Promoting equitable health care financing in the African context: current challenges and future prospects

Di McIntyre · Lucy Gilson · Mutyambizi

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Healthcare Systems and Reforms Pharmaceutical Economics and Policy Global Health Care Issues

Abstract

This Equinet paper evaluates how health services are currently funded, explores recent trends in health care financing and identifies lessons from the health care financing experience of African countries. The paper shows that the current level of health care funding from government tax revenue is relatively low in most African countries – in the majority of countries the health sector share of total government expenditure is below 10 per cent. One of the single largest sources of financing is that of out-of-pocket payments (OPP) which exceed 25 per cent of total health care expenditure in more than three-quarters of sub-Saharan African countries.\n\nThe paper recommends several actions in relation to health care financing within the African context including: explicit commitments by governments to move away from out-of-pocket funding of public health sector services; efforts to increase tax revenue through improved tax collection mechanisms; implementing effective mechanisms for identifying the poor and other vulnerable groups; equitable allocation of funds that are mobilised to ensure that all citizens have access to health services irrespective to whether they reside in a rural or urban area.

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References

2003Household catastrophic health expenditure: a multicountry analysis 2005What are the economic consequences for households of illness and of paying for health care in low- and middle-income country contexts?2001Equity and health sector reforms: can low-income countries escape the medical poverty trap?2004Community-based health insurance in low-income countries: a systematic review of the evidence 1999Equity in the finance of health care: some further international comparisons 1988Financing health services in developing countries: an agenda for reform.1989WORLD HEALTH ASSEMBLY 2000Inequalities in health care use and expenditures: empirical data from eight developing countries and countries in transition.

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