Presented by Ghassan Karem. Part of a session - 'Context, gender, and sustainability in introducing and scaling-up essential health care packages in fragile and crisis-affected countries' - at the Fifth Global Symposium for Health Systems Research in October 2018. The essential package of health services is a mechanism for expanding equitable coverage of primary health care and essential hospital services in countries recovering from conflict. The session explored the evidence-base on such healthcare packages in different contexts and prioritized areas for strengthening research.

1. Essential Package of Health
Services (EPHS)

2. Why?
Part of Health Reform.
Mechanism of service delivery.
Blueprint of resource allocation.
Management framework.
Cost and finance.
UHC.

3. Health services:
comprehensive health services.
Hospital based and a large network of PHC.
lacking clarity on exactly what services at what level.
Ineffective referral system.
Health workforce inefficiently deployed.
Drugs expired in huge quantities, revealing a very
inefficient supply chain.
Financial resources were generous , huge wastage in the
system which in turn diluted service quality.

4. Health Care levels:
Secondary care (97)
Villager Hospitals(32),General Hospitals
(23),Teaching Hospitals(31), Specialized
Hospitals (11)
Tertiary care
Medical centers (5)
Primary Care(1355)
Units(728) , Centers(571) , Polyclinics(56)

5. PHC :
Polyclini
c
Regional Health Services Directorate
Center
Unit
PHC
directorate
Health
regions
directorate
M.o.H
M.S.
O
M.S.O
Branc
h
Regional
Warehous
e
Others
Hospital
s
Ambulance
services
Branches
ASO

6. Challenges
Active
Conflict
Political
Division
Corruption
Fragmente
d System
IDPs
Migrants
Loosing
competencie
s

7. International Partners:

8. Process
- Identify stakeholders
- Use international Support.
- Regulations and Rules.
- Conducting meetings and workshops.
- Visit many facilities at different levels.
- Use SARA2 report.
- Production of documents ( Inclusion
list , exclusion list , implementation
plan).

9. EPHS
Resource
Specificatio
n
Management
Component
Health
Programs
Care Levels
Implementation
Plan
Management
Toolkits
EPHS

10. Challenges:
Weak Political Leadership
and the Will.
Different opinions : (GP Board,
SIF and Donors)
Shortage of Supply.

11. Next Step
- Costing and Finance.
- Endorsement.
- Implementation (Services and
coverage).
- Monitoring and Evaluation.
- Improvement toward UHC (Access,
efficiency and quality).