WHO creates tool to assess public health financing

File photo: The San Fernando General Hospital.  Photo by Ayanna Kinsale
File photo: The San Fernando General Hospital. Photo by Ayanna Kinsale

To reduce wastage of public funds and ensure there is more access and equity in the public health care system, the World Health Organization (WHO) has created the Health Financing Progress Matrix – a standardised qualitative approach to assessing country health financing systems, in terms of both the development and implementation of health financing policy.

The implementation of the matrix in the Caribbean was discussed on Wednesday during a WHO on called assessing Caribbean countries’ progress towards universal health care.

Dr Althea LaFoucade, director of the Health Economics Unit, Centre for Health Economics at the University of the West Indies, St Augustine said for decades countries in the region have shown a concern and desire for the population to have proper access to health care.

She said there is clear evidence over that time that the policies and related arrangements pertaining to financing affects people’s access to universal health care.

“The Health Financing Progress Matrix has the capacity to assist countries in monitoring how their financing arrangements or policies pertaining to health financing may be impacting on progress towards universal health coverage. It is not perfect.”

The lead authors were Dr Matthew Jowett and Joseph Kutzin who helped create a list of 19 questions the public health sector must ask to assess its efficiency, inclusivity and expenditure.

Jowett is a senior health financing specialist at the WHO, while Kutzin is the leader of its health financing team in Geneva.

The matrix allows country progress to be systematically tracked over time, capturing the dynamic shifts in the policy development process, and not only changes in outputs and outcomes.

The areas looked at include health financing policy, process and governance, revenue raising, pooling of resources; purchasing and provider payment, benefits and conditions of access, public financial management and public health functions.

Some of the questions in the matrix include: Is there an up-to-date health financing policy statement guided by goals and based on evidence? Are health financing agencies held accountable through appropriate governance arrangements and processes?

How stable is the flow of public funds to health providers? To what extent does government use taxes and subsidies as instruments to affect health behaviours?

The matrix will be piloted in one or two Caribbean countries to better understand how the region could benefit from utilising the tool and what adjustments would be required.

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