A presentation from the Global Financing Facility (GFF) in Support of Every Woman Every Child Workshop, held in Nanyuki, Kenya.

1. Global Financing Facility in support
of Every Woman Every Child
Health Financing Session
November 2015

2. Some common health financing challenges
2
Health Financing: Resource mobilization, pooling, purchasing
Common health financing challenges
• High out-of-pocket expenditures
• Low / stagnant government spending on health
• Unpredictable, fragmented and “parallel” development assistance
• Lack of clarity on entitlements / essential package
• Inefficiencies / low value-for-money
• Inequalities in access and allocation of resources
• HF strategy delinked from strategic planning (IC)
– Needs-based planning vs. planning within financial constraint
– Need to look beyond global resource envelope

3. How can a HF Strategy Help Achieve GFF goals?
Presentation
3
Smart
• Results focus / results-based financing – access, equity,
quality
• Effective prioritization
• Better alignment of different financing sources
Scaled
• Additional external resources, at least over time (results
attract new money)
• Domestic resource mobilization
• Private (innovative) financing
• Better alignment of financing and improved prioritization
Sustainable
• Improved efficiency
• Domestic resource mobilization / innovative financing

4. The GFF Approach on Health Financing
4
Health Financing
Strategy
Situation analysis
&
Investment Case
RMNCAH priority interventions -
essential package design
Barriers to accessing RMNCAH
services
Fiscal space analysis -
financing constraints
By ensuring consistency between IC and HFS, the IC moves from being a fund-raising tool
to a realistic strategy that can be implemented

5. Health Financing Strategy – Process Issues
• Expectation that GFF countries will have a Health Financing Strategy
• As with IC, HF Strategy should build on existing processes and
documents – no reinventing of wheel
• Countries are at different starting points
– Health financing policy and reform vs. formal HFS process
• How can GFF process help?
– Diagnostics and technical support on technical issues
– Strategy development process
– Development of implementation plan and TA on implementation
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6. II. HFS Development: Some common topics
1. Purpose
2. Vision, guiding principles and objectives
3. Key challenges
4. Targets and theory of change
5. Strategic approaches and specific activities, including
– policies
– legislative and regulatory frameworks
– data and monitoring
– capacity building
6. Implementation phases, milestones and sequencing
7. Monitoring, implementation research, and reviews
8. Roles and responsibilities for implementation of specific
activities.
9. Description of HFS process and Operational Plan
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7. Common topics that HFS are grappling with
Domestic resource mobilization and sustainability
• Improving tax collection / prioritizing health
• Expanding contributory health insurance
• Private financing / innovative financing
• Financial and institutional sustainability of externally funded programs
Pooling
• Reducing fragmentation
• Purchaser-provider spilt
Efficiency / value-for-money
• Prioritization / essential package
• Improving budget execution
• Incentivizing providers for improved performance – payment reform
• Better aligning DAH with national health priorities
Reducing inequalities
• Resource allocation
• Targeting / reaching marginalized and vulnerable groups
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8. Health Financing Strategies – Some Common Issues
• Data gaps / adequacy of situation analysis
• Balancing ambition and realism
• Capacity gaps – strategy development & implementation
• Broad strategic direction vs. details (back-of-the envelope analysis
often sufficient)
• Time horizon (15 years)
• Managing competing pressures – stakeholder analysis and
consultation
• Time frame and political cycle
• One-off exercise vs. living process
• Link to Investment Case
• Strategy → implementation
8

9. III. Strategy Implementation
• Need for Operational Plan to guide actors involved in implementation and
sequencing of activities
Defining features:
• Long-term commitment (e.g., programmatic financing and technical
assistance)
• Extends beyond health (e.g. to address critical public finance issues)
• Key questions around how to build and sustain local capacity in health
financing
• Learning and innovation is critical (development of better instruments,
evidence and cross-country learning with existing networks e.g., Joint
Learning Network)
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10. Global Financing Facility in Support
of Every Woman Every Child
Q&A