This assessment guide seeks to inform national policy dialogue on strategic purchasing and assist in drawing attention to the need for aligning payment methods within and across purchasers as an important step for strategic purchasing and progress towards UHC.
This practical, step-by-step guide is designed to help countries find answers to their provider payment policy questions through a country-led participatory process.
The manual is the first costing-specific resource that bridges costing theory with practical, step by step guidance to address multiple challenges related to costing for provider payment in low- and middle-income countries (LMICs). It provides tools and templates based on the day-to-day experiences of a network of practitioners that can be adapted to a variety of contexts due to the unique, collaborative approach used in its design.
This book includes chapters on primary care per capita (capitation) payment, case-based hospital payment, and hospital global budgets. It also includes a primer on contracting. The volume’s final chapter provides an outline for designing, launching, and running a health management information system, as well as the necessary infrastructure for strategic purchasing.
This policy brief outlines what is meant by free health care policies and why it is important to discuss these in relation to universal health coverage.
This paper presents six important early lessons emerging from a collaborative learning exchange on provider payment reforms that can be adapted and applied by other countries that face similar challenges or are embarking on PHC reform efforts. The paper also identifies helpful resources with guidance that countries can adapt to their own contexts.
The Health Financing Country Diagnostic provides step-by-step guidance on how to undertake a situation analysis of a country’s health financing system.
In this seminal report, the World Health Organization maps out what countries can do to modify their financing systems in the pursuit of universal coverage. It builds on research and lessons learnt from country experience and provides an action agenda for countries at all stages of development.
This paper examines different measurement options using the System of Health Accounts (SHA) 2011 for systematic monitoring of primary healthcare (PHC) expenditure.
This paper discusses the theoretical foundations of earmarking, and it analyses country experience with earmarking for health and its impact on health sector budgets and the broader fiscal environment. The goal is to provide useful information to health and finance authorities, and to the international partners who support them, on the practical realities of designing, adopting and implementing earmarking policies.
The report identifies core features of priority-setting processes and institutions worldwide, and recommends creating fair and evidence-based national and global health technology assessment systems.
This book argues that the creation of an explicit health benefits plan—a defined list of services that are and are not available—is an essential element in creating a sustainable system of universal health coverage. It considers the many dimensions of governance, institutions, methods, political economy, and ethics that are needed to decide “what’s in and what’s out” in a way that is fair, evidence-based, and sustainable over time.
What issues do policy makers face in decisions about raising revenue? How do decisions about raising revenue have an impact on UHC? This policy brief answers these questions in the context of growing political momentum for UHC, and the challenges that many countries face to increase levels of domestic public funding for health.
While there is no one “best” financing strategy that applies in every context, this chapter synthesizes both theory and practice into principles that can be used to guide country progress with their financing reforms, while also highlighting pitfalls to avoid on the path to UHC.
This policy brief aims to show how strategic purchasing contributes to progress towards UHC and how countries can make their purchasing more strategic.
This policy brief explores how voluntary health insurance (VHI) fits within health financing policy and what we know from theory and practice about VHI. It highlights the inherent challenges of VHI, the overall limited coverage improvements and the potentially distorting impacts on the health system.
The Global Health Expenditure Database (GHED) provides internationally comparable data on health spending for close to 190 countries from 2000 to 2017. The database is open access and supports the goal of Universal Health Coverage (UHC) by helping monitor the availability of resources for health and the extent to which they are used efficiently and equitably.
The System of Health Accounts (SHA) 2011 tracks all health spending in a given country over a defined period of time. This global reference manual guides the compilation of health expenditure accounts.
"The purpose of this guide is to explore specifically the case-based groups (CBG) related policy questions and issues relevant to the context of low- and middle-income countries. The guide is written in a Question & Answer (Q&A) format. It provides literature references for further reading and more technical details as well as presents various country cases to illustrate specific issues."
"The IHR Costing Tool helps users generate and review cost estimates to support practical planning for sustainable capacity development to prevent, detect, and respond to public health threats, as defined by the International Health Regulations (IHR). This tool provides a framework to calculate costs for implementing and enhancing IHR core capacities. Costs are estimated by applying country-specific user input data to cost calculations developed using best practices for achieving the technical standards specified in the Joint External Evaluation Tool (JEE)."
"The Knowledge Action Portal (KAP) is a flagship online community-driven platform launched by the WHO Global Coordination Mechanism on the Prevention and Control of Noncommunicable Diseases (WHO GCM/NCD). The KAP presents users with an innovative way to enhance global understanding, interaction, and engagement across sectors for the purpose of fulfilling existing - and initiating new - commitments to noncommunicable disease (NCD) prevention and control."
"WHO’s Financing Common Goods for Health special issue of Health Systems & Reform brings together leading experts and policymakers from across a range of disciplines, to provide the technical and economic rationale for, estimate the cost of, and identify sources and modalities for action to safeguard the health and well-being of humanity. The articles and commentaries in this issue take on issues needed to build and support societies that can manage, and in some cases directly address, the often-paradoxical challenges presented by pandemics, population growth, aging, widening inequities in the case of increasing wealth, undernutrition, obesity, and environmental threats."
This tool "is designed to cost packages of community health services and produce results to help assess performance, plan future services, and prepare investment cases. The user-friendly, open-source, spreadsheet-based tool is designed to be used by health system managers and policy makers. It allows users to calculate the costs of all elements of comprehensive community health services packages, including start-up, training, and community-level service delivery costs, as well as support, supervision, and management costs at all levels of the health system. The tool also has a financing element that can be used to show program financing sources and gaps in current and future funding. The tool can be tailored for either national or sub-national programs and can project costs for up to five years."
This article describes a set of "key functional areas for investment and action in health emergency and disaster risk management (EDRM), and calculates the costs needed to establish and operate basic health EDRM services in low- and middle-income countries, focusing on management of epidemics and disasters from natural hazards." Here, policymakers and planners can explore options for the insititutional arrangements needed to design and impement EDRM using an "all-of-society" or "all-of-state institutions" approach.
"This special issue of Health Systems & Reform, sponsored by the World Health Organization (WHO), presents a comprehensive argument that “common goods for health” are a priority for action on the road to Universal Health Coverage (UHC).... This special issue proposes a key approach to moving the UHC agenda forward: financing the common goods that form the foundation of health globally."
"This edition of the Institute for Health Metrics and Evaluation’s annual Financing Global Health report, the 11th in the series, provides up-to-date estimates of domestic spending on health, development assistance for health, spending for HIV/AIDS, tuberculosis, and malaria, as well as projections of future health spending. Our health spending tracking and estimates show patterns between income groups and regions over time, highlight variations in how much each country spends on health, and identify where more resources are needed most."
"This paper provides tailored guidance for policy makers tasked with developing and implementing health financing policy in fragile and conflict affected situations, as well as those who advise such policy...The intention is to not to prescribe specific processes or health financing arrangement, but to guide policy makers to develop and implement policies in a way which increases resilience in the health system in both the short, medium and long-term. The recommendations are based on a review of evidence from a wide range of fragile and conflict-affected settings, as well as an extensive process of consultation with stakeholders.
"Read full profiles of international health systems describing the role of government, how systems are organized and financed, who and what is covered, and what is being done to ensure quality of care, reduce disparities, and promote care coordination."
This article outlines various challenges to and options for strengthening PHC systems based on an analysis of PHC systems in 20 LMICs. Here, readers can unpack determinants of PHC performance in LMICs and explore lessons for implementation, policymaking, and systems reform to help drive improvements in their PHC systems.
"Health financing schemes require the highly efficient implementation of multiple and complex business processes. Scheme operators in low- and middle-income countries struggle to achieve efficiencies in these schemes when they lack access to appropriate digital technologies. openIMIS is an open-source software which helps manage these processes...Being a global good, openIMIS improves and develops through the experiences and contributions of existing implementations, as well as the knowledge of experts worldwide."
"This book introduces and explicates the end-to-end resource tracking and management (RTM) framework, which includes five components that determine effective and efficient financing for PHC: resource mobilization, allocation, utilization, productivity, and targeting....In order to build a functional PHC system that addresses access, quality, and equity issues, this book highlights the key (public) financing issues that researchers, technical advisors, and policy makers would need to address in addition to more resources."