Responding to the health financing emergency: Immediate response and longer-term shifts

Overview

The World Health Organization (WHO) today released new guidance for countries on ways to counter the immediate and long-term effects of sudden and severe cuts to external funding, which are disrupting the delivery of essential health services in many countries.

The new guidance, called “Responding to the health financing emergency: immediate measures and longer-term shifts”, provides a suite of policy options for countries to cope with the sudden financing shocks, and bolster efforts to mobilize and implement sufficient and sustainable financing for national health systems.

Key policy actions for Immediate health financing measures

• Increase and protect budget allocations to respond to urgent health needs
• Protect priority population groups and services
• Accelerate options to enhance domestic sources of funding
• Address inefficiencies resulting from parallel and uncoordinated funding flows

Rapid analytics to support policy actions

• Map external funding volume, channels and use as a basis for reprogramming
• Evaluate fiscal and budgetary context to align with reprioritized funding needs
• Rapidly review covered services and provider payment systems and methods as a basis for aligning to new financing realities and service delivery models
• Review PFM rules and processes to identify improvements that maximize budget execution and align existing budget allocations with reprioritized services and functions

Key policy directions for Medium- to longer-term health financing shifts

Fiscal capacity and revenue raising

• Augment domestic fiscal capacity to ensure sustained reliance on domestic public funding for health
• Ensure budget prioritization for health within public spending
• Refine terms and conditions for external funding

PFM, funding flows and accountability

• Update budget allocation mechanisms and align budget structure to reprioritized service needs
• Improve expenditure management processes to make health spending more agile and responsive to the needs of service providers
• Support the incorporation of off-budget external funding flows into domestic PFM processes
• Enhance expenditure tracking and accountability with the help of digital tools

Pooling arrangements

• Reduce fragmentation, or mitigate its consequences, through more coherent funding flows across health programmes and coverage schemes
• Increase resource pooling among separate health coverage schemes to improve system efficiency and equitable resource distribution across different population groups and territories

Strategic purchasing

• Strengthen provider payment systems
• Align contracting, benefit design and the governance of purchasing with policy objectives
• Strengthen purchasing arrangements using digital technologies
• Regulate and support alignment of the role of private sector providers and private sector capital

Priority setting and benefit design

• Review and align the benefit package and benefit entitlement to health services
• Build capacity for and institutionalize evidence-informed priority setting and health technology assessment (HTA) to maintain sectoral efficiency and equity

Supportive analytics and capacity-building

• Expenditure tracking and analysis
• Evidenceinformed deliberative priority setting and HTA
• Fiscal analysis
• Investment appraisal and evaluation
• PFM performance review
• Technical efficiency assessment
• Strategic purchasing
• Equity analyses
• Financial protection
• Effects of digital technologies on health financing functions