Over the past decade, the Ethiopian health system has undergone a series of health financing reforms to ensure access to high-quality health services while reducing financial barriers for all Ethiopians. One of the key achievements of the reform is increased public funding for health. Despite this increase, the fiscal space remains limited to keep pace with our universal health coverage (UHC) commitments, requiring us to do more with the current financial envelope. Strategic health purchasing is an important lever in this regard because it promotes effective use of the available resources by directing health funds to priority populations, interventions, and services as well as actively creating incentives for providers to use funds equitably and in accordance with population health needs.
This report examines the overall landscape of Ethiopia’s health care purchasing arrangements and identifies barriers to and opportunities for building a foundation for strategic health purchasing. It also recommends strategic actions that, when implemented together, can support Ethiopia’s move toward UHC.