Health financing

A system-wide approach to analysing efficiency across health programmes

Health financing guidance No. 2

Susan Sparkes, Antonio Durán, Joseph Kutzin

Publication details

Editors: World Health Organization
Number of pages: 36
Publication date: 2017
Languages: English, French
ISBN: 9789241511964


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Health programmes are able to target health interventions for specific diseases or populations, and historically, countries have relied heavily on them to deliver priority services. In low- and middle-income countries, this organizational approach has been reinforced by donor assistance for priority areas that often leads programmes to operate largely autonomously from one another in seeking to optimize the achievement of a specific objective. This dynamic has implications for how priority interventions are delivered and sustained, sometimes with separate organizational arrangements resulting in inefficient overlaps and duplications.

As contexts change, and in particular, as responsibility for funding these programmes shifts more towards domestic resources, maintaining an array of programmes with distinct, separate organizational arrangements is unlikely to be affordable.

This “System-wide approach to analysing efficiency across health programmes” approach equips countries with a framework to identify and correct inefficiencies that compromise governments’ ability to improve, or at the very least sustain, the delivery of priority health services. More specifically, the aim is to look across the array of health programmes that are part of each country’s health system in order to detect “cross-programmatic” duplications, overlaps and misalignments. Once these have been identified, there is a foundation to address them through changes to specific aspects of how programmes are configured and operate within the context of a country’s overall health system.

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