
Regional Actors Addressing Health Financing in Africa: Comparative Advantages, Challenges and Opportunities
The African continent has seen pronounced movement toward regionalism in recent years to catalyze development and strengthen African integration and unity. Successful health financing systems are critical for achieving health targets and reaching Universal Health Coverage, a widely supported development goal. Thus, sustainable health financing is now at the forefront of development dialogue. African leaders have demonstrated strong political commitment through endorsing measures such as the Abuja Declaration of 2001 on increasing government funding for health, and the Monterrey Consensus of 2002 that established a set of guiding principles enabling developing countries to address the challenges faced in mobilizing sufficient financing for their economic development.
[Download Technical Brief]
[In French]
Visit the online database to browse through more than 120 regional organizations working in health in Africa. >>Database
The African continent has seen pronounced movement toward regionalism in recent years to catalyze development and strengthen African integration and unity. Successful health financing systems are critical for achieving health targets and reaching Universal Health Coverage, a widely supported development goal. Thus, sustainable health financing is now at the forefront of development dialogue. African leaders have demonstrated strong political commitment through endorsing measures such as the Abuja Declaration of 2001 on increasing government funding for health, and the Monterrey Consensus of 2002 that established a set of guiding principles enabling developing countries to address the challenges faced in mobilizing sufficient financing for their economic development.
[Download Technical Brief]
[In French]
Visit the online database to browse through more than 120 regional organizations working in health in Africa. >>Database

Health Care Financing Country Profiles
Source: African Strategies for Health
The African Strategies for Health project and Management Sciences for Health participated in the Financial Protection and Access to Care Workshop, held in Accra, Ghana from February 15-19, 2016. Convened by Ghana's Ministry of Health, the National Health Insurance Authority, the World Health Organization (WHO), and the United States Agency for International Development (USAID), the meeting brought together participants from nine African countries and representatives from the Bill & Melinda Gates Foundation, WHO's Africa Regional Office, the West African Health Organization (WAHO), the Joint Learning Network for UHC, the World Bank, the Mexican Ministry of Health, and various NGOs and private sector organizations.
The country profiles were developed for discussion at the workshop, and provide an in-depth perspective on the health financing situation in each of the nine countries in attendance (Benin, Côte d’Ivoire, Ethiopia, Ghana, Nigeria, Rwanda, Senegal, Togo, and Uganda).
Additional workshop materials including background documents, agenda, and presentations from each of the sessions, are available on the workshop website here. Additional Health Financing and Macro-Fiscal country profiles, developed by the PEPFAR- and USAID-funded Health Policy Project are available here.
Source: African Strategies for Health
The African Strategies for Health project and Management Sciences for Health participated in the Financial Protection and Access to Care Workshop, held in Accra, Ghana from February 15-19, 2016. Convened by Ghana's Ministry of Health, the National Health Insurance Authority, the World Health Organization (WHO), and the United States Agency for International Development (USAID), the meeting brought together participants from nine African countries and representatives from the Bill & Melinda Gates Foundation, WHO's Africa Regional Office, the West African Health Organization (WAHO), the Joint Learning Network for UHC, the World Bank, the Mexican Ministry of Health, and various NGOs and private sector organizations.
The country profiles were developed for discussion at the workshop, and provide an in-depth perspective on the health financing situation in each of the nine countries in attendance (Benin, Côte d’Ivoire, Ethiopia, Ghana, Nigeria, Rwanda, Senegal, Togo, and Uganda).
- Health Financing Profile: Benin [English] [French]
- Health Financing Profile: Côte d'Ivoire [English] [French]
- Health Financing Profile: Ethiopia [English] [French]
- Health Insurance Profile: Ghana [English] [French]
- Health Financing Profile: Nigeria [English] [French]
- Health Insurance Profile: Rwanda [English] [French]
- Health Financing Profile: Senegal [English] [French]
- Health Financing Profile: Togo [English] [French]
- Health Financing Profile: Uganda [English] [French]
Additional workshop materials including background documents, agenda, and presentations from each of the sessions, are available on the workshop website here. Additional Health Financing and Macro-Fiscal country profiles, developed by the PEPFAR- and USAID-funded Health Policy Project are available here.

Rwanda Health Private Sector Engagement Assessment
Source: African Strategies for Health
As Rwanda looks to sustain and build on its hard-earned gains in health, it faces a few vital constraints. Donor funding is declining and the Health Sector Strategic Plan III (HSSP III) is underfunded with a likely gap of $372- $697 million. Private sector investment, which could potentially help fill this gap, is only 1.7 percent. The Government of Rwanda’s goal of increasing this investment to 5 percent (or approximately $260 million/year) would cover almost 50 percent of annual total health expenditure. The Government of Rwanda, its development partners, and key stakeholders recognize the importance of increasing private sector engagement (PSE) as a means to accessible, equitable, efficient, and improved health services. In order to support the government to assess the landscape, identify potential opportunities and key obstacles, and develop a framework or roadmap toward increased and sustained PSE in health, USAID/Rwanda commissioned ASH to carry out the Rwanda Health PSE Assessment.
[Download the Full Assessment Report]
[Read the Summary Brief]
Source: African Strategies for Health
As Rwanda looks to sustain and build on its hard-earned gains in health, it faces a few vital constraints. Donor funding is declining and the Health Sector Strategic Plan III (HSSP III) is underfunded with a likely gap of $372- $697 million. Private sector investment, which could potentially help fill this gap, is only 1.7 percent. The Government of Rwanda’s goal of increasing this investment to 5 percent (or approximately $260 million/year) would cover almost 50 percent of annual total health expenditure. The Government of Rwanda, its development partners, and key stakeholders recognize the importance of increasing private sector engagement (PSE) as a means to accessible, equitable, efficient, and improved health services. In order to support the government to assess the landscape, identify potential opportunities and key obstacles, and develop a framework or roadmap toward increased and sustained PSE in health, USAID/Rwanda commissioned ASH to carry out the Rwanda Health PSE Assessment.
[Download the Full Assessment Report]
[Read the Summary Brief]

Community Health Worker (CHW) Incentives in Malawi: Lessons Learned
Source: African Strategies for Health
In order for governments and organizations to adopt, implement, and scale up community health programs, knowledge of the wide typology of CHW models and their associated incentive mechanisms is critical. It is equally important for policy makers and program implementers to understand the impact of program design factors, like incentives, and how they may contribute to optimal CHW performance and the achievement of sustained health impact. To better understand the impact of financial and non-financial incentives on CHW performance and retention in Africa, the African Strategies for Health (ASH) project undertook a literature review and in-depth studies in two countries, Malawi and Madagascar.
Malawi was selected as one of the two countries because of its national cadre of government-funded CHWs, as well as the array of incentives currently being used by community health programs. This technical brief presents key findings and recommendations based on research conducted in Malawi.
Technical Brief [Download]
Full Malawi Report [Download]
Technical Brief in French [Download]
Source: African Strategies for Health
In order for governments and organizations to adopt, implement, and scale up community health programs, knowledge of the wide typology of CHW models and their associated incentive mechanisms is critical. It is equally important for policy makers and program implementers to understand the impact of program design factors, like incentives, and how they may contribute to optimal CHW performance and the achievement of sustained health impact. To better understand the impact of financial and non-financial incentives on CHW performance and retention in Africa, the African Strategies for Health (ASH) project undertook a literature review and in-depth studies in two countries, Malawi and Madagascar.
Malawi was selected as one of the two countries because of its national cadre of government-funded CHWs, as well as the array of incentives currently being used by community health programs. This technical brief presents key findings and recommendations based on research conducted in Malawi.
Technical Brief [Download]
Full Malawi Report [Download]
Technical Brief in French [Download]

Community Health Worker Incentives in Madagascar: Lessons Learned
Source: African Strategies for Health
In Madagascar, CHWs play an essential part in improving access to quality health services in the context of a weak public sector and a severe shortage of trained healthcare workers. This technical brief presents key findings and recommendations based on research conducted in Madagascar, and may be useful for countries that are considering introducing, modifying or scaling up a community health program.
Technical Brief [Download]
Full Madagascar Report [Download]
Technical Brief in French [Download]
Source: African Strategies for Health
In Madagascar, CHWs play an essential part in improving access to quality health services in the context of a weak public sector and a severe shortage of trained healthcare workers. This technical brief presents key findings and recommendations based on research conducted in Madagascar, and may be useful for countries that are considering introducing, modifying or scaling up a community health program.
Technical Brief [Download]
Full Madagascar Report [Download]
Technical Brief in French [Download]

Cost-Effectiveness of Reproductive Health Vouchers and Community-Based Health Insurance in Uganda
Source: African Strategies for Health
When planned and used appropriately, financial incentives have proven effective in improving utilization and quality of maternal and child care. This technical brief, based on a study examining the cost-effectiveness of reproductive health vouchers and subsidized community-based health insurance programs in Uganda, provides an overview of the study findings as well as key policy options and recommendations for researchers, policymakers, and program managers. [Download]
Action Brief [Download]
To ensure that study findings and recommendations are translated into practice, Management Sciences for Health in Uganda and ASH partnered with the Ministry of Health and the USAID Mission in Uganda to convene a dissemination meeting and workshop in Kampala. The workshop, held on October 29th, 2015, provided a platform to share study findings and to discuss the use of RHVs and CBHI in Uganda. [Read the workshop report]
Source: African Strategies for Health
When planned and used appropriately, financial incentives have proven effective in improving utilization and quality of maternal and child care. This technical brief, based on a study examining the cost-effectiveness of reproductive health vouchers and subsidized community-based health insurance programs in Uganda, provides an overview of the study findings as well as key policy options and recommendations for researchers, policymakers, and program managers. [Download]
Action Brief [Download]
To ensure that study findings and recommendations are translated into practice, Management Sciences for Health in Uganda and ASH partnered with the Ministry of Health and the USAID Mission in Uganda to convene a dissemination meeting and workshop in Kampala. The workshop, held on October 29th, 2015, provided a platform to share study findings and to discuss the use of RHVs and CBHI in Uganda. [Read the workshop report]

A Review of Health-Related Corporate Social Responsibility in Africa
Source: African Strategies for Health
Increasingly a part of corporations' business strategies, corporate social responsibility (CSR) is an expression of the business desire to create value for both the corporation and the community in which it operates. In an effort to understand the potential for leveraging the
contributions of private companies to the health sector in Africa, the African Strategies for Health (ASH) project conducted a review of health-related CSR across the continent. The multi-country study focused on identifying the business incentives, main approaches, and coordination efforts currently practiced for CSR. The report provides a snapshot in time in an industry that is constantly evolving and becoming increasingly institutionalized and aims to provide a better understanding of existing CSR for health in Africa and opportunities for ministries of health and USAID missions to leverage CSR activities. Recommendations are intended to facilitate the development of meaningful relationships with local and international companies interested in investing in health programs in Africa to sustainably contribute to the improvement of health outcomes.
Full Report [Download]
Technical Brief [Download]

Health Care Financing Reform in Ethiopia: Technical B
Source: African Strategies for Health
The Second Global Symposium on Health Systems Research (HSR) took place in Beijing, China, on October 31 - November 3, 2012, and was dedicated to evaluating progress, sharing insights and recalibrating the agenda of science to accelerate universal health coverage (UHC). UHC is understood here in its broader sense of health service type, accessibility and financial risk coverage. This brief, developed for a USAID-hosted satellite session, describes the experience of Ethiopia in reforming health care financing and the resulting transformation of the health sector. [Download]
rief
Source: African Strategies for Health
The Second Global Symposium on Health Systems Research (HSR) took place in Beijing, China, on October 31 - November 3, 2012, and was dedicated to evaluating progress, sharing insights and recalibrating the agenda of science to accelerate universal health coverage (UHC). UHC is understood here in its broader sense of health service type, accessibility and financial risk coverage. This brief, developed for a USAID-hosted satellite session, describes the experience of Ethiopia in reforming health care financing and the resulting transformation of the health sector. [Download]