Health financing strategies for universal coverage

The way health systems are financed is a critical determinant for reaching universal coverage since they determine whether health services exist and are available and whether people can afford to use health services when they need them.

The availability of funds for health is a fundamental question to all countries. For poorer countries, the challenge is to increase the funding available for health so that they are able to provide and make accessible the needed set of health services - treatment, prevention, promotion and rehabilitationrehabilitation - of sufficient quality. For richer countries, the challenge is to protect the current levels of health expenditure while responding to the challenge of an ageing population and cost pressures from technological advances.

• More on revenue collection

Direct, out-of-pocket health payments, including payments for medicines, fees for consultations and procedures, and, sometimes, informal payments, are barriers to access to health services and cause financial hardship to those who have to resort to paying them in order to get the services they need. Reducing the reliance on direct, out-of-pocket payments will lower the financial barriers to access and reduce the impoverishing impact of health payments.

• More on financial risk protection

While the scarcity of funds for health is a constraint everywhere, all countries can already do more with the existing resources. Inefficiencies can be found in many areas, for example: in the way medicines are purchased and used, in the way hospital admissions are managed, in the way the health worker capacities and motivation are addressed, and in the way the health service mix is realized. The way that health financing arrangements are organized may also be a source of inefficiency.

• More on the equitable and efficient use of resources