Table 4 Health financing benchmarking matrix
Health financing objective | Reform scenarios | ||
|---|---|---|---|
MOH | NHI | Purchaser | |
Technical efficiency | No change expected, potential improvements depending on the outcomes of decentralization and hospital autonomy reforms | Potential improvements associated with more efficient purchasing e.g. improved treatment protocols, better financial management | Potential improvements associated with more efficient purchasing e.g. improved treatment protocols, better financial management |
Equity | Improvement dependent on national rollout of national ID | User fees likely necessary to incentivize enrolment – reduction in access for poor because of dysfunctional targeting and identification systems in place. Potential improvements in service quality. | Potential improvements in service quality |
Financial risk protection | No change expected | Depends on the introduction of user-fees and on the effectiveness of the identification of poor people and of the enrolment of informal sector populations; potential improvement through decreased reliance on informal payments | No direct impact; in the longer term, it can reduce providers’ reliance on user fees and informal payments |
Policy coordination and resource allocation process | Depends on implementation of upcoming reforms e.g. revised EHP | Opportunities and challenges, outcome dependant on strengthening MOH stewardship position | Opportunities and challenges, outcome dependant on strengthening MOH stewardship position |
Health outcomes | No change expected | Can improve outcomes through enforcement of standards of care and appropriate provider payment mechanisms | Can improve outcomes through enforcement of standards of care and appropriate provider payment mechanisms |
Revenue mobilisation | Widening funding gap | Potential savings due to improved contracting + additional revenue from premium collection, partially offset by higher administration costs | No additional revenue collection mechanism, but potential savings due to improved contracting |