Restitution du groupe de travail «Financement des politiques» Rapporteur: Michael Amara

Leçons opérationnelles principales (1) Sources of funding mixed (pub, donor, OOP) Inadequate costing, budgeting: hard to secure resources, ensure sustainability Need to analyze efficiency of all health resouces (re-allocate?) Need to analyze financial burden (equity) Proper, timey disbursement requires functional gov’t systems Different (short) donor timelines make it hard to ensure sustainability

Leçons opérationnelles principales (2) Difficult to get funds to peripheral level (decentralization can help or make harder) Seek sustainable gov’t funding sources (Ghana 2% tax?, meet Abuja decl.) Seek additional, non-traditional funding sources (insurance, taxes) Rich better at accessing subsidies – need to address other barriers to access (transport, physical access) Supporting legislation can ensure continuity Loss of incentive systems related to cost recovery

Recommandations aux décideurs politiques Precede policy with broad consultation Create national health financing framework; conduct technical analysis (costing, effficiency, equity, sustainability) Enshrine policy in legislation Ensure effective public finance management system to make timely disbursements Put in place complementary incentive systems to compensate for « lost » revenues at facility level

Recommandations aux PTF Harmonize resources and structures to maximize efficiency and minimize burden/duplication Make funds disbursement timely and predictable Provide technical assistance and capacity building to support national health financing frameworks and address key technical analyses (costing, sustainability, efficiency, equity)

Priorités pour les experts Disseminate workshop lessons nationally Strenthen M and E to document impact (financing, efficiency, equity, pilots, institutionalize NHA) Build capacity for financial analysis, costing Improve documentation, technical guidance Develop framework for joint implementation and assessment Pursue legislation « firm ground » Increase gov’t leadership to harmonize within national financing framework