Most developing countries have a Central Bank, whose role is to oversee monetary policy and support the economic policy of the government. The Central Bank is also typically responsible for licensing and regulating commercial banks as well as deposit-taking microfinance institutions, and in some cases oversees the insurance industry. Although this is not standard, some teams have met with the Central Bank to learn more about financing issues pertinent to the private health sector, especially if there is interest in establishing a Development Credit Authority (DCA)–a loan guarantee underwritten by USAID. View and download questions.
Most countries have a Drug Regulatory Authority or similar entity tasked with regulation of medicines, especially regarding importation of drugs, compliance of retail pharmacies, and control of black market or counterfeit medicines. It is often helpful to interview a representative from this agency to gain an understanding of the pharmaceutical landscape and procurement issues. View and download questions.
The Ministry of Finance (MOF) typically determines budget allocations for all government functions, including the health system, and also determines tariffs on imports, including medical equipment, products, and drugs. In some countries, the MOF also regulates insurance. Depending on the scope and objectives of the assessment, the team may want to interview relevant MOF officials, especially those involved in budgeting. View and download questions.
The Ministry of Health (MOH) oversees the health sector in most developing countries. This ministry is typically responsible for setting policy related to the overall health sector (public and private) as well as provision of services at primary-, secondary- and tertiary-level public facilities. In addition to the minister, key positions include the permanent secretary, chief medical officer, chief epidemiologist, and health planner. While each country’s Ministry of Health may be organized differently, most generally have the following departments:
- Health Policy and Planning Health Promotion
- Procurement/Drug Regulatory Authority
- Human Resources/Licensing
- Disease Control
- Clinical Services
- Community Health
- Public Affairs
Given its important role as steward of the health system, teams typically engage MOH officials in the assessment process, and interview key representatives as noted below. View and download questions.
Many developing countries have publicly financed health insurance for government employees. This is sometimes used as a foundation for national health insurance. If national health insurance is being considered in the country being assessed, there may be interest in exploring a potential role for the private sector. In this case, the team may want to learn more about the existing public health insurance program. View and download questions.