Health Financing

In low income countries, health care costs continue to

pose a barrier to the access of health care services. Out-of-pocket remains to be the traditional
source of private funding as governments struggle to meet public health spending requirements.
Families are especially vulnerable to economic ruin when no safety net mechanism exists to protect
against increasing medical costs.

EPOS’ involvement in health financing has been to support governments as they embark on
financing reforms that improve performance of health care providers, ensure cost-efficiency in the
purchase of services and mitigate out-of-pocket spending of health care users. Our work concerns
different aspects of financing reform. In Malawi and Kenya, our studies to determine maternal and
child health services costs were used to inform policy discussions on the essential health package.
The government of Lao PDR is following a roadmap to merge several health financing mechanisms
together that was developed in conjunction with our team and included in the national financing
strategy. We helped establish insurance systems in Indonesia, Serbia and Cameroon with the aim of
providing universal social protection.

The past decade has seen several innovations in financing health care and EPOS is taking part in
carrying out these schemes. A number of countries have adopted results-based financing to
incentivize performance and improve quality of care. EPOS is involved in the design, testing and
evaluation of results-based financing schemes in Niger, Tajikistan and Republic of Congo. Voucher
schemes were set up in Cambodia and Kenya, where our team assists in managing an incentive
system for users of sexual reproductive health services. Public-Private Partnership arrangements
are key topics in our assistance to countries for developing ways to use private sector resources and
capacities to achieve national health goals.

Project References:

 Kenya: Sustainable Institutionalization of the Kenyan Health Sector

Dynamic Costing Model (GIZ)

 Lao PDR: Support to the Government’s Capacity Development in the

Health Sector Location (ADB)
 Cameroon: Promotion of Health Insurance Approaches (GIZ)

 Serbia: Capacity Building of the Health Insurance Fund in Serbia

(EU)

 Republic of Congo:Technical Assistance Agency for the Monitoring

and Evaluation of the Performance-Based Financing Programme
(WB)

 Cambodia:Social Health Protection Programme, Vouchers for

Reproductive Health (KfW)