Public Financial Management (PFM) applies to the way government budgets are allocated, spent, and accounted for to implement policies. Strategic purchasing in health relates to how health service providers are paid for the delivery of services. Both aim for efficient, and equitable delivery of quality services. While it is documented that PFM and health financing should better align, it is less clear to many practitioners how to do this. Building on an active health finance and PFM engagement by the World Bank and USAID/Abt Associates in Tanzania, this blog illustrates five ways in which these disciplines are really two sides of the same coin.