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Implementation of the Tallinn Charter: Final Report

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IMPLEMENTATION OF THE TALLINN CHARTER: FINAL REPORT OF THE TALLINN IMPLEMENTATION THE WHO REGIONAL OFFICE FOR EUROPE The World Health Organization (WHO) is a specialized agency of the United Nations created in 1948 with the primary responsibility for international health matters and public health. The WHO Regional Office for Europe is one of six regional offices throughout the world, each with its own programme geared to the particular health conditions of the countries it serves. MEMBER STATES Albania Greece Republic of Moldova Andorra Hungary Romania Armenia Iceland Russian Federation Austria Ireland San Marino Azerbaijan Israel Serbia Belarus Italy Slovakia Belgium Kazakhstan Slovenia Bosnia and Herzegovina Kyrgyzstan Spain Bulgaria Latvia Sweden Croatia Lithuania Switzerland Cyprus Luxembourg Tajikistan Czech Republic Malta The former Yugoslav Denmark Monaco Republic of Macedonia Estonia Montenegro Turkey Finland Netherlands Turkmenistan France Norway Ukraine Georgia Poland United Kingdom IMPLEMENTATION OF THE Germany Portugal Uzbekistan TALLINN CHARTER: FINAL REPORT World Health Organization Regional Office for Europe UN City, Marmorvej 51, DK-2100 Copenhagen Ø, Denmark Tel.:+45 45 30 70 00. Fax: +45 45 30 70 01 E-mail: [email protected]. Web site: www.euro.who.int Cover photo: The Old Raeapteek (Town Pharmacy) and traditional house on Raekoja Plats (Town Hall Square) in Tallinn. Design & layout Phoenix Design Aid, Denmark IMPLEMENTATION OF THE TALLINN CHARTER: FINAL REPORT This report has been summarized for the 65th session of the WHO Regional Committe for Europe (EUR/RC65/8) Keywords DELIVERY OF HEALTHCARE eHEALTH HEALTH FINANCING HEALTH POLICY HEALTH SERVICES HEALTHCARE SYSTEMS PUBLIC HEALTH © World Health Organization 2015 All rights reserved. The Regional Office for Europe of the World Health Organization welcomes requests for permission to reproduce or translate its publications, in part or in full. The designations employed and the presentation of the material in this publication do not imply the expression of any opinion whatsoever on the part of the World Health Organization concerning the legal status of any country, territory, city or area or of its authorities, or concerning the delimitation of its frontiers or boundaries. Dotted lines on maps represent approximate border lines for which there may not yet be full agreement. The mention of specific companies or of certain manufacturers’ products does not imply that they are endorsed or recommended by the World Health Organization in preference to others of a similar nature that are not mentioned. Errors and omissions excepted, the names of proprietary products are distinguished by initial capital letters. All reasonable precautions have been taken by the World Health Organization to verify the information contained in this publication. However, the published material is being distributed without warranty of any kind, either express or implied. The responsibility for the interpretation and use of the material lies with the reader. In no event shall the World Health Organization be liable for damages arising from its use. The views expressed by authors, editors, or expert groups do not necessarily represent the decisions or the stated policy of the World Health Organization. CONTENTS Acknowledgements.....................................................v Abbreviations ..........................................................vi Key messages .........................................................vii Introduction ............................................................1 Background ..........................................................1 Methodology .........................................................3 Structure of the report..................................................6 Limitations ...........................................................7 Health and related developments in the Region since Tallinn.............8 The global economic crisis ..............................................8 Health 2020: the new European health policy framework....................11 Reaffirming intersectoral collaboration in promoting public health ............11 Strengthening evidence-informed decision-making in health policy ..........12 Resilience of the health system .........................................14 Commitment 1 ........................................................16 Main messages ......................................................16 Reorienting service delivery to strengthen primary care and public health . 17 Making explicit the commitment to solidarity through health financing .......19 Setting goals and targets to address health workforce needs.................21 Ensuring equitable access to high-quality medical products.................22 Aligning health systems with the goals of Health 2020......................25 Commitment 2 ........................................................27 Main messages ......................................................27 Targeting non-traditional settings for delivery of health services .............28 Aligning financial flows within and between sectors .......................28 Securing the health workforce across sectors .............................30 Fostering collaboration for improved research and development of HTP .......31 Strengthening stewardship ............................................31 Commitment 3 ........................................................34 Main messages ......................................................34 Measures to keep providers and institutions accountable ...................35 Improving transparency in health system financing . 38 Promoting health workforce accountability ...............................38 Promoting rational and evidence-driven use of HTP ........................39 Establishing the role of stewards in measuring and evaluating health systems . 41 Commitment 4 ........................................................45 Main messages ......................................................45 Reorganizing services to improve access to quality services .................46 Improving responsiveness through financial mechanisms ...................49 Aligning health workforce capacities with patient needs....................50 Prioritizing innovation and fair pricing ...................................53 Strengthening patient rights and entitlements ............................54 Commitment 5 ........................................................56 Main messages ......................................................56 Decentralizing the planning and implementation of health services...........56 Improving dialogue and engagement with ministries of finance..............57 Involving the health workforce in policy-setting ...........................57 Engaging stakeholders to improve efficiency in HTAs ......................58 Participatory governance ..............................................59 Commitment 6 ........................................................62 Main messages ......................................................62 Developing a vision for coordinated/integrated care........................62 Learning from experience in implementing health financing reforms..........63 Learning about the health workforce.....................................63 Standardizing HTA methodology........................................64 Improving knowledge in the stewardship function .........................65 Commitment 7 ........................................................66 Main messages ......................................................66 Ensuring availability and quick access to essential services . 67 Securing finances for times of crises .....................................67 Preparing human resources for health....................................68 Ensuring availability of essential technologies and medicines ...............69 Preparing stewards to lead and coordinate during times of crisis .............70 Conclusions ...........................................................73 Economic crisis . 73 Health systems for health and wealth, Health 2020 and future directions . 74 The way forward .....................................................76 References ............................................................78 IV Implementation of the Tallinn Charter ACKNOWLEDGEMENTS This report was prepared by Margrieta Langins, Technical Consultant in the Division of Health Systems and Public Health, WHO Regional Office for Europe. The author wishes to thank Hans Kluge, Director of the Division of Health Systems and Public Health, for his strategic and technical guidance throughout the process. The report is founded on work by national counterparts and all those individuals in Member States who responded to the call to report on the implementation of the Tallinn Charter. Particular thanks are due to WHO representatives and the heads of WHO country offices for facilitating this process. The report has benefited greatly from the input and insight from senior staff in the Division of Health Systems and Public Health: Tamàs Evetovits, Elke Jakubowski, Hanne Bak Pedersen, Galina Perfilieva, Govin Permanand, Juan Tello and Sarah Thompson. For additional input in specific areas, thanks are due to other colleagues within the WHO Regional Office for Europe: Klaus Boisen from the Division of Information, Evidence Research and Innovation; Christine Brown, Monika Kosinska and Isabel Yordi Aguirre from the Division of Policy and Governance for Health
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