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:
- We analyse and package evidence on the importance of investing in health and present it to parliamentarians and decision-makers at national and sub-national levels. For example:
- Learning brief on ‘Making the case’ for increasing domestic investment in priority health services
- Why Ghana needs to invest more in mental health
- The critical role of health in achieving Nigeria’s Human Capital Development Goals
- Improving public investments in family planning in Jigawa and Kano, Nigeria
- We build the capacity of civil society groups to analyse budgets to assess the extent to which budget allocations align with national or sub-national priorities and commitments, and track budgets to monitor how allocated funds are being disbursed and used. For example:
- 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, so that they can make the case for additional funding and hold government to account for how this is spent.
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 design and implement 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.
- 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 by increasing public awareness.
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.
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.