Financing for Reproductive, Mother, Newborn, Child, and Adolescent Health for UHC ACCELERATING PROGRESS ON EARLY ESSENTIAL NEWBORN CARE September, 2015 | Tokyo, Japan

ACCELERATING PROGRESS ON EARLY ESSENTIAL NEWBORN CARE MEETING 21–25 September 2015 | Tokyo, Japan | 2  Global financing and progress  Universal Health Coverage (UHC) action framework  Health expenditure overview  Bridging the finance gap  Moving forward

ACCELERATING PROGRESS ON EARLY ESSENTIAL NEWBORN CARE MEETING 21–25 September 2015 | Tokyo, Japan | 3 Current Situation  Push towards MDGs  US$45 billion in new financing, almost 60% (US$ 34.2 billion) has been disbursed  Landmark accountability framework for women and children’s health Progress  Renewal of the Every Woman Every Child Strategy  Development of the Sustainable Development Goals  Dialogue amongst global financing institutions about graduation and financial sustainability  12 billion in domestic and international funding pledged for select countries Source: The PMNCH 2014 Report, Adapted from World Bank and WHO

ACCELERATING PROGRESS ON EARLY ESSENTIAL NEWBORN CARE MEETING 21–25 September 2015 | Tokyo, Japan | 4  MDG 4 and 5 unfinished agenda  Large remaining funding gap - significant additional investments from both domestic and international resources needed  Equitable and sustained progress under threat as countries transition from low- to middle-income status  Inefficiencies in RMNCAH investments due to poor targeting and fragmented financing  Need for strengthening of civil registration and vital statistics systems (CRVS) Source: adapted from the World Bank and WHO

ACCELERATING PROGRESS ON EARLY ESSENTIAL NEWBORN CARE MEETING 21–25 September 2015 | Tokyo, Japan | 5 Roll-out plan Eligibility – 63 low and lower-middle income countries – Must be willing to commit to increasing domestic mobilization and to using IDA/IBRD for RMNCAH Sequencing: – Four frontrunner countries – Ongoing discussion about how to phase in remaining countries and volume of resources required Resource allocation – Three criteria: need, population, income – Methodology for combining based on IDA formula – Floor of US$10 million; ceiling of US$50 million – No repartition by issues/target population – CRVS fully integrated but additional funding up to US$10 million if country includes in investment Case and uses IDA/IBRD Source: adapted from the World Bank

ACCELERATING PROGRESS ON EARLY ESSENTIAL NEWBORN CARE MEETING 21–25 September 2015 | Tokyo, Japan | 6  Access to good quality of needed services –Prevention, promotion, treatment, rehabilitation and palliative care  Financial protection –No one faces financial hardship or impoverishment by paying for the needed services.  Equity –Everyone, universality 6

ACCELERATING PROGRESS ON EARLY ESSENTIAL NEWBORN CARE MEETING 21–25 September 2015 | Tokyo, Japan | 7 Guiding principles Guiding principles Functions of Health Systems Impact on people (UHC) Financing Mobilize resource Managing funds Allocate budget Pay for services Quality Financial protection Service delivery Human resources Medicines Equipment Infrastructure Available, accessible and affordable Governance legislation, policy, supervision, information Equity Efficiency Sustainability

ACCELERATING PROGRESS ON EARLY ESSENTIAL NEWBORN CARE MEETING 21–25 September 2015 | Tokyo, Japan | 8  Taking a whole-of- system approach  Alignment with national health priorities  Focus on sustainability of finances  Integration of service delivery RESILIENCE QUALITY Regulations Effective, responsive services Individual and community engagement ACCOUNTABILITY Government leadership Partnerships Transparency, monitoring and evaluation EQUITY Financial protection Service coverage Non-discrimination EFFICIENCY System architecture Incentive for appropriate provision and use of services Managerial efficiency and effectiveness RESILIENCE Public health emergency preparedness System adaptability and sustainability Community capacity

ACCELERATING PROGRESS ON EARLY ESSENTIAL NEWBORN CARE MEETING 21–25 September 2015 | Tokyo, Japan | 9 Total Health Expenditure as (%) of GDP Source: WHO Global Health Expenditure Database

ACCELERATING PROGRESS ON EARLY ESSENTIAL NEWBORN CARE MEETING 21–25 September 2015 | Tokyo, Japan | 10 Structure of Total Health Expenditure (2013) Source: WHO Global Health Expenditure Database

ACCELERATING PROGRESS ON EARLY ESSENTIAL NEWBORN CARE MEETING 21–25 September 2015 | Tokyo, Japan | 11 External Funding as (%) of THE Source: WHO Global Health Expenditure Database

ACCELERATING PROGRESS ON EARLY ESSENTIAL NEWBORN CARE MEETING 21–25 September 2015 | Tokyo, Japan | 12 Source: World Bank

ACCELERATING PROGRESS ON EARLY ESSENTIAL NEWBORN CARE MEETING 21–25 September 2015 | Tokyo, Japan | 13 Reorient Health System for Better Health Improve efficiency  Coordinate and integrate service delivery and financing  Reduce fragmentation  Prioritize services and population groups  Channel external funding through existing national financing mechanisms Mobilize more domestic funding  Mobilize more resources for health as a whole (make the pie bigger)  Prioritize public health programs (get a larger slice) – Public health implication – Economic impact – Household financial burden  Advocate for predictable external funding

ACCELERATING PROGRESS ON EARLY ESSENTIAL NEWBORN CARE MEETING 21–25 September 2015 | Tokyo, Japan | 14 Moving forward 3. Mobilization of domestic funds Increase funding to achieve desired health outcomes 1. Moving towards UHC Whole-of-system approach Equity, Efficiency, Quality, Accountability, Resilience 2. Improve efficiency Cost effectiveness, burden of disease (population need) Budget constraint Tracking of health expenditure data

ACCELERATING PROGRESS ON EARLY ESSENTIAL NEWBORN CARE MEETING 21–25 September 2015 | Tokyo, Japan | 15 THAN

ACCELERATING PROGRESS ON EARLY ESSENTIAL NEWBORN CARE MEETING 21–25 September 2015 | Tokyo, Japan | 16  Trade-off with the three dimensions  Resource constraints  Priority-setting  Equity, efficiency, and sustainability

ACCELERATING PROGRESS ON EARLY ESSENTIAL NEWBORN CARE MEETING 21–25 September 2015 | Tokyo, Japan | 17 General Government Health Expenditure as (%) of THE,