Present and Potential Roles of Global Health Funds and Health Systems Strengthening

Author(s): G. Ooms1
Affiliation(s): 1Public Health, Institute of Tropical Medicine, Antwerpen, Belgium
Keywords: Global health funds, health systems strengthening, health workforce, recurrent costs
Background:

The crucial issue for health systems strengthening in low-income countries is to expand the health workforce, which requires additional funding for salaries. Classic international aid is not reliable enough to be used for recurrent costs, like salaries. Recently created global health funds seem to provide more reliable aid. But they also seem reluctant to finance salaries of health workers.

Results/Conclusions:  Different reasons might explain why global health funds are reluctant to finance salaries of health workers:
- The pressure to deliver quick results;
- Disease-specific objectives, in which salaries for health workers providing comprehensive primary health care do not fit;
- The informal ‘division of labor’ with the World Bank, leaving health systems strengthening with the World Bank. The final report of the Taskforce on Innovative International Financing for Health Systems reveals a new dichotomy between the ‘WHO normative’ and the ‘Marginal Budgeting for Bottlenecks’ (MBB) approach; global health funds might unintentionally push towards the MBB approach.
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