The Health Resource Allocation Game (HRAG) is a simulation board game that recreates a health planning exercise for a hypothetical province in a fictitious country. The game allows players to plan, implement and evaluate a complete health system from village up to province level by allocating a limited budget to competing health programs and resources – from hospitals to primary care units, prevention programs, transportation and communication, infrastructure etc. During the game, players are challenged while deciding on how to use the available resources for the optimal benefit of the population.

The game was developed by KIT more than 40 years ago and is continuously updated (last update 05-2017) and has been used by public health training institutions around the world. For more information and obtaining the game, contact us at courses@kit.nl.

Introduction

Health resources are limited whereas the demands are insatiable. The effective and equitable utilization as well as distribution of these limited resources for the optimal benefit of the population is a challenge for any nation, whether rich or poor. This game helps the user to experience firsthand these challenges with a view to understanding the consequences of each action or inaction.

In its present form, the game is played as a board game where a hypothetical province is provided on a large map showing the main geographic features and the population distribution. The burden of disease is given and additional information regarding the most important demographic and socioeconomic characteristics of the population is also provided. With this information plus a realistic budget for running the health care delivery system the player is expected to plan a health system for the entire province, from the village and district level up to the provincial level.

Target group

The Health Resource Allocation is a game suitable for students from Public Health programs as well as for health professionals and managers of the Health Sector. It can also help students reorienting from a biomedical view to a more holistic view of a health system.

Playing the Health Resource Allocation Game

The game can be divided into three phases:

Planning phase

In the first phase or planning phase the participants work in separate groups with each group having its own map and building its own health system. All necessary information is distributed, including background information and information on available resources and running cost. The main considerations in this phase will be on the coverage of the health care system and the quality of care to be provided. Each group develops its own criteria and objectives for the optimal health care delivery to the entire province. At this stage the groups can consult anybody fromoutside for advice. At the end of this phase all the groups would have successfully completed the allocation of the various resources in the entire province and placed their corresponding symbols on the maps.

Implementation phase

In the second phase or implementation phase each group is provided with a stack of 150 patient cards in 3 colours – green, yellow and red. Each card represents individuals in a particular location in the province and seeking care for a particular health problem. Each green card represents 300 cases; yellow card represent 10 cases and each red card a single case. The health problem may vary from trivial to serious and is indicated by the different colours on the card. The minimal level at which care should be given is also indicated on the cards. The group will make the decision whether adequate coverage was provided by taking into account certain factors like road, distance, availability of transportation, and seriousness of the cases.

Evaluation phase

The last phase or evaluation phase, unlike the previous phases is a plenary session for all groups. Calculations are made regarding the efficiency, success and failure rates. The groups discuss their results and brainstorm on possible alternatives, thereby exchanging experiences.
The following parameters are calculated in the evaluation phase (their definitions and how they can be calculated are given in ‘definition and calculation of rates’):

• The disease prevention rate
• The payment failure rate
• The care failure rate
• The cure failure rate
• The preventable death rate
• The economic failure rate

Practical information

To play the game in total usually takes 1-2 days. By using groups of 4-6 students for 1 set the students get to discuss on e.g. the allocation of the budget and the location of the health facilities. The group discussions that accompany these decisions are important for the learning process.

Options for buying the game

As non-profit organization we are not aiming to sell the game for profit, our price is based on time investments and printing costs. You can purchase either a number of printed sets or digital documents for printing.

• Full printed version sent by post: The cards and sheets are printed on high quality thick paper and some are also laminated and can be reused.
• You can also purchase the digital version of all documents, assuming that you will do the printing and further arrangements. Please note that tokens and chips are then not included and the map of the province and disease and program cards will need additional formatting and cutting.
• Our experienced game facilitators can also facilitate the game at your institution.
• There is also an opportunity to request a short training of trainers workshop at your institution to observe and learn how to facilitate the Health Resource Allocation Game or attend a game session at KIT.

In addition to the game, we include in the package at no further cost some small continuous technical assistance (in form of questions and answers) and regular updates on the game.

It is possible to visit and join a group to observe the game session. We play the HRAG at KIT 3 times a year with the master students of the MIH and ICHD.

Interested in this educational game? Do contact us by sending an email to courses@kit.nl