.tmb-1920v.jpg?sfvrsn=6ac4d8a_1)
Financing
Overview
Health financing is a core function of health systems that enables progress towards universal health coverage (UHC) by improving effective service coverage and financial protection. Health financing encompasses policies and practices related to the 3 core functions of: revenue raising (sources of funds, including government budgets, compulsory or voluntary prepaid insurance schemes, direct out-of-pocket payments by users, and external aid); pooling of funds (the accumulation of prepaid funds on behalf of some or all of the population); and purchasing of services (the payment or allocation of resources to health service providers). These functions are achieved through the health and social sector financing schemes that exist in countries, and the integration of rehabilitation within these is crucial for its financing.
In many countries, there is limited integration of rehabilitation into health financing schemes, and this has resulted in a relatively small budget allocation and a subsequent disconnect between what is financed and made available compared with what is needed by the population. When public investment in rehabilitation is low, service users must pay more out-of-pocket costs and unfortunately rehabilitation often becomes unaffordable for many people who need it. Additionally, many countries rely on funding by external development partners which results in challenges to the long-term provision and sustainability of rehabilitation services.
Current projects
Rehabilitation in national health accounts
WHO is working with Results for Development and the Health System Strengthening Accelerator to develop a knowledge product on rehabilitation in national health accounts. Understanding how health systems allocate and spend funds for rehabilitation is central to monitoring the availability of resources for rehabilitation and how they are utilized. Health accounts provides valuable evidence to inform decision-making. This product is aimed at rehabilitation and national health accounts stakeholders and will be launched in second half of 2024.
Rehabilitation investment case
WHO is working with partners to develop a resource that will outline an investment case for rehabilitation.
Relevant resources
Rehabilitation in health financing opportunities on the way to universal health coverage
Health financing is a key lever for achieving the UHC goals of enhancing access, protecting from financial hardship and facilitating quality services, however, the knowledge of how health financing practices can be harnessed to promote these goals for rehabilitation services is limited. This resource addresses the knowledge gap by considering the unique features of rehabilitation, exploring current practices for financing of rehabilitation services, framing major challenges and opportunities, and offering guidance to decision-makers engaged in strengthening rehabilitation within health systems.
Despite the large need for rehabilitation services in the population, the financial coverage of these services is limited, which often leads to high out of pocket costs for patients. In many countries rehabilitation is overlooked resulting in limited rehabilitation expenditure within health financing schemes and its omission from the planning and financing of essential health service packages. Supporting countries to harness the opportunities within health financing for rehabilitation is a focus of the resource.
The resource considers rehabilitation across the health financing functions of how revenues for health are collected, pooled and paid out to providers of health care services and processes. It explores the features of rehabilitation services that are relevant to financing, including how they are delivered and organized, and then draws on evidence, current practices and offers policy and practical guidance. The resource is designed to equip both health financing and rehabilitation stakeholders with information and guidance to assist them in decision-making related to rehabilitation in health financing.
Using the Package of interventions for rehabilitation in Georgia
The Package of interventions for rehabilitation (PIR) outlines the most essential interventions for rehabilitation for 20 health conditions, together with information on the required material resources and workforce that is usually skilled to deliver these interventions. As such, the PIR presents an indispensable resource for countries when planning for and budgeting the integration of rehabilitation services into their health systems. This report illustrates the use of the PIR in developing a first rehabilitation service package in Georgia. It demonstrates how the PIR was used to prioritize the target population for this service package, as well as how information on interventions for rehabilitation was used to define the service package, and how the costing of it was informed. Insights into the steps that were taken to implement the service package are also described. Together with the lessons learned from these processes, this report provides valuable information on how countries can use the PIR when developing a rehabilitation service package and the practical aspects to be considered during implementation.
