Over the past decade, a number of national or state-level reforms have been implemented by governments that are committed to achieving universal health coverage through “demand-side” financing models, often specifically targeting the poorest and informal sectors of their populations. While many implementing countries have not yet achieved universal health coverage, reforms are underway in countries as varied as Chile, Colombia, Estonia, Ghana, India, Indonesia, Kenya, the Kyrgyz Republic, the Philippines, Thailand and Vietnam.

Over the past decade, a number of national or state-level reforms have been implemented by governments that are committed to expanding health coverage through “demand-side” (third-party) financing models, to reach the poorest and informal sectors of their populations.  These reforms are ambitious in their goals, but challenging to implement successfully.  Many organizations and initiatives currently provide helpful policy assistance for and generate valuable information on these new and innovative reforms.

New and improved vaccines and drugs are urgently needed to reduce the burden of suffering and loss from diseases such as AIDS, tuberculosis, and malaria in developing countries. But creating these new health products requires extremely difficult long-term scientific efforts, and the markets for these kinds of life-saving vaccines and drugs are both uncertain and may not be very lucrative. Because of these barriers and risks, many scientific organizations and biopharmaceutical companies shy away from investing in these areas.

In developing countries, financial resources for health are highly constrained and often channeled in a short-term and unpredictable fashion. Families have relatively little protection against the financial and economic costs imposed by ill-health, and foreign aid programs in the sector, however well-intentioned, tend to be inadequately coordinated and aligned with local priorities. Extensive work has been done on these challenges, with many excellent contributions by thoughtful researchers and institutions around the world.

Throughout the developing world, most health systems are characterized by mixed public and private financing and delivery of care. In many countries, private providers--including a plethora of different types of formal and informal, for profit and not for profit organizations and individuals—are more numerous than their government counterparts.

Until recently, global health has focused on disease- and population-specific programs while health systems have been neglected. The insufficient attention paid to the transformation of health systems and to the capacity development needed for high-performing health systems in developing countries has resulted in weakened stewardship, dysfunctional service delivery, and inequitable financing.

Attached File(s): 

Public Stewardship of Private Providers in Mixed Health Systems.pdf

Innovative Pro-Poor Healthcare Financing and Delivery Models.pdf