Global network for health financing (P4H)
Title: Providing for health (P4H) sector project
Commissioned by: German Federal Ministry for Economic Cooperation and Development (BMZ)
Overall term: 2008 to 2018
One billion people do not have access to adequate health care and more than 100 million fall into poverteach year due to the high cost of medical treatment, drugs and other health services. For many others, selling their productive resources, foregoing an education and drastically reducing their standard of living are the only way they can meet the costs incurred in connection with illness, accidents and the related treatment. Medical expenses are one of the biggest obstacles to poverty alleviation and economic development. In response to this challenge, the global community has enshrined universal health coverage (UHC) in the 2030 Agenda for Sustainable Development, under target 3.8. Universal health coverage is designed to safeguard access to health services and cover the costs of illness for all citizens in a given country, financed by the community.
Many low-income and middle-income countries are striving to establish UHC and are turning to development partners for technical and financial support. A failure to adequately balance diverging interests is often one of the main barriers to in-country reform, with stakeholders from sectors such as health, social affairs, finance and the private sector pulling in different directions.
Responding to this need for cross-sectoral and cross-donor cooperation, France and Germany launched Providing for Health (P4H), a global health financing network, as a G8 initiative in 2007. The network has since become the main coordination platform for investors in UHC. Its members include the World Health Organization (WHO), the International Labour Organization (ILO), the World Bank, the African Development Bank (AfDB), the Asian Development Bank (ADB), France, Germany, Spain, Switzerland and the USA.
The P4H network has made a significant contribution to the implementation of UHC in selected developing countries and emerging economies.
The P4H sector project presented here supports BMZ in coordinating and implementing the German contribution to the network. The Swiss Agency for Development and Cooperation (DEZA) makes a substantial contribution to the financing of the sector project, which is based in Bonn and has further offices in Eschborn, Washington DC, Dar es Salaam, Phnom Penh and Antananarivo.
The various members of the P4H network now work together in 36 countries. In doing so, they use their existing on-site organisational structures. The focus of their activities is on promoting political commitment to universal health coverage in the respective partner country and providing the country with tailored support. The network members endeavour to bring the responsible parties from different ministries, associations and civil society together around one table.
All members exchange information regarding their activities on the ground. A Coordination Desk hosted by WHO and the World Bank, the network’s own intranet and Focal Points in six selected countries also ensure the flow of information between all members and partners in the individual countries.
The sector project provides one third of the financing for this Coordination Desk as well as for the Focal Points in Tanzania, Cambodia and Madagascar.
The sector project participates in joint advisory missions and in specialist studies conducted by the P4H network, thereby supporting dialogue and strategy formulation processes. For instance, together with Agence Française de Développement (AFD) the project has assigned an international consultant to help draft the national UHC strategy in Madagascar.
The consulting firm FFW Deutschland GmbH supports the implementation of the project.
The sector project plays an important role in coordinating the contributions not only of network members but also of local institutions and ministries in the partner countries. In Tanzania, for example, the project has worked together with other P4H partners over the last three years to help develop a coherent health financing strategy.
The sector project also assists with reform processes by offering training programmes on topics such as health financing and improving management and political leadership skills. In cooperation with the World Bank, the sector project launched the Leadership for Universal Health Coverage (L4UHC) programme. Leading figures engaged in social reform at ministerial and policy level provide support for the programme’s participants in a number of ways. These include supporting them to apply their individual leadership skills more effectively in respect of the ongoing processes of reform in partner countries, incorporate their own ideas and create scope for independent development and the establishment of cross-ministerial and cross-sectoral alliances. At the end of the programme, the political process for introducing universal health coverage in a particular country will ideally be at a more advanced stage, with the country teams defining their own objectives.