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Financing arrangements in health sector under sector-wide management

Lo Veasnakiry Ministry of Health, Cambodia (2014) C3

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Health sector financing by centre and states/UTs in India, 2015 -16 to 2017-18

National Health Accounts Cell Ministry of Health & Family Welfare Government of India (2018)

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Towards Mapping the Fiscal Space: Health Sector Financing Strategy in Mozambique

N’weti, Wemos (2024) CC

This paper was commissioned by N´weti and Wemos as part of the project “Equitable health financing for a strong health system in Mozambique”. Its purpose is to contribute to the debate of the Mozambican Ministry of Health’s draft Health Sector Financing Strategy (HSFS) 2025 – 2034

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Health sector spending and spending on HIV/AIDS, tuberculosis, and malaria, and development assistance for health: progress towards Sustainable Development Goal 3

Global Burden of Disease Health Financing Collaborator Network Lancet (2020) C1

Background: Sustainable Development Goal (SDG) 3 aims to “ensure healthy lives and promote well-being for all at all ages”. While a substantial effort has been made to quantify progress towards SDG3, less research has focused on tracking spending towards this goal. We used spending estimates to ... more

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Africa’s Health Financing in a New Era

Africa Centres for Disease Control and Prevention (Africa CDC) (2025) CC

Africa’s health sector is facing an unprecedented financing crisis, driven by a sharp decline of 70% in Official Development Assistance (ODA) from 2021 to 2025 and deep-rooted structural vulnerabilities. This collapse is placing immense pressure on Africa’s already fragile health systems as ODA ...is seen as the backbone of critical health programs: pandemic preparedness, maternal and child health services, disease control programs are all at risk, threatening Sustainable Development Goal 3 and Universal Health Coverage. Compounding this is Africa’s spiraling debt, with countries expected to service USD 81 billion by 2025—surpassing anticipated external financing inflows—further eroding fiscal space for health investments. Level of domestic resources is low. TThe Abuja Declaration of 2001, a pivotal commitment made by African Union (AU) member states, aimed to reverse this trend by pledging to allocate at least 15% of national budgets to the health sector. However, more than two decades later, only three countries—Rwanda, Botswana, and Cabo Verde—have consistently met or exceeded this target (WHO, 2023). In contrast, over 30 AU member states remain well below the 10% benchmark, with some allocating as little as 5–7% of their national budgets to health. In addition, only 16 (29%) of African countries currently have updated versions of National Health Development Plan (NHDP) supported by a National Health Financing Plan (NHFP). These two documents play a critical role in driving internal resource mobilisation. At the same time, public health emergencies are surging, rising 41%—from 152 in 2022 to 213 in 2024—exposing severe under-resourcing of health infrastructure and workforce. Recurring outbreaks (Mpox, Ebola, cholera, measles, Marburg…) alongside effects of climate change and humanitarian crises in Eastern DRC, the Sahel, and Sudan, are overwhelming systems stretched by chronic underfunding. The situation is worsened by Africa’s heavy dependency with over 90% of vaccines, medicines, and diagnostics being externally sourced—leaving countries vulnerable to global supply chain shocks. Health worker shortages persist, with only 2.3 professionals per 1,000 people (below the WHO’s recommended 4.45), and fewer than 30% of systems are digitized, undermining disease surveillance and early warning. Without decisive action, Africa CDC projects the continent could reverse two decades of health progress, face 2 to 4 million additional preventable deaths annually, and a heightened risk of a pandemic emerging from within. Furthermore, 39 million more Africans could be pushed into poverty by 2030 due to intertwined health and economic shocks. This is not just a sectoral crisis—it is an existential threat to Africa’s political, social, and economic resilience, and global stability. In response, African leaders, under Africa CDC’s stewardship, are advancing a comprehensive three-pillar strategy centered on domestic resource mobilization, innovative financing, and blended finance. more

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How much bilateral and multilateral climate adaptation finance is targeting the health sector? A scoping review of official development assistance data between 2009– 2019

Alcayna T., O’Donnell D., Chandaria S. PLOS Global Public Health (2023) CC

Climate change is adversely affecting human health. Rapid and wide-scale adaptation is urgently needed given the negative impact climate change has across the socio-environmental determinants of health. The mobilisation of climate finance is critical to accelerate adaptation towards a climate resili... more

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A case for Financial Inclusion of Persons with Disabilities - CBM Livelihood Technical Guideline

Christoffel Blinden Mission (CBM) & Center for Financial Inclusion at Accion (CFI) (2016)

This technical guideline highlights barriers faced by persons with disabilities and makes recommendations to CBM Member Associations, Regional Offices and partners on how to engage with the financial sector to promote equitable financial inclusion of persons with disabilities.

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UN-Water GLAAS TrackFin Initiative: tracking financing to sanitation, hygiene and drinking-water at national level

World Health Organization (WHO) (2017) C_WHO

This guidance document sets out a methodology to identify and track financing to the WASH sector in a coherent and consistent manner across several countries. It is designed to help countries track financing to the WASH sector on a regular and comparable basis and analyse this information to support... more

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Multi-Sector Nutrition Education and Communication Strategy (NECS) II 2021-2025

Government of Malawi; Department of Nutrition; HIV and AIDS Ministry of Health (2021) CC2

The Department of Nutrition, HIV and AIDS (DNHA) in Ministry of Health and Population is grateful to all stakeholders who contributed to the development of the Nutrition Education Communication Strategy II. The DNHA acknowledges the financial and technical support from the World Bank and USAID throu... more

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Rwanda: Health Sector Policy

Ministry of Health, Rwanda (2015) C2

The Health Sector Policy gives general orientations for the sector which are further developed in the various sub-sector policies guiding key health programs and departments. All health sub-sector policies will be updated in line with this new policy. The Health Sector Policy is the basis of nationa... more

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Financing HIV Programming: How Much Should Low And Middle-Income Countries and their Donors Pay?

Galarraga, O.; V. J. Wirtz; Y. Santa-Ana-Tellez et al. PLOS One (2013) C1

Global HIV control funding falls short of need. To maximize health outcomes, it is critical that national governments sustain reasonable commitments, and that international donor assistance be distributed according to country needs and funding gaps. We develop a country classification framework in t... more

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Making Universal Health Coverage Effective in Low- and Middle-Income Countries: A Blueprint for Health Sector Reforms

Peter O. Otieno, Gershim Asiki IntechOpen (2020) CC

Health sector reforms not only require attention to specific components but also a supportive environment. In low- and middle-income countries (LMICs), there is still much to be done on ensuring that people receive prioritized healthcare services. Despite LIMCs spending an average of 6% of their GDP... more

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Health Financing Progress Matrix assessment, Kenya 2023: summary of findings and recommendations

Kenya Ministry of Health, World Health Organization (WHO) (2024) CC

This comprehensive HPFM report thoroughly explores Kenya’s health financing landscape. It provides an in-depth analysis of the current state of affairs and sheds light on required strategic changes in health financing. The report points out the need to improve public financial management within th... more

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National Multi-Sector Nutrition Policy 2018–2022

Department of Nutrition, HIV and AIDS Government of Malawi (2018) CC2

This new Policy aims at ensuring that evidence-based, highimpact nutrition interventions are developed and implemented at scale. The Policy will be implemented in line with the overarching National Development Strategy, which considers nutrition as one of the priority area under the social developme... more

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Financing transformative health systems towards achievement of the health Sustainable Development Goals: a model for projected resource needs in 67 low-income and middle-income countries

Stenberg, K.; O. Hanssen; T. Tan-Torres Edejer et al. Lancet Glob Health (2017) C1

Background The ambitious development agenda of the Sustainable Development Goals (SDGs) requires substantial investments across several sectors, including for SDG 3 (healthy lives and wellbeing). No estimates of the additional resources needed to strengthen comprehensive health service delivery to... more

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Reforms in the Health Sector in Ukraine. Revolutionizing care: Ukraine's sectoral approach to anti-corruption health

Steingrüber, S. World Bank (2022) C2

Following the 2014 Euromaidan Revolution, Ukraine embarked on a national reform program to reduce widespread corruption within government. In the health sector, the government introduced several complementary reforms that aimed to improve the health outcomes of Ukrainian citizens, but designed in su... more

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Rwanda Fourth Health Sector Strategic Plan (July 2018-June 2024)
recommended

Ministry of Health, Rwanda (2018) C2

Rwanda’s fourth health sector strategic plan (HSSP4) is meant to provide the health sector with a Strategic Plan that will highlight its commitments and priorities for the coming 6 years. It will be fully integrated in the overall economic development plan of the Government. HSSP4 will fulfill the... more

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Increasing equity in health service access and financing: Health strategy, policy achievements and new challenges

Annear, Peter Leslie; Veasnakiry, Lo; Momoe Takeuchi World Health Organization (WHO) (2016) C_WHO

Policy note: Cambodia Health Systems in Transition.
The health system includes a mix of public and private providers. The use of private providers is much greater among the wealthy, while the use of informal-sector health providers is greater among the poor. Due to these circumstances there is ... more

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From Double Shock to Double Recovery – Implications and Options for Health Financing in the Time of COVID-19

Kurowski, C.; D. B. Evans; A. Tandon et al. The World Bank (2021) CC

The COVID-19 pandemic has resulted in a double shock - health and economic. As of March 1, 2021, COVID-19 has cost more than 2.5 million lives and triggered an economic recession surpassing any economic downturn since World War II. Part I of this paper explores the impact of this current macro-fisc... more

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Model Legislative Framework On Community Health Workers Training, Registration and Licensing and (Financing)

Amref Health Africa (2020) CC

The object of this bill is to provide for a legal framework to promote the existence of Community Health Workers (CHWs) and to provide for clarity in the role and responsibilities assigned to CHWs in the Health sector and to promote and strengthen service delivery at the Community level. ... more

Rwanda Fourth Health Sector Strategic Plan (July 2018-June 2024) recommended

Rwanda Fourth Health Sector Strategic Plan (July 2018-June 2024)
recommended