Implementing health financing reforms in fragile and conflict-affected settings

As part of WHO’s response to increasing fragility globally, WHO has reviewed the evidence, and tailored its existing recommendation on health financing policy specifically for those working in fragile and conflict-affected settings (FCAS). The guidance follows the functional approach to health financing, analyzing health systems in terms of the core functions of revenue raising, pooling of funds, purchasing of services, and policy on benefit design. It builds on a set of guiding principles but recognizes three deficits which are features of FCAS; deficit in a government’s capacity and willingness to provide basic services, deficits in a government’s ability to provide security and stability, and deficits in the legitimacy of government.

Key recommendations include:

• prioritizing Common Goods for Health, including population-based interventions such as disease surveillance, ensuring safe medication, and water and sanitation systems
• the critical importance of coordinated action in support of domestic systems where possible, or otherwise mirror critical public functions, to prevent uncoordinated and unsustainable interventions and to strengthen resilience
• the important role of cash and voucher assistance as a complement to supply-side support for the delivery of essential services, whilst maintaining access free at the point of use.