A central component of universal health coverage is public health spending. Since the inception of the Abuja Declaration, most African countries have increased their budget allocation to health. From 2000 to 2016, economic growth in Africa averaged 4.6 percent annually, making it the second-fastest-growing region worldwide. Despite this, funding has not yet reached the required levels to ensure universal health coverage. It is widely fluctuating, making that sector unable to plan and implement health interventions effectively, partly caused by aid dependence. Even though primary and preventive care is vital to achieving equity and sustainable progress towards UHC, governments are unwilling to allocate sufficient funding for key population programmes.
The 55 Member African States made a solid commitment to increasing health resources at home while strengthening health systems to address Africa’s health priorities while improving resource utilisation through enhanced accountability. The coverage, financial protection, and equity are directly impacted by how public funds are allocated, spent, and used. The Sustainable Development Goals (SDGs) were adopted in 2015. There is now a growing awareness that it is more important to consider the nature of resources available and their use than focus solely on the volume of resources required to succeed.
Learnings from countries’ experiences in promoting UHC through reform of public spending indicate that success requires a combination of:
- Appropriate allocation of resources to health care – public resources are not allocated efficiently and do not target priority areas, notably health services for the most vulnerable;
- Annual public health budgets are not fully disbursed because of financial management efficiencies, resulting in missed opportunities for better health outcomes;
- It is often possible to move toward more equitable service coverage and financial protection without significant expenditures if public funds are used differently.
Under the Global Action Plan to achieve the SDGs, the Sustainable Financing for Health Accelerator (The Global Fund to fight AIDS, Tuberculosis and Malaria, the Global Financing Facility in particular) as well as the Global Fund Advocates Network Africa, RBM Partnership to end Malaria, WACI Health and UHC 2030 are collaborating to develop and deliver training on UHC Budget Advocacy in sub-Saharan Africa. The multi-stakeholder collaboration aims to hold governments accountable for health funding policies, levels, and allocations, in a constructive way.
The training aims to develop training on health financing, UHC,As a result, there and budget advocacy to country-level actors from civil society, media organisations, and elected representatives and that can provide in-country support to budget advocacy activities undertaken by CSO actors and mentorship.
Countries that participated are Ethiopia, Ghana, Kenya, Liberia, Malawi, Mozambique, Nigeria, Rwanda, Sierra Leone, Tanzania, Uganda, and Zambia.