June 2021 Reflections

All is now set for the second webinar in our policy dialogue series, ‘ChangingtheConversation’ featuring our long-awaited discussion on performance-based financing (PBF). PBF is one of those topics that arouses deep sentiments and emotions, with some really against it and others all for it – no half measures here. But the real question is whether PBF supports countries to strengthen their purchasing functions more holistically and not just within one scheme. So, come with your comments, questions and arguments. We want to hear them all!

Since the last webinar, we have been busy putting up all the policy briefs from the nine countries mapped by our technical partners, up on the website. If you have not read these, please click here and take a read…or a couple. One of these policy briefs formed the basis for our Twitter chat earlier in the month. The country in focus, Cameroon, has made remarkable progress in purchasing more strategically through the voucher system and the PBF scheme. But, much like what we have observed in other countries the purchasing improvements in these schemes have not influenced similar improvements in the broader health system. The panelists on the chat shared their thoughts on what their country was doing to address the challenges and it was gratifying to hear that strategic purchasing is captured in the country’s strategic plan for health financing.

In Kenya, our home base, some amendments have been proposed for the National Hospital Insurance Fund. These are commendable but raise questions that have been asked in other countries with the same reforms. For instance, when a country makes a contribution to the health insurance scheme mandatory, how can this be enforced when payment is through premiums? Is tax-funding or budget financing the answer?

This reflection on taxes was the main subject of the launch event for a Health Financing & Taxation report for Sustainable Healthcare that I attended last week. The report discussed the role of tax-funding in health financing based on studies carried out in five countries – Kenya, Malawi, Burundi, Nigeria and South Sudan. The studies revealed leakages of potential tax revenue across all studied countries – funding that could have made a difference in the health sector. Our work with our technical partners has shown that countries can leverage tax and/or budget funding to make progress towards strategic health purchasing and universal health coverage, even in the absence of a health insurance scheme. So, this report raises age-old questions on how countries can better leverage this large source of pooled funds.

Is tax financing being effectively utilized in your country to fund the health sector?

What else are you observing in the strategic purchasing landscape in your country?
Drop a note and let us know.

Continue to stay safe and healthy!

June 2021 Reflections

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