Sustainable Health Agenda for the Americas 2018-2030, Goal 4: Health Financing

GOAL 4

Goal 4

Achieve adequate and sustainable health financing with equity and efficiency, and advance toward protection against financial risks for all persons and their families.

SCOPE

This goal aims at increasing and improving health financing with equity and efficiency as a necessary condition to advance toward universal health, addressing the following components in coordination and collaboration with financial authorities:

  • financing for universal access to health and universal health coverage;
  • increase public expenditure on health and improve quality of the expenditure, as necessary;
  • elimination of direct payments that constitute a barrier to access at the point of service;
  • protection against financial risks due to health events that cause catastrophic expenditure;
  • regulation and oversight of organisms that administer health funds;
  • efficient organization of health systems;
  • investment in health (infrastructure, equipment, training of personnel), prioritizing the first level of care;
  • use of pooling arrangements based on solidarity;
  • development of systems of purchase and payment to suppliers which promote efficiency and equity in the allocation of strategic resources.
TARGETS FOR 2030
  • Achieve a level of public expenditure in health of at least 6% of GDP[1] (updated PAHO Strategic Plan outcome 4.1).
  • Reduce out-of-pocket expenditure on health[2] in collaboration with the financing authorities (PAHO Strategy for Universal Access to Health and Universal Health Coverage, document CD53/5, Rev. 2 [2014]).
  • Develop and strengthen policies and strategies to reduce the segmentation of health system financing (PAHO Strategy on Universal Health Access and Universal Health Coverage, document CD53/5, Rev. 2).
  • Implement policies and/or strategies to develop systems of purchase and payment to providers, which promote efficiency and equity in the allocation of strategic resources (PAHO Strategy on Universal Health Access and Universal Health Coverage, document CD53/5, Rev. 2 [2014]).
  • Develop and strengthen strategies to reduce segmentation and improve the mechanisms for health financing, in collaboration with relevant decision-makers and actors, that promote efficiency and equity in the allocation of resources (PAHO Strategy on Universal Health Access and Universal Health Coverage, document CD53/5, Rev. 2 [2014]).
goal 1

 

  • [1] Public expenditure on health equivalent to 6% of GDP is a useful benchmark in most cases and is a necessary, though not sufficient, condition to reduce inequities and increase financial protection.
  • [2] In the Strategy for Universal Access to Health and Universal Health Coverage (CD53.R14), the PAHO Member States committed to move toward the elimination of direct payments at the time services are provided, which becomes an access barrier. The corresponding regional indicators will be defined in PAHO's strategic plans, based on technical assessments to estimate sustained regional reductions.