Health Financing Policy Papers
A collection of papers based on our support to Member States
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Co-payment policy: considerations for Ukraine (2021)
This policy brief aims to contribute to these discussions, detailing the ways in which people currently already pay out of pocket for health care, looking at international evidence on co-payments as a policy instrument, and highlighting policy considerations for Ukraine.
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Aligning health and decentralization reform in Ukraine (2021)
Ukrainian decentralization reform has increased and democratized local government responsibility for health care at the level of local government closest to communities and has increased regional and local government responsibility for public health. Decentralization affects health system reform in three important areas: health financing, individual health services and public health.
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Feasibility study for the introduction of mandatory health insurance in Uzbekistan (2021)
Uzbekistan has decided to introduce mandatory health insurance (MHI) to move towards universal health coverage. This feasibility study assesses the impact of potential revenue sources to expand the fiscal space for health under MHI. Using population, employment and economic data, it projects three scenarios of the potential public revenue mix for health.
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Budgetary space for health in Ukraine. Policy document to support budget preparation dialogue for 2021(2020)
This summary paper provides background on each of these dimensions of potential budgetary space for health in Ukraine, along with draft recommendations on how to enlarge that space in the medium term.
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Strengthening the health financing response to COVID-19 in Europe (2020)
This short paper sets out the key health financing actions countries in Europe can take to reduce the adverse effects of the COVID-19 pandemic as part of a broader health system response.
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Ukraine: review of health financing reforms 2016–2019 (2019)
In 2015, the Government of Ukraine initiated transformative reforms of its health system to improve population health outcomes and ensure financial protection from excessive out-of-pocket payments. This report is based on a joint WHO–World Bank review carried out in April–July 2019 looking at progress implementing health financing reforms in Ukraine towards these objectives.
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Ukraine: review of health financing reforms 2016-2019. Summary
In 2015, the Government of Ukraine initiated transformative reforms of its health system to improve population health outcomes and ensure financial protection from excessive out-of-pocket payments.
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How does the introduction of patient co-payments for selected health services affect formal and informal out-of-pocket payments and utilization? Evidence from Armenia (2017)
This report presents the findings of an evaluation of the introduction in Armenia of patient co-payments for specific services provided through the publicly financed basic benefits package (BBP) at the inpatient level.
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Single vs multiple competing purchasing agencies: analysis of options for the health system in Cyprus (2017)
This report considers the requirements, advantages and risks associated with operating a proposed new national health system in Cyprus through a single purchasing agency versus through multiple competing purchasers.
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The functions and governance of purchasing agencies: issues and options for Georgia (2017)
This paper discusses the key functions and governance structures of purchasing agencies in single-payer health systems.
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Long-term trends in the financial burden of health care seeking in Kyrgyzstan, 2000–2014 (2016)
This is a unique, repeated cross-sectional survey to assess financial burden on the population and access to care over a 15-year period. The survey provides evidence of impressive reduction in financial burden associated with health care seeking due to the introduction of comprehensive health reforms during 2000-2009.
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Can reductions in informal payments be sustained? Evidence from Kyrgyzstan, 2001-2013 (2016)
The persistence of informal payments remains a problem because they continue to impose an unpredictable financial burden on patients and undermine the credibility of the State-guaranteed benefit package. A comprehensive, multi-pronged approach that addresses the causes simultaneously could succeed if public funding is maintained at current levels.
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2012/1 A review of health financing reforms in the Republic of Moldova
In the context of global efforts to move towards universal coverage in health systems, this report reviews health financing reforms in the Republic of Moldova and looks in particular at how the population´s access to health services has been affected.
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2011/1 Behind the estimates of out-of-pocket spending on health in the former Soviet Union
The countries of the former Soviet Union rely heavily on out-of-pocket payments for health care financing. However, out-of-pocket spending statistics are difficult to compare due to different data collection methodologies.
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2010/3 Income-related inequality in health care financing and utilization in Estonia since 2000
This paper summarizes recent research on income-related inequalities in health care financing and utilization in Estonia for the period 2000 to 2007. Quantitative analysis is used to analyse evidence for a number of priority policy issues.
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2010/2 Responding to the challenge of financial stability in Estonia's health system
Exploring how to move from values to action by implementing the Tallinn Charter: Health Systems for Health and Wealth
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2010/1 Extending population coverage in the national health insurance scheme in the Republic of Moldova
Recommendations for possible courses of action to reach the goal of ensuring equal and adequate access to health services for all citizens
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2009/1 Income-related inequality in health care financing and utilization in Estonia 2000-2007
Analyses out-of-pocket payments, the distribution of the taxation burden to finance health care and income-related inequality in health care utilization
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2008/4 Governance of the health system, health insurance fund and hospitals in Estonia – opportunities to improve performance
Overview of Estonia’s health system governance and its current challenges in three sections
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2008/3 Evaluation of Moldova’s 2004 Health Financing Reform
Study of institutional arrangements and resource allocation, their change as a result of health financing reform and the effects of the changes
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2008/2 Payment for performance: international experience and a cautionary proposal for Estonia
The hospital sector is the primary focus of this report
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2008/1 Health financing policy: a guide for decision-makers
An approach that countries can adapt to their own contexts
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2007/3 Voluntary health insurance in Armenia: issues and options
Issues and options including how to organize the pooling of funds from the revenue potentially available from public and private sources
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2007/2 Financing HIV/AIDS and tuberculosis interventions in Estonia
A detailed cost analysis of public health programmes covering all main sources of financing and services provided to the target population
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2007/1 The Ukrainian health financing system and options for reform
Thorough analysis of the health care financing system and suggestions for feasible changes
