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Germany’s contribution to P4H – Providing for Health

A global network for health financing

Germany is one of the founding members of P4H – Providing for Health, the global network for health financing. It continues to fully support the network’s objectives, be it as active member, through the secondment of P4H country focal points or through its support for the L4UHC Programme. How does all this work?

A flexible and evolving network approach

Launched as a G8 initiative in 2007, Providing for Health (P4H) supports the development of sustainable and equitable health financing systems. There is no one-size-fits-all solution to challenges countries face on their path towards UHC. Thus, P4H uses a flexible and evolving network approach that adapts to the interests of the development partners involved, while allowing for a customized response to countries’ particular needs. P4H aims to assure coherence across global, regional and national levels as well as health, finance and social sectors. Local P4H networks ensure the identification of country needs and gaps, the dissemination of relevant information, and joint working based on national priorities.

P4H in Madagascar: Support to the setup of the National Health Solidarity Fund

In Madagascar, P4H supported the setup of a pre-payment mechanism for health aiming to improve risk pooling and health access to reduce out-of-pocket payments, especially for informal sector workers and the poor.  In its 2016-2017 cycle, the L4UHC programme brought together an inter-ministerial group and accelerated its efforts to develop needed legislation and mobilize key government stakeholders.  A feasibility study supported by P4H defined the benefit package. A presidential decree established the National Health Solidarity Fund in October 2017.  Today, this fund is responsible for collecting, pooling and managing financial resources to cover the whole Malagasy population with essential health services.

P4HC+ in Cambodia: Coordinating financial assistance in health

In Cambodia, P4H is known as P4HC+. P4HC+ maximizes the impact of financial assistance (20% of total health expenditure) by coordinating relevant development partners, thus avoiding duplications and promoting aligned investments. For example, P4HC+ functions as the country coordination platform for the US$175m Health Equity and Quality Improvement programme (H-EQIP). It thereby contributes to the country’s effort to minimize out-of-pocket expenditures for poor people especially through the Health Equity Funds that receive technical and financial assistance from H-EQIP.  P4HC+ also determines ways to channel money from global health initiatives through existing government funding mechanisms, hereby reducing considerable overheads. Last not least, P4HC+ assists the government in building its M&E system for UHC and produces relevant studies with a focus on equity to assist in knowledge translation.

P4H Focal Points help align investments to national priorities

Nepal team discussing way forward at Tokyo L4UHC module
Nepal team discussing way forward at Tokyo L4UHC module

P4H Focal Points are the key instrument of the P4H Network. They are health financing experts who facilitate joint working of national ministries (health, finance, labour) and international actors. Sustainable health financing is crucial to scale up domestic resource mobilization and improve the efficiency of health systems. Moreover, health financing systems suffer from fragmentation that is often exacerbated by international donors focusing on specific diseases or population groups only. In order to build equitable, sustainable, and efficient health financing systems for UHC, P4H Focal Points impartially seek to align investments in accordance with national priorities. To do so, P4H Focal Point establish, foster and maintain coordination, collaboration and learning and help to build the necessary national health financing capacities.

The L4UHC Programme: Building leadership for UHC

Team from Chad debating on UHC at Rabat module
Team from Chad debating on UHC at Rabat module

The Leadership for Universal Health Coverage (L4UHC) programme enables senior decision-makers to develop the collaborative skills and collective actions needed to bring together different national stakeholders to advance UHC. This collaborative approach is especially important for overcoming the political barriers to UHC, with its different interest groups. Significantly, the skills developed are used to initiate practical, collective actions in participating countries, supported by in-country coaches, funding and technical expertise. These actions help catalyse additional initiatives, creating the momentum for greater progress.

What has the course achieved in different countries and regions of the world? You can find a series of articles about L4UHC on this portal:

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© GIZ Nepal
© Juliette Papy

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