Health financing

We support national and sub-national governments and partners to implement financing solutions that enable more efficient, effective and equitable delivery of health services.  We are driven by the goal of achieving universal health coverage. By using a health systems approach, our support ensures financial risk protection and access to quality health care services for all.  Our health financing expertise focuses on four strategic areas:

1. We support ministries of health to identify and implement health financing solutions 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 in the system. 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.
  • Applying systems thinking: Process mapping in Bangladesh
  • Mapping of fund flows for Family Planning services and commodities in Bangladesh
• 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

Working with local government, civil society organisations, and accountability groups, we advocate for the prioritisation of health within government budgets. We support those groups to hold governments to account for their resource allocation and expenditure commitments.  For example:

• We analyse and package evidence on the importance of investing in family planning and maternal health, and present it to parliamentarians and decision-makers at national and sub-national levels. 
• We build capacity of civil society groups to undertake budget analysis to assess the extent to which budget allocations align with national or sub-national priorities and commitments, and budget tracking to monitor how allocated funds are being disbursed and used.
  • Influencing public sector investment in family planning through budget monitoring and tracking: Lessons from six low- and middle-income countries
• We provide technical expertise to accountability coalitions to hold their governments accountable for commitments made as part of international and national initiatives, such as FP2020, or the Global Financing Facility. 
• We demystify financing and economic arguments in health by presenting evidence in accessible ways for diverse audiences including the media and civil society, thus enabling them to make the case for additional funding and hold government to account for how this is spent.  

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:

• We have designed and implemented voucher programmes to reduce the direct and indirect financial barriers to accessing maternal health and family planning services.
• In Nigeria, we supported Jigawa State government to design a benefit package for health insurance schemes which included comprehensive family planning services.
  • Leveraging health insurance to achieve sustainable financing for family planning in Jigawa
• In Kenya, we supported the Bungoma County Health Management Team to increase uptake of free maternity services by building capacity of facilities to process claims and increasing public awareness.
  • Implementing Linda Mama in Bungoma County

4. We influence global policy and practice on health financing

We work with key players that shape global policy on health financing to ensure that strategic guidance is grounded in the realities of what works in practice. By drawing on evidence from our programmes as well as the wealth of experience of our country teams, we bring valuable perspectives that help to inform practical and workable solutions for health financing goals.  For example:

• We document progress made at the country level so that national governments and donors can learn from these experiences.
  • Increasing domestic financing for family planning commodities in Kenya
• 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 are currently undertaking a review of the ways in which European donor governments seek to support and incentivise domestic resource mobilization for SRHR.  Based on this we will develop advocacy recommendations for Countdown 2030 Europe.