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Financing health system elements in Africa: A scoping review
Humphrey Cyprian Karamagi1, David Njuguna2, Solyana Ngusbrhan Kidane1
1Data Analytics and Knowledge Management, World Health Organization (WHO) Regional Office for Africa, Brazzaville, Republic of Congo.
Plos One
|September 13, 2023
Summary
Planning for Universal Health Coverage (UHC) requires understanding health financing across all system elements. Current data collection often overlooks crucial areas, necessitating improved expenditure tracking for sustainable healthcare systems.
Area of Science:
- Health Systems Research
- Health Economics
- Financing for Universal Health Coverage
Background:
- Achieving Universal Health Coverage (UHC) necessitates long-term financial planning.
- Current health financing mechanisms across health system elements lack detailed conceptualization.
- Evidence on utilizing diverse funding sources for African health systems is limited.
Purpose of the Study:
- To generate evidence on optimizing resource utilization from various funding sources within African health systems.
- To review existing literature on health financing mechanisms and their interplay with health system elements.
Main Methods:
- A comprehensive scoping review was conducted using the Arksey & O'Malley and Levac, Colquhoun & O'Brien frameworks.
- Extensive searches of Medline, Cochrane Library, PubMed, WHO, World Bank, and Google Scholar databases were performed.
- Data from 156 selected studies (1975-2021) were narratively synthesized, including thematic analysis and descriptive statistics.
Main Results:
- Public sources are the dominant form of health financing.
- A significant portion of studies focused on service delivery (45%), human resources (13%), and medical products (5%).
- Global health expenditure tracking fails to capture funding for all essential health system dimensions, including intangibles.
Conclusions:
- There is a critical need for improved expenditure tracking across all health system dimensions.
- Developing a comprehensive framework for assessing health financing sources is essential.
- Future frameworks should evaluate financing based on efficiency, feasibility, sustainability, and equity.
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