Frequently Asked Questions
What is HANSHEP?
HANSHEP is a collaboration platform through which development agencies, governments and foundations with a shared interest in supporting pro-poor mixed health systems can come together to share knowledge and co-finance new initiatives. It was established by its Members in 2010 and seeks to improve the performance of the non-state sector in delivering better healthcare to the poor by working together, learning from each other, and sharing this learning with others. It is neither a funding agency nor a legal entity, and does not maintain any centrally managed funds on behalf of the Members.
What are the main objectives of HANSHEP?
The HANSHEP platform provides a space for Members to collaboratively design, finance and scale programs that achieve one or more of the following shared objectives:
- Improve the delivery of quality healthcare to poor people;
- Reduce the number of poor people paying out-of-pocket for medicine and treatment;
- Improve the access of poor people to quality health systems;
- Reduce the price of medicine;
- Improve access of poor people to information on preventive care, treatment options and appropriate prices for services;
- Increase access to affordable priority disease-specific interventions; and
- Increase the financial protection of poor people against catastrophic expenses for medicines or medical services.
What are non-state actors?
Often referred to loosely as the ‘private’ sector, non-state actors encompass far more than the for-profit or commercial healthcare providers that people often think of when they hear the word “private”. The non-state sector also includes Non-Governmental Organizations (NGOs), Community-Based Organizations (CBOs) and Faith-Based Organizations (FBOs) as well as a wide range of front-line workers such as unqualified drug sellers, pharmacists, midwives, traditional healers, unqualified practitioners and qualified doctors, lab technicians, and NGO community health workers and peer educators. In recognition of this diversity, HANSHEP prefers to use the term ‘non-state actor’ rather than ‘private’ in this context.
Why is HANSHEP focusing on non-state actors?
In 2009, the Taskforce for Innovative International Financing for Health Systems released a landmark report exploring some of the key factors that would support the achievement of the health Millennium Development Goals by 2015. It found that "improving the health of the world’s poor will often involve managing, harnessing, mobilizing and raising the performance of the non-state sector – in addition to strengthening the role of the government in governance, regulation, contracting and quality enhancement – a neglected area over the past decades". This prompted a recommendation of the Taskforce to "Strengthen the capacity of governments to secure better performance and investment from private, faith-based, community, NGO and other non-state actors in the health sector." [Recommendation 6]
HANSHEP was formed in 2010 as a response to this recommendation, bringing together development agencies and countries seeking to improve the performance of the non-state sector in delivering better healthcare to the poor by working together, learning from each other, and sharing this learning with others.
What role can non-state actors play in improving health outcomes for the poor?
The role and contribution of non-state actors in the health sector today is considerable, and given the scale and the fact that their services are used by the poor as well as the better off, non-state actors must therefore be considered within any national and international health policy and planning framework. However, a key characteristic of the non-state health sector is its fragmentation and lack of regulation, compounded by a scarcity of reliable data around the quality or range of services delivered by these providers. This makes it difficult to identify and influence the factors contributing to improved health outcomes for the poor, which might include the development of public-private partnerships, the scaling up of innovative financing and delivery mechanisms, staff training programmes and/or the creation of effective regulatory frameworks. These and other challenges, accentuated by the inherent complexity, dynamism and variety of health systems around the world, have contributed to a widespread lack of knowledge about how to engage with non-state actors, be they for-profit or not-for profit.
Does HANSHEP support only non-state actors, or government as well?
Establishing sustainable, inclusive (pro-poor) health systems requires support for both governments and non-state actors to understand how they can best work together to improve health outcomes. The HANSHEP platform seeks to build capacity of both sectors by funding research to build a more comprehensive evidence base around the potential role and contribution of non-state actors in healthcare in developing countries (including exploring innovative models of public-private collaboration); offering technical assistance to both governments and non-state actors to support the development of mutually beneficial partnerships where appropriate; and providing resources to enable the piloting and scaling of successful interventions. However, HANSHEP members are interested in non-state health delivery channels not for their own sake but because they believe they can, under certain circumstances, be the most appropriate channels / partners for governments seeking to maximise goals of coverage and equity. HANSHEP Members do not have a preference for or against non-state provision, nor a preference for or against public sector provision. Increasing the non-state sector share of the health market, in either financing or provision, is not an objective for HANSHEP members.
Who are the current members of HANSHEP?
A list of current HANSHEP Members can be found on the ‘Our Members’ page of the HANSHEP website.
Who can become a member of HANSHEP?
A maximum of 13 institutions can be a member of HANSHEP at any one time, with a mix of ‘Funding Members’ that co-finance HANSHEP programs and share the administrative costs of the platform, and ‘Non-Funding Members’ from developing countries that provide insight into the policy and practice needs, challenges and innovations relating to mixed health systems at country and regional levels. Membership is by invitation only, with organisations selected through a majority decision of the existing Members. Each Member is then represented by one or two senior health specialists from within their organisation.
How does HANSHEP operate?
HANSHEP Members meet quarterly (twice in person, and twice by teleconference) to share knowledge and resources, review program proposals and enhance their learning around mixed health systems through project visits and Guest Speakers with new insights to share from research, policy and practice. These meetings are convened by the HANSHEP Chair, who is elected by the Members from among the Member agencies, and who rotates on an annual basis. These meetings, the HANSHEP website (www.hanshep.org) and the more general day-to-day activities associated with the HANSHEP platform are managed by the HANSHEP Secretariat (currently MDY Legal) which reports to the Chair.
What is a HANSHEP Program?
A HANSHEP program is an initiative that contributes to the aims and objectives of the HANSHEP platform and that two or more HANSHEP Members have agreed to finance or support in-kind. All HANSHEP programs are independently managed and evaluated by the relevant funding Members in accordance with their own institutional policies and processes, with the outputs and learning from these programs shared through the HANSHEP platform.
What kinds of programs are supported by HANSHEP Members?
Under its Funding Principles, HANSHEP Members consider co-financing programs that:
- Improve the evidence base, knowledge and learning around the role of non-state actors in contributing to pro-poor health systems;
- Demonstrably benefit poor people and other marginalised groups by enhancing access to and quality of health services to improve health outcomes;
- Address government and/or market failures that prevent non-state actors from fulfilling their potential in health systems that provide high quality, equitable healthcare;
- Have high potential for scale or replicability, accepting risk and embracing innovation;
- Contribute to agreed health goals by strengthening country health systems; and
- Add value as international and multi-donor initiatives.
I have a specific question about HANSHEP – who should I ask?