Published in BMJ Global Health, Reducing Fragmentation of Primary Healthcare Financing for More Equitable, People-Centred Primary Healthcare by Agnes Gatome-Munyua, Susan Sparkes, Gemini Mtei, Martin Sabignoso, Prastuti Soewondo, Pierre Yameogo, Kara Hanson, and Cheryl Cashin examines the persistent issue of fragmented financing in primary healthcare (PHC). Despite global commitments to strengthening PHC, many low- and middle-income countries struggle with underfunding and inefficient resource allocation due to fragmented and rigid funding structures.
The authors analyse the key drivers of fragmentation, including low public spending, reliance on external funding, and the proliferation of financing schemes that do not align with universal healthcare principles. Using case studies from Argentina, Burkina Faso, Indonesia, and Tanzania, the study highlights practical strategies to mitigate these challenges, such as consolidating coverage schemes, harmonising purchasing functions, and streamlining provider-level funding. The findings offer valuable lessons for policymakers seeking to enhance the efficiency and equity of PHC financing, emphasising the need for a system-wide approach to ensure sustainable and inclusive healthcare reforms.