Challenges in the planning, budgeting and financing activities in the healthcare system can explain most of the drawbacks in the healthcare delivery and outcomes landscape. These activities determine the way in which health system’s aspirations and priorities are articulated in strategic and operational plans, how operational plans and their priorities are translated into budgets, and how resources are effectively mobilized from various stakeholders, efficiently pooled and equitably allocated to delivery channels through appropriate purchasing mechanisms.

Available estimates from Health Accounts show that out-of-pocket (OOP) spending in fee-for-service (FFS) delivery represents the dominant source of healthcare financing. This portends a potentially vicious cycle of poor-health due to the consequences of catastrophic events. To alleviate this burden and protect population health, proposed reforms include transition from private financing of healthcare dominantly through out-of-pocket (OOP) payments, toward predictable, sustainable and responsive (all-inclusive) public financing; shift from input-based (supply-side) financing toward sustainable output-based (demand-side) financing mechanisms; making public health expenditures more pro-poor; and shifting greater resources toward strengthening primary healthcare services and preventive care at community level.