EQUINET commissioned this desk review paper. It aims to contribute to a regional understanding of the positive and negative implications of the different domestic health financing options being explored, advocated and implemented in the East and Southern African (ESA) region. It presents issues to be addressed in the implementation of these financing options from the perspective of equitable progression towards universal health coverage (UHC), to inform policy dialogue and decisions on domestic health financing in ESA countries. The paper considers only one aspect of health financing reform, namely, revenue collection. It distinguishes between policy instruments, i.e., the sources of finance, and policy strategies, i.e., how these instruments are deployed to achieve various objectives or to address contextual features. Non-contributory sources (essentially tax-financed) and contributory (employment-based) options are explored. The paper presents: a. A typology of domestic revenue instruments and strategies; b. Domestic financing trends and options in place, or under consideration, in ESA countries; c. A review of low- and middle-income country experiences of domestic financing options; and d. Conclusions on the findings and lessons for ESA countries.
Resource allocation and health financing
Title of publication EQUINET Discussion paper 119: Critical assessment of different health financing options in east and southern African countries
Date of publication
Critical assessment of different health financing options in east and southern African countries’. EQUINET Discussion paper 119. EQUINET: Harare.
health financing; domestic financing; UHC; east and southern Africa
East and southern Africa region
Equinet Publication Type