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From commitment to accountability

Joint Learning Agenda on Health Financing

When civil society can follow the money, health financing works harder for the people

Overview

WACI Health advocates for health budgets that are adequate, transparent and spent where the need is greatest. Through budget advocacy and accountability, including work on public financial management, it equips civil society to follow health money from allocation to spending and audit.

The Joint Learning Agenda (JLA) is a civil society capacity-strengthening programme on health financing, universal health coverage (UHC), and public financial management (PFM), led by two African women-led organisations: WACI Health coordinates the anglophone countries and Impact Santé Afrique (ISA) the francophone countries. Its third phase works with civil society organisations (CSOs) in 22 countries.

In the current financing environment, how well domestic health budgets are allocated, released, spent and audited is a central question for Africa’s health systems and the people they serve. These decisions are made in budget processes that civil society often finds hard to enter, because the documents are technical, the calendars are short and the entry points are rarely publicised. The JLA trains civil society organisations to read budget documents, track expenditure, and engage ministries of health and finance and parliamentary committees at the points in the budget cycle where those decisions are taken.

The programme began with backing from a consortium of global health initiatives: the Global Financing Facility, the Global Fund, Gavi, the Partnership for Maternal, Newborn and Child Health, and UHC2030. Its first two phases trained 535 civil society representatives from over 400 organisations.

Phase 3 focuses on PFM, the systems that decide how public money is planned, released, spent and audited. Supported by the Health Financing Strategic Initiative (HF-SI), hosted by the Global Fund, it trains civil society alongside government and parliamentary stakeholders in 22 countries on budget tracking, expenditure analysis and fiscal transparency.

Joint Learning Agenda on Health Financing

Purpose

  1. 01 Push for adequate, sustained public funding for health, in line with the commitments African governments have made.
  2. 02 Make health budgets transparent, so that the public can see what is allocated, released and spent.
  3. 03 Equip civil society to take part in national and local budget decisions, and to make the case for spending that puts underserved communities first.
  4. 04 Hold governments to account for spending health money as planned, so that it reaches clinics, health workers and medicines.
Civil society participants in a JLA group work session
Joint Learning Agenda on Health Financing

What We Do

Working with the JLA partners and participants, WACI Health equips civil society to engage ministries of finance and health and parliamentary committees at each stage of the budget cycle. The approach varies by country, as the JLA programme tailors training and support to each. Where a country is new to the programme, national trainers are trained first and then go on to train local civil society organisations. The advocacy and accountability work then builds on the trainers and coalitions already in place.

The PFM toolkit developed for the programme guides civil society advocates on reading budget documents, understanding budget cycles, tracking expenditure, monitoring health budgets and overseeing procurement. Each country team develops advocacy and accountability plans that include PFM activities and receives seed funding that helps carry out priority actions from those plans.

Regional bootcamps and an online Community of Practice connect civil society across all 22 countries in Phase 3 with technical experts and with each other. With the International Budget Partnership, the programme also develops practical tools that countries can adapt, such as a citizen budget guide.

A speaker at the Joint Learning Agenda podium during a panel session
Publications

Reports, briefs and statements

All resources
Cover of Wemos – Paying for Universal Health Coverage (April, 2018) JLA

Wemos – Paying for Universal Health Coverage (April, 2018)

2024

A JLA publication from the WACI Health knowledge library, published in March 2024.

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Cover of State of Health Financing in the African Region JLA

State of Health Financing in the African Region

2024

A JLA publication from the WACI Health knowledge library, published in March 2024.

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Cover of Impact of Covid-19 on Domestic Health and HIV Financing in EAC JLA

Impact of Covid-19 on Domestic Health and HIV Financing in EAC

2024

A JLA publication from the WACI Health knowledge library, published in March 2024.

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Cover of Wemos – Financing for Health (May, 2018) JLA

Wemos – Financing for Health (May, 2018)

2024

A JLA publication from the WACI Health knowledge library, published in March 2024.

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Cover of Harvard – This is PFM (Public Financial Management) JLA

Harvard – This is PFM (Public Financial Management)

2024

A JLA publication from the WACI Health knowledge library, published in March 2024.

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Cover of Fiscal Space for Health and Four Ways to Increase It (April, 2019) JLA

Fiscal Space for Health and Four Ways to Increase It (April, 2019)

2024

A JLA publication from the WACI Health knowledge library, published in March 2024.

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Cover of Public Finance Targets for UHC (December, 2018) JLA

Public Finance Targets for UHC (December, 2018)

2024

A JLA publication from the WACI Health knowledge library, published in March 2024.

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Cover of Prospects for Public  Spending on Health (October, 2020) in Africa JLA

Prospects for Public Spending on Health (October, 2020) in Africa

2024

A JLA publication from the WACI Health knowledge library, published in March 2024.

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