Financing primary health care in Low- and Middle-Income Countries

The 2022 report from the Lancet Global Health Commission on Financing Primary Health Care highlights key financing functions and the “political economy,” crucial for an increased focus on primary health care (PHC) and progress towards universal health coverage.

The report’s main recommendations are that:

1. Public resources should provide the bulk of PHC funding.
2. Pooled funds should cover PHC, enabling all people to receive PHC that is provided free or nearly free at the point of service use.
3. Resources for PHC should be allocated equitably across levels of service delivery and geographic areas.
4. Properly designed PHC provider payment mechanisms should be implemented, with capitation at its core.

In this symposium we will critically examine this attempt to revive PHC, particularly whether the recommendations are realistic in country contexts. Potential obstacles could be that the population might view their needs differently from what the traditional PHC approach implies. Furthermore, the political and economic elite may have other interests in relation to the health system and services than prioritising PHC.

The political, economic perspective, which is emphasised in the Commission’s report as well as by the World Health Organization’s recent “how to guide” on Political Economy Analysis for Health Financing, is a relevant though challenging aspect, and rarely addressed because discussions are mostly dominated by “technicians”, like public health specialists and health economists, with little interest in and understanding of the political aspects of the problems faced.

With an outset in the recommendations by the Lancet Commission’s report, this symposium will examine the complex landscape of financing PHC and best ways forward.

The audience will have the opportunity of asking questions after each intervention, as well as interact during the panel discussion.

Abebe Alebachew Asfaw

Mr. Alebachew is an economist specialised in the health sector, based in Ethiopia and working as an international consultant. After working in the Ethiopian Ministry of Planning & Economic Development on the health sector policy, programming and financing, he has for the last 15 years provided consultancy services in health systems related fields such as financing, planning and budgeting for a variety of clients, governments as well as international agencies.

He was a member of the Lancet Global Commission on Financing Primary Health Care.

Suneth Agampodi

Dr. Agampodi is a Research Scientist at the International Vaccine Institute in Seoul, South Korea, and a visiting professor at Yale School of Medicine, USA. Previously, he served as a senior professor and chair of the Department of Community Medicine at Rajarata University of Sri Lanka. Before joining academia, he worked as a primary care physician and community physician in various parts of Sri Lanka. Specializing in infectious disease epidemiology, Dr. Agampodi focuses on equitable vaccine development and distribution for low- and middle-income countries and global health initiatives.

 Joe Kutzin

Mr. Kutzin is an internationally known health economist, with numerous influential publications. After almost 30 years with WHO he has since 2023 worked as an independent consultant and a Senior Fellow with Results for Development. In WHO he headed the Health Financing Unit for over a decade, being responsible for strengthening WHO’s capacity in this crucial area.

Sabine Margarete Damerow

Dr. Damerow is a postdoctoral researcher at the University of Southern Denmark with a diverse academic and professional background in Business Sciences, Public Health, and Global Health. Focusing on global health policy, financing and healthcare systems, her current work centers on health systems strengthening for improved maternal and child health in rural Guinea-Bissau.

Helene Probst

Dr Probst is a Specialist in Community Medicine with a Masters degree in public administration. She is currently the Technical Director Health with the Danish Regions. Before that she had several positions within the Danish health system, including 2,5 years as the Deputy Director in the Danish Board of Health.

She has been working in Africa – Ghana and Tanzania – for three periods during her career, lastly as Senior Technical Adviser to the Ministry of Health in Tanzania. 

Finn Schleimann

Dr. Schleimann is a phycisian with a master in public administration. He has worked 38 years in development assistance to the health sector, most of the time for Danida, including a number of years as Chief Technical Adviser in the Danish Ministry of Foreign Affairs, but also for the World Bank and WHO. As part of his work he has lived in Botswana, Bangladesh, India and Tanzania for a total of 11 years. For the past seven years he has worked as a health systems consultant based in Copenhagen.