Advance Domestic Health Financing

The Advance Domestic Health Financing project seeks to contribute to increasing domestic investments in health and promoting efficient utilisation of health budgets, with a focus on primary healthcare (PHC), girls’ and women’s health. 

The project will build on African governments’ commitments to increasing domestic financing for health and improving efficiency in budget expenditure through such commitments as the 2001 Abuja Declaration, the 2019 African Union (AU)‘s Africa Leadership Meeting (ALM) declaration commitments, and other domestic, regional, and global commitments related to PHC, girls and women’s health including the ICPD+25, FP2030, the 2021 generation equality forum, and SDGs. 

The ALM declaration recognised the importance of investments in health and education in developing the human capital needed to drive economic growth, stability, peace, and security. 

The project seeks to leverage the momentum of the ALM, political influence moments as they arise, precisely the commitments from the domestic ALM country dialogues in front-runner countries like Kenya, and the health financing country strategies and health reform plans. 

The project undertakes interventions to support the generation and translation of evidence to inform decisions on the increased and efficient use of health resources, strengthen advocacy and accountability for increased domestic financing for health and improved efficiency, provide technical assistance to government agencies to stimulate action and improved accountability; provide capacity development for increased domestic financing and efficiency in the use of health allocations. 

Evidence generation and translation 

Below is a summary of the types of evidence the project will generate:  

i) Rapid systematic reviews and syntheses to provide policymakers at national and sub-national levels with feasible interventions for increasing domestic financing for health and for improving efficiency in health budget spending. 

ii) Modelling, forecasting and scenario building to track progress towards achieving different targets as necessary (i.e., ICPD+25, SDGs, among others) to make a case for ‘value for money for what national governments are investing and spending in their health systems and the returns on such investments. 

iii) Monitoring investment versus needs and use of health budgets: To complement the ALM tracker/scorecard that tracks country/national progress, the project will develop and operationalise sub-national level monitoring and reporting frameworks in project countries to track and monitor health investment needs versus actual investments made, as well as the health budget expenditure for PHC and MNCAH.  

Intensified advocacy for domestic health financing 

To strengthen advocacy and accountability for increased domestic financing for health and improved efficiency, the project will conduct the following activities; i) strengthening champions for domestic health financing and improved efficiency, ii) engaging the private sector, CSOs, and media to intensify advocacy for domestic health financing at national and sub-national levels will comprise three dimensions, and iii) strengthening the capacity of national and sub-national CSOs in effective advocacy for increased domestic financing for health and improving efficiencies. 

Technical assistance 

The project will work at both national and sub-national levels with a focus on providing technical assistance to support countries to implement their commitments made through their policies/strategies as well as those made towards the realisation of the ALM goals; support countries to design and implement best practice interventions identified through the evidence generation above, and support countries to strengthen systems and processes for improving availability and analysis of data for decision-making that improves domestic financing for health and enhances efficiency in health budget expenditure.  

Capacity development 

i) Strengthen MoHs’ capacity to collect, analyse and present health financing data. The project will strengthen institutional and individual technical capacity at national and sub-national levels in collecting, analysing and presenting health financing data. 

ii) Train and mentor MoH staff in key skills needed to drive increases in domestic financing and enhance efficiency in spending. 

iii) Support strengthening of information and decision-making systems needed to foster increases in domestic financing for health and improvements in efficiency in health budget spending. 

iv) Strengthen the capacity of the MoH to leverage private sector investments in health. Since the private sector remains a key player in healthcare provision in Africa, we will identify the capacity gaps hindering MoH-private sector cooperation (e., public-private partnership) and support interventions that strengthen the capacity of the MoH and sub-national health departments to leverage private sector investments for healthcare provision.

The project will employ strategic and practical approaches to realise the project’s goal of increasing and efficient utilization of domestic health financing with a focus on PHC and women’s and girls’ health.  The primary outcome is “increased salience of domestic financing for health and improving efficiency in health budget expenditure with a focus on PHC, girls & women’s health”, which will be achieved through the following three intermediate outcomes.  

Increased use of evidence by decision-makers when allocating and utilizing domestic health financing with a focus on PHC, and women’s and girls’ health in Kenya, Zambia and the African region with a focus on primary health care (PHC), and women’s and girls’ health.  This outcome will be realised through evidence generation and translation activities including rapid analyses and syntheses, modelling and scenario building to generate evidence responding to emerging questions and opportunities, efficiency and value for money (VfM) analyses, macro-economic analyses on the criticality of health, and organising forums for disseminating the evidence to raise awareness and inform decision making.  

Strengthened champions for PHC, girls and women’s health from the private sector, government, and civil society organisations at national and subnational levels in two countries. This outcome will be realised through mentorship and capacity-building interventions targeting selected representatives from the Ministry of Health, government departments, parliament, CSOs, media, and the private sector.  

Strengthened south-to-south cooperation and political will for early adoption of effective health policies and programs focusing on PHC and girls and women’s health with the highest impact on mortality and mitigation strategies. This outcome will leverage the existing capacities and extensive partnerships of AFIDEP and PPD-ARO in evidence synthesis and translation and convening high-level African decision-makers to galvanise commitments for population and health issues and follow-up for accountability.  

Partners in Population Development Africa Regional Office (PPD-ARO)