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Health System Strengthening: Health Financing

Health System Strengthening: Health Financing. Catherine Connor, MBA June 14, 2010. What is Health Financing?. Revenue Collection Pooling Purchasing. What is Health Financing? Revenue Collection. Donors. Households Out-of-pocket payments to providers. Taxes.

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Health System Strengthening: Health Financing

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  1. Health System Strengthening: Health Financing Catherine Connor, MBA June 14, 2010

  2. What is Health Financing? • Revenue Collection • Pooling • Purchasing

  3. What is Health Financing?Revenue Collection Donors Households Out-of-pocket payments to providers Taxes

  4. What is Health Financing? Pooling The healthy subsidize the sick and the wealthy subsidize the poor • People pay for health services according to their ability to pay (Vertical equity) • People use health services according to their need (Horizontal equity)

  5. What is Health Financing? Purchasing Health Workers Infrastructure Drugs, equipment, supplies

  6. Why strengthen Health Financing? Sustainability: reduce donor dependency Equity: reduce out-of-pocket payments for health Efficiency: more “bang for the buck” Source: HIV/AIDS Sub-Accounts

  7. How to strengthen Health Financing? Local actors in the driver’s seat

  8. Kenya: Increased public funding for health based on evidence Households (over half of whom live in poverty) financed 51% of all health expenditures Policy Impact: Provided evidence for the Ministry of Health to secure a 30% increase in its 2006 budget allocation from the Ministry of Finance, the biggest increase since 1963. Republic of Kenya, Ministry of Health 2007. Kenya National Health Accounts 2001-2003.

  9. Ghana: Insurance increased use of formal medical services *Cross-sectional household surveys in 2 districts in 2004 and 2007; n = 415 and 409 respectively

  10. Ghana: Insurance (pooling) reduced household spending on health 2004 2007 Ghana Health Service.“An Evaluation of the Effects of the National Health Insurance Scheme in Ghana”. http://www.healthsystems2020.org/content/resource/detail/2361/

  11. Linkages • Service delivery – pay for quality, remove financial barriers to access • Human Resources – strategies to improve performance, retention • Medical Products – strategies to improve access (revolving drug fund), efficiency (reimburse generics only)

  12. Linkages • Governance • financing arrangements that empower consumers • financial accountability • transparent and effective financial management • HIS – data to be able to all of the above!

  13. Thank you Reports related to this presentation are available at www.healthsystems2020.org

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