Towards Universal Health Coverage: thinking public
This report offers a comprehensive deep-dive analysis of public financing for health in LMICs by assessing the changing relationship between domestic public financing for health and the economy, the budget and overall sector financing. The analysis reveals that the period (2000-2014) is characterized by reduced sensitivity of public expenditure on health to macro-fiscal expansion, which in turn has contributed to a reduced role for domestic public funds in financing the sector. With the impact of external sources removed, there is no evidence of an effective “health financing transition” from private to public financing for health in low-income countries (LICs). The relative reduction in out-of-pocket spending reflects a combination of an increase in external health aid with stagnation in domestic public funding.
Recent changes in the relationship between public financing for health and its macro-fiscal and health financing environment call for a renewed emphasis on domestic public funds as the core of future health financing policy. Looking ahead, the study underlines the importance of tracking domestically funded public expenditure separately from external sources in future data collection and analysis efforts to better inform decision making. This information is particularly important given the transition away from external funding taking place in many countries. The refined classification of health expenditures (SHA 2011) will facilitate this process.
