Publication:
World Bank Group Support to Health Financing

Loading...
Thumbnail Image
Files in English
English PDF (2.49 MB)
1,029 downloads
English Text (287.75 KB)
167 downloads
Date
2014-07
ISSN
Published
2014-07
Editor(s)
Abstract
The way countries finance health care influences how well a health system performs and achieves its expected outcomes, including how equitable and efficient it is. Countries decide how to mobilize revenues from different sources for financing health care, how to pool revenues in public and private insurance and in a national health system with automatic coverage (risk pooling), and how to purchase care from health care providers. The World Bank has implemented health financing activities in 68 countries during FY03-12. Health financing interventions are found in about 40 percent of the Bank s Health, Nutrition, and Population portfolio. Most projects include interventions on revenue collection from public sources. Almost half of the projects support public health insurance and automatic coverage. More recently, results-based financing (RBF) operations became more prominent. The International Finance Corporation (IFC) delivered a small program in health financing. The evaluation makes five main recommendations: support government commitment and build technical and information capacity; address health financing as a cross-cutting issue at the country level; focus on health financing as a core comparative advantage; integrate all health financing functions; and strengthen monitoring and evaluation in Bank and IFC projects.
Link to Data Set
Citation
Independent Evaluation Group. 2014. World Bank Group Support to Health Financing. © http://hdl.handle.net/10986/21310 License: CC BY 3.0 IGO.
Associated URLs
Associated content
Report Series
Other publications in this report series
Journal
Journal Volume
Journal Issue

Related items

Showing items related by metadata.

  • Publication
    Government Spending on Health in Lao PDR : Evidence and Issues
    (Washington, DC, 2012-12) World Bank
    The note analyzes overall trends in government health financing and expenditure patterns and discusses some of the efficiency and equity issues pertaining to current government health spending patterns. The policy note is one of a series of health financing analyses, complementing earlier policy notes focusing on out-of-pocket spending as well as community-based and social health insurance schemes in the country. This reliance on out-of-pocket payments represents a considerable financial barrier to utilization of health services. The prominence of out-of-pocket spending in the form of user fees and revolving drug funds (RDFs) also raises concerns over management of funds at health facility level and regarding the potential for over prescription. In contrast, social health insurance expenditures are very low in Lao PDR: social insurance schemes cover about 11.4 percent of the population but account for only about 2.8 percent of total health spending. The Lao government has committed to increasing government spending to 9 percent of the budget, implying roughly a three-fold rise compared to plan spending for fiscal year 2011/12. If the policy goal is to raise government health spending equitably across the provinces, achieving it will be challenging. The overall economic outlook for Lao PDR is positive. Economic growth is projected to be 8.3 percent in 2012, and is expected to be in the range of 7-8 percent over the period 2013-2015. This note is one of a series of complementary health financing analyses on out-of-pocket spending and community-based and social health insurance schemes in the country. Additional analytical work in progress will review and assess demand-side pilot interventions currently being initiated by the government, such as the national free maternal and child health policy and the conditional cash transfer pilot.
  • Publication
    Healthy Partnerships : How Governments Can Engage the Private Sector to Improve Health in Africa
    (World Bank, 2011) International Finance Corporation
    Health systems across Africa are in urgent need of improvement. The public sector should not be expected to shoulder the burden of directly providing the needed services alone, nor can it, given the current realities of African health systems. Therefore to achieve necessary improvements, governments will need to rely more heavily on the private health sector. Indeed, private providers already play a significant role in the health sector in Africa and are expected to continue to play a key role, and private providers serve all income levels across sub- Saharan Africa's health systems. The World Health Organization (WHO) and others have identified improvements in the way governments interact with and make use of their private health sectors as one of the key ingredients to health systems improvements. Across the African region, many ministries of health are actively seeking to increase the contributions of the private health sector. However, relatively little is known about the details of engagement; that is, the roles and responsibilities of the players, and what works and what does not. A better understanding of the ways that governments and the private health sector work together and can work together more effectively is needed. This Report assesses and compares the ways in which African governments are engaging with their private health sectors. Engagement is defined, for the purposes of this report, to mean the deliberate, systematic collaboration of the government and the private health sector according to national health priorities, beyond individual interventions and programs. With effective engagement, one of the main constraints to better private sector contributions can be addressed, which in turn should improve the performance of health systems overall.
  • Publication
    Rapid Assessment of the Effect of the Economic Crisis on Health Spending in Mongolia
    (World Bank, Washington, DC, 2010-12) Sande Lie, Geir Sølve; Bredenkamp, Caryn; Brenzel, Logan
    This rapid assessment examines the effect of Mongolia's economic crisis on government health budgets and health expenditure, household out-of-pocket spending and donor health commitments. This study was part of a larger assessment conducted in four countries on the effects of the economic crisis on health spending. A standardized approach was developed for all country case studies and consisted of a desk review of internationally-available literature and databases, extensive in-country review of data and documents available in government and donor offices, and semi-structured interviews with government staff, health providers and development partners. This assessment in Mongolia reveals a substantial reduction in the government health budget: the 2009 national health budget was significantly lower than the previous year's, and then was further reduced by 10 percent in a subsequent budget amendment. At national level, budget cuts were concentrated in investment line items. Among recurrent line items, the pharmaceutical budget was hardhit, but salaries were largely preserved, and there were no retrenchments. Similar patterns were observed at sub-national level for hospital budgets, which depend on the central allocations, but not for primary care facilities, which are funded on a capitation basis. Compared to other sectors, the health sector was relatively protected during the economic crisis and the share of health in the total government budget was higher after the budget amendment than before. To protect households from the effects of the economic crisis on health spending, the government undertook specific policy measures to expand health insurance coverage to vulnerable groups. Donor commitments to the health sector during the crisis largely tracked previously planned commitments.
  • Publication
    Health Financing Options for Samoa : Challenges and Opportunities
    (World Bank, Washington, DC, 2013-09) Anderson, Ian
    Samoa currently faces two important public policy challenges in the health sector. One is to stem, and then reverse, the rapid rise of non-communicable diseases (NCDs). The second challenge is to put the country on a health-financing path that is effective, efficient, and financially affordable and sustainable. The two challenges are interconnected. This discussion paper examines eight options to address these challenges. The eight options are the following: (1) increasing government expenditure via higher general taxation; (2) increasing government expenditure via deficit financing; (3) increasing the share of government expenditure to health; (4) increasing external and donor financing; (5) increasing specific taxes; (6) mobilizing additional nongovernment resources via insurance (including social health insurance, and community and private insurance); (7) increasing cost-recovery measures; and (8) increasing efficiency. The paper concludes that the chief opportunity arises from more efficient use of resources already in the health system that are not presently used to maximum effect. Improving technical and allocative efficiency of the existing system has the potential to make a large difference and is technically feasible.
  • Publication
    Health Financing in Indonesia : A Reform Road Map
    (World Bank, 2009) Rokx, Claudia; Schieber, George; Tandon, Ajay; Harimurti, Pandu; Somanathan, Aparnaa
    Indonesia is at a critical stage in the development and modernization of its health system. The government of Indonesia has made major improvements over the past four decades, but struggles to maintain and continue to improve important health outcomes for the poor and achieve the Millennium Development Goals. Nevertheless, some key health indicators show significant progress. Infant and child (under five) mortality rates have fallen by half since the early 1990s, although the speed of the decline appears to have slowed since 2002. Maternal mortality rates show a declining trend, but remain among the highest in East Asia. Indonesia's population program is one of the worlds most successful: fertility rates have declined impressively since the 1970s and continue to fall. Previously declining malnutrition rates among young children have, however, stagnated. The slowing down of progress may be explained by a poorly functioning health system as well as by new and ongoing challenges posed by demographic, epidemiological, and nutrition transitions, which require new policy directions, a reconfigured and better performing health system, and long-term sustainable financing.

Users also downloaded

Showing related downloaded files

  • Publication
    Media and Messages for Nutrition and Health
    (World Bank, Washington, DC, 2020-06) Calleja, Ramon V., Jr.; Mbuya, Nkosinathi V.N.; Morimoto, Tomo; Thitsy, Sophavanh
    The Lao People’s Democratic Republic (Lao PDR) has experienced rapid and significant economic growth over the past decade. However, poor nutritional outcomes remain a concern. Rates of childhood undernutrition are particularly high in remote, rural, and upland areas. Media have the potential to play an important role in shaping health and nutrition–related behaviors and practices as well as in promoting sociocultural and economic development that might contribute to improved nutritional outcomes. This report presents the results of a media audit (MA) that was conducted to inform the development and production of mass media advocacy and communication strategies and materials with a focus on maternal and child health and nutrition that would reach the most people from the poorest communities in northern Lao PDR. Making more people aware of useful information, essential services and products and influencing them to use these effectively is the ultimate goal of mass media campaigns, and the MA measures the potential effectiveness of media efforts to reach this goal. The effectiveness of communication channels to deliver health and nutrition messages to target beneficiaries to ensure maximum reach and uptake can be viewed in terms of preferences, satisfaction, and trust. Overall, the four most accessed media channels for receiving information among communities in the study areas were village announcements, mobile phones, television, and out-of-home (OOH) media. Of the accessed media channels, the top three most preferred channels were village announcements (40 percent), television (26 percent), and mobile phones (19 percent). In terms of trust, village announcements were the most trusted source of information (64 percent), followed by mobile phones (14 percent) and television (11 percent). Hence of all the media channels, village announcements are the most preferred, have the most satisfied users, and are the most trusted source of information in study communities from four provinces in Lao PDR with some of the highest burden of childhood undernutrition.
  • Publication
    South Asia Development Update, April 2024: Jobs for Resilience
    (Washington, DC: World Bank, 2024-04-02) World Bank
    South Asia is expected to continue to be the fastest-growing emerging market and developing economy (EMDE) region over the next two years. This is largely thanks to robust growth in India, but growth is also expected to pick up in most other South Asian economies. However, growth in the near-term is more reliant on the public sector than elsewhere, whereas private investment, in particular, continues to be weak. Efforts to rein in elevated debt, borrowing costs, and fiscal deficits may eventually weigh on growth and limit governments' ability to respond to increasingly frequent climate shocks. Yet, the provision of public goods is among the most effective strategies for climate adaptation. This is especially the case for households and farms, which tend to rely on shifting their efforts to non-agricultural jobs. These strategies are less effective forms of climate adaptation, in part because opportunities to move out of agriculture are limited by the region’s below-average employment ratios in the non-agricultural sector and for women. Because employment growth is falling short of working-age population growth, the region fails to fully capitalize on its demographic dividend. Vibrant, competitive firms are key to unlocking the demographic dividend, robust private investment, and workers’ ability to move out of agriculture. A range of policies could spur firm growth, including improved business climates and institutions, the removal of financial sector restrictions, and greater openness to trade and capital flows.
  • Publication
    Remarks at the United Nations Biodiversity Conference
    (World Bank, Washington, DC, 2021-10-12) Malpass, David
    World Bank Group President David Malpass discussed biodiversity and climate change being closely interlinked, with terrestrial and marine ecosystems serving as critically important carbon sinks. At the same time climate change acts as a direct driver of biodiversity and ecosystem services loss. The World Bank has financed biodiversity conservation around the world, including over 116 million hectares of Marine and Coastal Protected Areas, 10 million hectares of Terrestrial Protected Areas, and over 300 protected habitats, biological buffer zones and reserves. The COVID pandemic, biodiversity loss, climate change are all reminders of how connected we are. The recovery from this pandemic is an opportunity to put in place more effective policies, institutions, and resources to address biodiversity loss.
  • Publication
    Economic Recovery
    (World Bank, Washington, DC, 2021-04-06) Malpass, David; Georgieva, Kristalina; Yellen, Janet
    World Bank Group President David Malpass spoke about the world facing major challenges, including COVID, climate change, rising poverty and inequality and growing fragility and violence in many countries. He highlighted vaccines, working closely with Gavi, WHO, and UNICEF, the World Bank has conducted over one hundred capacity assessments, many even more before vaccines were available. The World Bank Group worked to achieve a debt service suspension initiative and increased transparency in debt contracts at developing countries. The World Bank Group is finalizing a new climate change action plan, which includes a big step up in financing, building on their record climate financing over the past two years. He noted big challenges to bring all together to achieve GRID: green, resilient, and inclusive development. Janet Yellen, U.S. Secretary of the Treasury, mentioned focusing on vulnerable people during the pandemic. Kristalina Georgieva, Managing Director of the International Monetary Fund, focused on giving everyone a fair shot during a sustainable recovery. All three commented on the importance of tackling climate change.
  • Publication
    The Journey Ahead
    (Washington, DC: World Bank, 2024-10-31) Bossavie, Laurent; Garrote Sánchez, Daniel; Makovec, Mattia
    The Journey Ahead: Supporting Successful Migration in Europe and Central Asia provides an in-depth analysis of international migration in Europe and Central Asia (ECA) and the implications for policy making. By identifying challenges and opportunities associated with migration in the region, it aims to inform a more nuanced, evidencebased debate on the costs and benefits of cross-border mobility. Using data-driven insights and new analysis, the report shows that migration has been an engine of prosperity and has helped address some of ECA’s demographic and socioeconomic disparities. Yet, migration’s full economic potential remains untapped. The report identifies multiple barriers keeping migration from achieving its full potential. Crucially, it argues that policies in both origin and destination countries can help maximize the development impacts of migration and effectively manage the economic, social, and political costs. Drawing from a wide range of literature, country experiences, and novel analysis, The Journey Ahead presents actionable policy options to enhance the benefits of migration for destination and origin countries and migrants themselves. Some measures can be taken unilaterally by countries, whereas others require close bilateral or regional coordination. The recommendations are tailored to different types of migration— forced displacement as well as high-skilled and low-skilled economic migration—and from the perspectives of both sending and receiving countries. This report serves as a comprehensive resource for governments, development partners, and other stakeholders throughout Europe and Central Asia, where the richness and diversity of migration experiences provide valuable insights for policy makers in other regions of the world.