Restitution du groupe de travail
«Financement des politiques»
Rapporteur: Michael Amara
Leçons opérationnelles principales (1)
• Sources of funding mixed (pub, donor, OOP)
• Inadequate costing, budgeting: hard to
secure resources, ensure sustainability
• Need to analyze efficiency of all health
resouces (re-allocate?)
• Need to analyze financial burden (equity)
• Proper, timey disbursement requires
functional gov’t systems
• Different (short) donor timelines make it hard
to ensure sustainability
Leçons opérationnelles principales (2)
• Difficult to get funds to peripheral level
(decentralization can help or make harder)
• Seek sustainable gov’t funding sources (Ghana
2% tax?, meet Abuja decl.)
• Seek additional, non-traditional funding
sources (insurance, taxes)
• Rich better at accessing subsidies – need to
address other barriers to access (transport, physical
access)
• Supporting legislation can ensure continuity
• Loss of incentive systems related to cost
recovery
Recommandations aux décideurs
politiques
• Precede policy with broad consultation
• Create national health financing framework;
conduct technical analysis (costing,
effficiency, equity, sustainability)
• Enshrine policy in legislation
• Ensure effective public finance management
system to make timely disbursements
• Put in place complementary incentive
systems to compensate for « lost » revenues
at facility level
Recommandations aux PTF
• Harmonize resources and structures to
maximize efficiency and minimize
burden/duplication
• Make funds disbursement timely and
predictable
• Provide technical assistance and capacity
building to support national health
financing frameworks and address key
technical analyses (costing, sustainability,
efficiency, equity)
Priorités pour les experts
• Disseminate workshop lessons nationally
• Strenthen M and E to document impact
(financing, efficiency, equity, pilots, institutionalize NHA)
• Build capacity for financial analysis, costing
• Improve documentation, technical guidance
• Develop framework for joint implementation
and assessment
• Pursue legislation « firm ground »
• Increase gov’t leadership to harmonize
within national financing framework