Promoting equitable health care financing in the African context: current challenges and future prospects

This Equinet paper evaluates how health services are currently funded, explores recent trends in health care financing and identifies lessons from the health care financing experience of African countries. The paper shows that the current level of health care funding from government tax revenue is relatively low in most African countries – in the majority of countries the health sector share of total government expenditure is below 10 per cent. One of the single largest sources of financing is that of out-of-pocket payments (OPP) which exceed 25 per cent of total health care expenditure in more than three-quarters of sub-Saharan African countries.

The paper recommends several actions in relation to health care financing within the African context including: explicit commitments by governments to move away from out-of-pocket funding of public health sector services; efforts to increase tax revenue through improved tax collection mechanisms; implementing effective mechanisms for identifying the poor and other vulnerable groups; equitable allocation of funds that are mobilised to ensure that all citizens have access to health services irrespective to whether they reside in a rural or urban area.