Health financing

Delivering effective health financing to support universal health coverage

We believe in a world where everyone can access the high-quality health services they need, without financial burden. This cannot be achieved without effective, efficient and equitable health services. We support national and sub-national governments and partners to implement financing solutions to make this a reality.

By using a health systems approach, we ensure that end users can access quality health care, in a way which protects them against financial risk. 

Our health financing expertise focuses on four strategic areas:

1. We support ministries of health to overcome bottlenecks in the health system

We work with ministries of health to ensure that scarce public funds are channelled where they are needed most, with minimal delay and maximum efficiency. We develop and use a range of analytical tools to identify health system challenges and provide tailored solutions to addressing bottlenecks. For example:

  • We undertake Public expenditure reviews (PERs) to examine the extent to which public spending in health aligns with stated priorities and identify opportunities to make better use of available funds.
  • We develop funding flow maps for government partners to highlight existing barriers to the efficient flow of funds and the financial gaps to implement current commitments.
  • We provide public financial management expertise to governments to ensure strategic allocation and efficient use of resources. 
  • We support the design and implementation of Performance Based Financing (PBF) schemes to address health systems challenges such as stock-outs of medicines and supplies, staffing gaps and infrastructure weaknesses. 

​2. We support advocacy and accountability for improved investment in health

We support local government, civil society organisations, and accountability groups to hold governments to account for how they allocate and spend funds. For example:

See examples of our work here.

3. We support strategies to increase financial risk protection

We help design and implement innovative demand-side financing schemes, as well as leverage existing health financing mechanisms, such as health insurance or fee waiver schemes, to ensure that those most in need can access essential health services. For example:

4. We influence global policy and practice on health financing

Drawing on evidence from our programmes and the rich experience of our country teams, we work with the change makers that shape global policy on health financing to ensure that strategic guidance reflects what works in practice. For example:

  • We document progress made at the country level so that national governments and donors can learn from these experiences.
  • We have mapped multilateral donor approaches to aid transition, identifying the key risks of a change in donor financing and recommending how donors and recipient countries can manage this transition.
  • We have reviewed the ways in which European donor governments seek to support and incentivise domestic resource mobilization for SRHR. Based on this we developed advocacy recommendations for Countdown 2030 Europe.

Results

  • Since 2019, Options has contributed to an increased annual budget allocation of US$8 million for health and US$15 million for family planning through targeted and evidence informed advocacy and accountability for increased public investment across 7 countries.

  • Since 2018, SP/SRH has been prioritised in national and sub-national budgets across 10 countries with low contraceptive prevalence rates

  • In Nepal, Aama has helped increase institutional deliveries by almost 40% over ten years, starting in 2006.  As of 2019, the initiative is benefitting two million women across the country.

  • Maternal deaths in Malawi saw a statistically significant reduction in districts using Results-Based Financing compared to non-RBF districts – 7 fewer deaths per 100,000 live births every month.

  • Over 42,000 vouchers were distributed to poor mothers in Bungoma, Kenya, enabling them access quality maternal health services. This helped to double the percentage of deliveries assisted by skilled birth attendants, from 41% in 2014 to 82% in 2018.

For more information:

Related publications

Our experts

  • Corinne Grainger
    Corinne is an experienced health financing and systems strengthening consultant who is passionate about innovative, evidence-based approaches that widen access to healthcare in low-income, fragile and conflict-affected countries. She provides technical assistance to reproductive, sexual, maternal, child & adolescent health, and mental health programmes and has supported WISH programme teams in Bangladesh, Burkina Faso, DRC, Madagascar and Malawi.
  • Sarah Fox
    Sarah is a health financing specialist with over 15 years’ experience working to advance universal health coverage through health systems reforms. Sarah provides strategic programme support and helps manage a global team of technical specialists. Sarah has worked extensively in Africa, focussing on policy and planning, domestic resource mobilisation for health, results-based financing and financial risk protection.
  • Linet Oyucho
    Linet is a health system strengthening specialist with expertise in advocating to government for health system reforms. She leads on health financing strategies under the FCDO’s flagship WISH2ACTION program across 9 countries in Africa and Asia. This involves advocating to government on the importance of sustainable financing and budget advocacy for family planning. Linet holds a PhD in Health Policy and Systems Development.
  • Michael Olawuyi
    Michael is a health system strengthening expert with special interest in health financing and policy. He leads the Sustainability output comprising health financing and accountability pathways for the WISH programme in Nigeria. Michael believes that Universal Health Coverage is attainable in resource-constrained countries and has provided technical assistance to national and subnational Governments in Nigeria on this subject over the last decade.

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