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Scoping review on classification and focus comparison of health financing frameworks - P4H Network

Scoping review on classification and focus comparison of health financing frameworks

This study reviews 21 health financing frameworks, classifying them into groups, highlighting their diverse perspectives, and emphasizing their adaptability for policymakers based on local contexts and challenges.

The purpose of this study is to review the current frameworks for understanding and assessing health financing and draw out the dimensions of conceptual frameworks. This scoping review was conducted using the five stages of Arksey and O’Malley’s framework. We reviewed all published peer-reviewed literature indexed in PubMed, SCOPUS, and Embase from 2000 up to 2021 for inclusion.

We identified 21 frameworks developed to assess financing in the health system. We classified frameworks by grouping them into: frameworks focusing on health financing as a constituent of health system and frameworks focusing on health financing only. We classified health financing frameworks further into three main groups according to the general commonalities among them. These three groups are as follows: (1) frameworks providing general recommendations for improving health financing system regardless of sources of financing, (2) frameworks focusing on improving the performance of health insurance schemes, and (3) frameworks focusing on managing public health financing.

Despite being diverse, various health financing frameworks offer synergistic views to the health financing system and provide a comprehensive picture of the health financing system. These frameworks can help policymakers decide which framework is more appropriate to start with based on their local contextual features and the changes they are going to bring about in their health financing system.


  • Differences in context, regional challenges, and level of development have resulted in introducing different health financing frameworks.
  • They vary in terms of area of assessment, changes they want to bring about and the importance they place on institutional and organisational factors.
  • They are not static; rather, adaptable in response to new evidence, innovations, demands and opportunities.
  • Policymakers can decide which framework is more compatible with the challenges they are going to deal with.