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Finance

Challenge

Sufficient financial resources are essential to the delivery of health services, such as those that serve women and children. In addition, the resources must be allocated well to attain desired impacts. Providers and suppliers of inputs make many resource allocation decisions on a daily basis. In doing so, they respond to incentives that either influence them to use the resources well or allow them to use the resources inefficiently, or even abuse them. Consumers, especially the poor, often under-use health services even when they are available. Frequently, these disadvantaged populations carry the highest burden of poor health. Thus, the health system, including the government and private sectors, must mobilize financing nationally and externally, allocate funds well among needs, align incentives with desired behaviors, and ensure access to the disadvantaged.

Approach

Health Systems 20/20 works with system actors to test, develop, apply, and institutionalize tools and approaches such as National Health Accounts (NHA) and subaccounts and cost and cost-effectiveness analysis, to address the mobilization and allocation of financing. In addition, Health Systems 20/20 works with counterparts on issues of access and equity to reduce financial barriers to use of priority services, especially by the disadvantaged. The tools employed include financial risk-sharing mechanisms such as community-based and social health insurance and targeting of subsidies. Finally, Health Systems 20/20 focuses on efficiency in use of resources by providers and consumers, using approaches that address incentives for efficiency and quality and protect against misuse such as provider payment mechanisms, performance-based contracting, conditional cash transfers, accreditation, and management information systems.