Send to friendWHO's Member States have set themselves the target of developing their health financing systems to ensure that all people can use health services, while being protected against financial hardship associated with paying for them. In this report, the World Health Organization maps out what countries can do to modify their financing systems so they can move more quickly towards this goal - universal coverage - and sustain the gains that have been achieved.
Chapter 4 focuses on the efficient use of financial, material and human resources with the objective of improving health outcomes and achieving a universal coverage. While the authors do not dismiss the need to invest more money in the struggling health systems of low-income countries, they point out the importance of making the most of what is already available. The leading causes of health care systems inefficiency are highlighted, as well as possible ways of solving them. Suggestions include cutting unnecessary medicines expenses, providing alternative care to limit inappropriate hospital admissions and length of stay, improving supervision and promoting high work ethics to fight corruption, resource leakage and fraud.
The authors see Results-Based Financing (RBF) as one of the instruments to address the inefficiency of health systems. The paper mentions different types of RBF, such as performance-based contracting (PBC), performance-based financing (PBF) and pay-for-performance (P4P), and discusses some of these schemes in high-income countries. It also gives examples of several developing countries where RBF have been implemented, noting that the schemes have achieved promising results. At the same time the authors suggest caution before jumping to conclusions and point out to the lack of solid evidence. They conclude the chapter by emphasizing that potential reforms should be tailored to each country’s needs and characteristics.