Frameworks and References

Frameworks help countries rally policy makers and shape social health protection and health financing systems. Fundamental to developing and implementing frameworks is a shared understanding of key terms. Framework development and implementation also depends on collaborations across sectors and on stakeholders having ready access to relevant and accessible knowledge resources.

A health financing (HF) framework is determined by four health financing system functions: revenue raising, pooling, purchasing and benefit design. An HF framework helps to define country specific HF arrangements, governance and reform policies and strategies that can advance universal health coverage (UHC). Embedded in the health financing framework of the World Health Organization is the belief that advancing equity in delivery of health services people need requires  financial protection and service of sufficient quality. These requirements drive HF reforms in countries to improve equity in the distribution of health system resources, efficiency, transparency and accountability.

UHC is an overarching goal: to strengthen health systems and SHP to ensure that all people access health care services without financial hardship or income insecurity in case of sickness. The objectives, functions and principles of SHP are grounded in international social security standards developed by the International Labour Organization.  

Developing and implementing SHP and HF frameworks furthers national reforms. Frameworks help countries provide comprehensive health services of sufficient quality to all while assuring financial protection for those who need it. The P4H Network supports the twin goals countries have to develop and implement frameworks by facilitating the exchange of knowledge, sharing best practices and country experiences, facilitating dialogues, organizing events at global, regional, and country levels, and promoting partnerships across different sectors engaged in SHP and HF reforms to advance UHC. 

Low- and middle-income countries often cite lack of good governance as causing scarce government revenue and inadequate levels of public spending on health and SHP, inequity, inefficiency, over-reliance on out-of-pocket payments, and lack of explicitly defined benefits. No single solution or model addresses these challenges. However, SHP and HF frameworks, as well as guiding principles and standards, can help countries effectively address their individual challenges. Some key declarations, conventions, resolutions and reports, guidelines and tools, as well as training opportunities for SHP and HF – examples of global goods – can certainly be of use.