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Restitution du groupe de travail «Financement des politiques». Rapporteur: Michael Amara. Leçons opérationnelles principales (1). Sources of funding mixed (pub, donor, OOP) Inadequate costing, budgeting: hard to secure resources, ensure sustainability
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Restitution du groupe de travail «Financement des politiques» Rapporteur: Michael Amara
Leçons opérationnelles principales (1) • Sources of funding mixed (pub, donor, OOP) • Inadequate costing, budgeting: hard to secure resources, ensure sustainability • Need to analyze efficiency of all health resouces (re-allocate?) • Need to analyze financial burden (equity) • Proper, timey disbursement requires functional gov’t systems • Different (short) donor timelines make it hard to ensure sustainability
Leçons opérationnelles principales (2) • Difficult to get funds to peripheral level (decentralization can help or make harder) • Seek sustainable gov’t funding sources (Ghana 2% tax?, meet Abuja decl.) • Seek additional, non-traditional funding sources (insurance, taxes) • Rich better at accessing subsidies – need to address other barriers to access (transport, physical access) • Supporting legislation can ensure continuity • Loss of incentive systems related to cost recovery
Recommandations aux décideurs politiques • Precede policy with broad consultation • Create national health financing framework; conduct technical analysis (costing, effficiency, equity, sustainability) • Enshrine policy in legislation • Ensure effective public finance management system to make timely disbursements • Put in place complementary incentive systems to compensate for « lost » revenues at facility level
Recommandations aux PTF • Harmonize resources and structures to maximize efficiency and minimize burden/duplication • Make funds disbursement timely and predictable • Provide technical assistance and capacity building to support national health financing frameworks and address key technical analyses (costing, sustainability, efficiency, equity)
Priorités pour les experts • Disseminate workshop lessons nationally • Strenthen M and E to document impact (financing, efficiency, equity, pilots, institutionalize NHA) • Build capacity for financial analysis, costing • Improve documentation, technical guidance • Develop framework for joint implementation and assessment • Pursue legislation « firm ground » • Increase gov’t leadership to harmonize within national financing framework