Outline of the Project

Project Name

The project for improving quality of healthcare services and financial management of the hospitals

Subject

Health

Country

Lao PDR

Date R/D Signed

Sep. 3, 2021

Project Site

Vientiane, Southern four provinces (Champasak, Salavan, Sekong, Attapeu)

Term of Cooperation

Mar. 27, 2022 to Mar. 26, 2025

Implementing Organization

Ministry of Health (Department of Healthcare and Rehabilitation, National Health Insurance Bureau, Department of Finance)

Background

The Ministry of Health of Lao PDR has positioned "Service delivery and hospital management" as an important issue in its "Health Sector Reform Strategy and Framework (HSRSF) 2013-2025," including it among the five pillars to be addressed to achieve UHC by 2025. Japan has supported improving the quality of health services in four southern provinces of Laos through the technical cooperation project "The Project for Improving Quality of Health Care Services (QHC Project)" since 2016. The QHC project has established a system for implementing quality improvement activities in hospitals, enabled each hospital to formulate and implement a quality improvement plan with a limited budget, and improved patient satisfaction with health care services.

The hospital accreditation system is a system that includes evaluation of hospital quality. To obtain accreditation, it is necessary to continuously improve the quality of healthcare services and get accreditation, in addition to implementing the system. Therefore, further assistance is required to expand the activities to improve the quality of healthcare services to district-level health facilities under the Dok Champa Hospital Accreditation.

On the other hand, improvement of financial management at hospitals is also needed to provide quality-assured health care services continuously, and appropriate hospital accounting management in the target hospitals of the QHC project will lead to further improvement of the quality of health care services in hospitals and continuation of improvement activities. Although the coverage of any financial protection Scheme for health became 94% in 2019, increasing access to health care services for the population, accounting management in hospitals remains a challenge. In addition to the lack of understanding of the health insurance system, some costs that should be covered by insurance are collected from patients. Hospitals' poor accounting management capacity prevents them from conducting proper accounting operations, resulting in delays in reimbursement billing and preventing hospitals from receiving necessary allocations of medical expenses promptly, thus creating a bottleneck in the continuous provision of health care services. To resolve these issues, the Lao government requested technical cooperation to ensure the quality of healthcare services and proper financial management of hospitals.

The Overall Goal

Improved healthcare services are being maintained with financial protection in the target provincial and district hospitals.

Project Purpose

Quality of healthcare services and financial management are ensured-in the target provincial and district hospitals.

Output

Output1: The quality of healthcare services is improved towards certification of Doc Champa Hospital Accreditation.

Output2: Hospital accounting/financial management, including the health insurance fund managemanet, is strengthened.

Project Activities

1-1.	Organize Quality of Healthcare improvement (QHC) Committee. (Province, District)
1-2.	Conduct accessors training courses for Dok Champa Hospital Accreditation. (Province, District)
1-3.	Conduct assessment using the national standards of Dok Champa Hospital Accreditation. (Province, District)
1-4.	Develop a method to improve hospital services and functions (quality improvement activities) and introduce the method to the hospitals. (Province, District)
1-5.	Make an improvement plan to improve hospital services and functions (quality improvement plan) according to the results of the assessment. (Province, District)
1-6.	Develop a document (e.g. implementation manual ) describing the method to improve hospital services and functions (quality improvement activities) based on the experiences having introduced the method to the provincial and district hospitals.
1-7.	Implement quality improvement activities. (Province, District)
1-8.	Conduct supervisions for quality improvement activities. (Central to Province, Province to District)
1-9.	Organize meetings for monitoring and sharing experiences of quality improvement activities. (Four provinces, each province)
1-10.	Strengthen infection prevention and control and patient safety activities in the hospitals. (Province, District)
1-11.	Summarize the quality improvement activities of the hospitals in documents.
1-12.	Make recommendations on quality improvement activities to MOH and other development partners based on the project's activities and lessons learned in the four southern provinces.
2-1.	Gather information about hospital accounting/financial management, including the health insurance fund management, to grasp the situation.(Province, selected district)
2-2.	Develop a method to ensure implementation of the work related to the national standards of hospital accounting/financial management, including the health insurance fund management. (Province, District) (related to Activity 1-4) management. (Province, District) (related to Activity 1-4)
2-3.	Conduct training courses related to the health insurance fund management following the national guidelines such as Health Insurance Verification Guideline etc. (Province, District)
2-4.	Conduct training courses related to the hospital accounting/financial management following the national guidelines such as Public Financial Management Guideline for the Health Sector etc. (Province, District)
2-5.	Conduct supervisions for hospital accounting/financial management, including the health insurance fund management. (Central to Province, Province to District)
2-6.	Organize meetings for monitoring and sharing experiences of hospital accounting/financial management activities, including the health insurance fund management. (Four provinces, each province)
2-7.	Make recommendations on hospital accounting/financial management strengthening activities, including the health insurance fund management, to MOH and other development partners based on the project's activities and lessons learned in the four southern provinces.
2-8.	Learn and share lessons through meetings/workshops regarding the financial protection system for health with Thailand, in collaboration with the JICA technical cooperation project in Thailand.

Inputs

[Japanese side]

1. JICA experts
   (1) Long-term JICA experts
   - Chief Advisor
   - Project Coordinator
   - Quality Management
   - Hospital Accounting
   (2) Short-term JICA experts
   - Infection prevention and control / patient safety
   - Accounting management
   - Other experts related to project activities
2. Training (in Japan or third countries)
3. Equipment
4. Operational Costs
5. Others

[Laos side]

1. Counterpart
   (1) Project Director
   (2) Project Manager
   (3) Relevant staff from the central, provincial, district levels for the project activities
2. Facility and equipment
   (1) Project office in Champasak Provincial Health Office
   (2) Project office in MoH in Vientiane
3. Local cost
   (1) Personnel cost for counterparts
   (2) Running cost (water, electricity etc.)