FOR PREVENTIVE HEALTHCARE SERVICES
Target:
Target of this component is to carry out a pilot study for the implementation of preventive healthcare interventions against Non-Communicable Diseases (NCD) at the provincial level by using output-based financing mechanisms.
Component B, which was included in the project as a pilot implementation, was cancelled and excluded from the scope of the project due to the fact that the activities under Component B would be implemented nationally and covered by the general budget.
COMPONENT C: CAPACITY BUILDING OF THE SOCIAL SECURITY INSTITUTION
Component C: Capacity Building of the Social Security Institution will be carried out by SSI.
1.2. Project Development Objectives
(i) Increasing the effectiveness of the Social Security Institution (SSI) and Ministry of Health (MOH) in formulating and implementing reforms in provider payments and health systems performance;
(ii) Piloting output-based financing for non-communicable diseases (NCD) prevention and control.
1.3. HTSSRP Key Performance Indicators
1- Increase in the utilization of primary healthcare,
2- Increase in the percentage of first-time visits to specialists that are referred by family medicine practices,
3- Increased client satisfaction with health services,
4- Decrease in SSI expenditures on pharmaceuticals and outpatient health care,
5- Smoking prevalence among 18-29 age group in Output-Based Financing pilot provinces decreases more relative to non-pilot provinces,
6- High blood pressure in population in Output-Based-Financing pilot provinces decreases more as compared to non-pilot provinces.