Health Financing in Sub-Saharan Africa: From Analytical Frameworks to Empirical Evaluation

Health financing is central to the functioning of health systems and the attainment of health-related sustainable development goals, including universal health coverage (UHC). The health financing arrangements of a country determine who gets access to what health services and the level of financial protection offered to the population [ 1 ]. Often the financing arrangements are influenced by the historical, social, political and economic development of the country [ 2 , 3 ]. In general, health financing covers three basic functions of revenue collection, risk pooling and purchasing of health services [ 4 , 5 ]. Revenue collection deals with raising of funds from different sources (taxes, social security/insurance systems, fees, grants, loans, etc.) to finance the health system [ 4 ]. Risk pooling involves combining and managing revenue in such a way that individuals in a pool share collective health risk and, in so doing, protect members of the pool from payment of applicable health expenditures. Purchasing is the transfer of pooled funds to health service providers to provide health services to the population [ 4 , 6 ]. Regardless of income level, all countries face challenges in financing healthcare. However, these challenges are more acute in low- and middle-income countries (LMICs), where the need for healthcare is greatest and resources are most scarce [ 7 ].