Resource allocation and health financing

Earmarked donor funding and resource allocation

It should not be assumed that earmarked donor funding automatically increases the allocation of developing-country resources towards programmes that yield the greatest health benefits. Sometimes it does, sometimes it does not - how the funding is designed can influence this. This is true particularly in the longer term, once the earmarked funding has ended. This is according to an article in Volume 82, Number 9, of the Bulletin of the World Health Organization.

Resource tracking estimates for HIV/AIDS expenditure in low- and middle-income countries

This UNAIDS report summarises the most recent data available on spending from all sources of AIDS programmes in low- and middle-income countries. Its purpose is to identify the magnitude of global resources available relative to the estimated resource needs. The report also reviews and compares the methodological approaches used to track HIV/AIDS expenditure at global and national levels, and identify gaps in HIV/AIDS financial information and present ways they can be addressed.

The Prevention of Mother-to-Child HIV Transmission - Costing the service in South Africa

The maturity of the HIV/AIDS epidemic in South Africa has brought competing agendas for prevention and impact mitigation to the table. Given the resource constraints it is imperative that any interventions are thoroughly assessed for their efficacy, costs and benefits. The challenge to succeed with primary prevention of new infections remains the key long-term solution to the epidemic. Ensuring the availability of resources for delivering this intervention in a cost-effective and sustained manner remains a challenge. This report contributes to this by providing an assessment of the cost side of this equation. This research is part of a larger evaluation of the pilot PMTCT programme in South Africa, and has been commissioned by the Health Systems Trust on behalf of the Department of Health.

Financing HIV/AIDS Prevention and Care in Low- and Middle-Income Countries

In the past two years, the political commitment to respond to the HIV/AIDS pandemic has increased substantially. In this policy environment, the importance of information on resources allocated to HIV/AIDS prevention and care has increased. In order to avoid resource misallocation, policy makers need information on the level and flow of current resource allocations to HIV/AIDS. They need to know where money for HIV/AIDS prevention and care is coming from, the services and commodities that are purchased with these funds, and the population coverage of the implemented interventions. At the same time, to identify needs and plan strategically, policy-makers require information on the scale of resources required to prevent the further spread of HIV and to provide adequate care for those people living with HIV/AIDS.

Tracking resource flows for HIV/AIDS

This PRHPlus article outlines the key advantages of using the National Health Accounts (NHA) Subanalysis to track resource flows for HIV/AIDS. In light of the HIV/AIDS epidemic, many countries are facing increased pressure to expand health care resources with limited and unreliable public funding. While global initiatives have responded in part to these concerns, there is growing need to use available funds efficiently, and to track resources which promote transparency and accountability. The authors maintain that financial indicators to track resource use, which link to health outcomes, are an integral part of the monitoring and evaluation strategy.

Estimating Resource Needs for HIV/AIDS Health Care Services in Low-Income and Middle-Income Countries

This paper presents a model for estimating HIV/AIDS health care resource needs in low- and middle-income countries. The model presented was the basis for the United Nations' call for US$9.2 billion to address HIV/AIDS in developing countries by 2005 with US$4.4 billion to address HIV/AIDS health care and the rest to deal with HIV/AIDS prevention. The model has since been updated and extended to produce estimates for 2007. This paper details the methods and assumptions used to estimate HIV/AIDS health care financial needs and it discusses the limitations and data needs for this model.

** Fair financing in health systems
Abstract Of Paper Presented At The Equinet Conference, Durban, 8-9 June 2004, by Lucy Gilson, Centre for Health Policy, University of the Witwatersrand

The starting point of this paper is to briefly discuss alternative definitions of ‘fair financing’. The term ‘fair financing’ was popularised by the WHO in their 2000 World Health Report, which set about evaluating and ranking health systems around the world. The WHO has defined this concept as individuals paying for health services in proportion to their income. Others suggest that a more ‘progressive’ definition of fair financing would be appropriate. The focus of the paper is to review the key findings of work relating to health care financing that has been supported by Equinet over the past few years. In addition, other striking health care financing trends in the SADC region will be referred to.

Further details: /newsletter/id/30458
Community-Based health financing: An overview

In the context of inadequate public expenditure in the health sector, many countries have installed cost recovery systems, such as user fees, as a supplementary financing approach for health care services. This practice has raised concerns over equity and access to health care for the poor, and the search for complementary financing solutions continues. A 1997 review identified 81 documented CBHF schemes from throughout the world, with the majority in sub-Saharan Africa and Asia. This document aims to answer basic questions on CBHF that might be posed by policymakers and technical assistance providers interested in this topic.

Extra spending on clean water promises eight-fold economic benefits, says WHO

The economic benefits of better access to clean water outweigh the extra investment necessary eight-fold by creating a healthier workforce, the World Health Organisation said in a report. An additional investment of around 11.3 billion dollars (9.5 billion euros) per year on top of the money already being spent on improving basic sanitation facilities could generate a total economic benefit of 84 billion dollars annually, the report said. Such an investment would reduce the global occurrence of diarrhoea by an average of 10 percent, according to the study by the Swiss Tropical Institute, which was commissioned by the WHO.

Global funding for HIV/AIDS in resource poor settings

This fact sheet analyses current trends in the global funding of HIV/AIDS. It argues that funding to address the epidemic (provided by major donor governments, multilateral organisations, affected countries, and the private sector) has only recently increased to significant levels, but it is still less than estimated need. Actual spending is typically less than budgeted funding, and in 2003 both were well below the estimated need of $6.3 billion. Some key findings included the fact that budgeted funding for HIV/AIDS in 2003 totalled $4.2 billion while actual spending in 2003 totalled about $3.6 billion. In addition, donor governments provide 61% of budgeted funding to address HIV/AIDS in resource poor settings utilising bilateral and multilateral channels.

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