Global Financing Facility in supportof Every Woman Every Child

Health Financing Session November 2015

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Some common health financing challenges

Health Financing: Resource mobilization, pooling, purchasing

Common health financing challenges• High out-of-pocket expenditures• Low / stagnant government spending on health• Unpredictable, fragmented and “parallel” development assistance• Lack of clarity on entitlements / essential package• Inefficiencies / low value-for-money• Inequalities in access and allocation of resources

• HF strategy delinked from strategic planning (IC)– Needs-based planning vs. planning within financial constraint– Need to look beyond global resource envelope

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How can a HF Strategy Help Achieve GFF goals? Presentation

Smart

• Results focus / results-based financing – access, equity, quality

• Effective prioritization• Better alignment of different financing sources

Scaled

• Additional external resources, at least over time (results attract new money)

• Domestic resource mobilization• Private (innovative) financing• Better alignment of financing and improved prioritization

Sustainable • Improved efficiency• Domestic resource mobilization / innovative financing

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The GFF Approach on Health Financing

Health FinancingStrategy

Situation analysis&

Investment Case

RMNCAH priority interventions -essential package design

Barriers to accessing RMNCAH services

Fiscal space analysis -financing constraints

By ensuring consistency between IC and HFS, the IC moves from being a fund-raising tool to a realistic strategy that can be implemented

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Health Financing Strategy – Process Issues

• Expectation that GFF countries will have a Health Financing Strategy

• As with IC, HF Strategy should build on existing processes and documents – no reinventing of wheel

• Countries are at different starting points– Health financing policy and reform vs. formal HFS process

• How can GFF process help?– Diagnostics and technical support on technical issues– Strategy development process– Development of implementation plan and TA on implementation

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II. HFS Development: Some common topics

1. Purpose2. Vision, guiding principles and objectives3. Key challenges4. Targets and theory of change5. Strategic approaches and specific activities, including

– policies– legislative and regulatory frameworks– data and monitoring– capacity building

6. Implementation phases, milestones and sequencing7. Monitoring, implementation research, and reviews8. Roles and responsibilities for implementation of specific

activities.9. Description of HFS process and Operational Plan

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Common topics that HFS are grappling withDomestic resource mobilization and sustainability• Improving tax collection / prioritizing health• Expanding contributory health insurance• Private financing / innovative financing• Financial and institutional sustainability of externally funded programsPooling• Reducing fragmentation• Purchaser-provider spiltEfficiency / value-for-money• Prioritization / essential package• Improving budget execution• Incentivizing providers for improved performance – payment reform• Better aligning DAH with national health prioritiesReducing inequalities• Resource allocation• Targeting / reaching marginalized and vulnerable groups

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Health Financing Strategies – Some Common Issues

• Data gaps / adequacy of situation analysis• Balancing ambition and realism• Capacity gaps – strategy development & implementation• Broad strategic direction vs. details (back-of-the envelope analysis

often sufficient)• Time horizon (15 years)• Managing competing pressures – stakeholder analysis and

consultation• Time frame and political cycle• One-off exercise vs. living process• Link to Investment Case• Strategy → implementation

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III. Strategy Implementation

• Need for Operational Plan to guide actors involved in implementation and sequencing of activities

Defining features:

• Long-term commitment (e.g., programmatic financing and technical assistance)

• Extends beyond health (e.g. to address critical public finance issues)

• Key questions around how to build and sustain local capacity in health financing

• Learning and innovation is critical (development of better instruments, evidence and cross-country learning with existing networks e.g., Joint Learning Network)

Global Financing Facility in Supportof Every Woman Every ChildQ&A