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With shifting disease burdens, growing populations, and rising expectations comes a greater focus on value for money. International health funders and agencies want to know how to make the most of money spent by focusing on the highest impact interventions among the most affected populations. Whether through better procurement systems for health commodities, results-based financing, or more detailed assessments of the effective ness of health technology, CGD’s work aims to make health funding go further to save, prolong and improve more lives.
Early this month, CGD co-hosted a conference with the Inter-American Development Bank (IDB), highlighting progress, challenges, and lessons learned from the first phase of the Salud Mesoamerica Initiative (SMI), a seven-year-old results-based funding (RBF) partnership between donors and national governments in health. Uniquely, the event brought together country governments, external funders, intermediaries, and evaluators—from different stages of the program—to discuss motivations, results, issues, and lessons learned.
As developing nations are increasingly adopting economic evaluation as a means of informing their own investment decisions, new questions emerge. The right answer to the question “which perspective?” is the one tailored to these local specifics. We conclude that there is no one-size-fits-all and that the one who pays must set or have a major say in setting the perspective.
In collaboration with the Salud Mesoamerica Initiative (SMI), CGD is pleased to invite you to a two-day conference highlighting lessons learned from SMI and how SMI’s experience can inform other programs in the future of healthcare. CGD has worked on results-based financing for years. From analyzing performance-based incentives to exploring cash on delivery aid to improving value for money for the Global Fund and its partners, we have been examining ways to maximize the impact of funding on health outcomes. We now have rigorous evaluations and evidence from SMI, a large-scale results-based funding program. This model public-private partnership allocates funding at the national level based on measurable improvements in coverage and quality of reproductive, maternal, newborn, and child healthcare. It has brought together international donors, a development bank, regional bodies, national governments, and local stakeholders in an innovative partnership that rewards for health system strengthening and increased equity.
Today, politicians are under growing pressure to squeeze more out of every dollar and guarantee greater access to better, more affordable healthcare for their citizens. In such a resource-constrained environment, wasting trillions of dollars on health every year is not viable. This note provides an overview of some of the approaches and policy options that the National Health Service in England has been using to maximise value for money.
In 2013, a CGD working group signaled important benefits of development impact bonds, and worked through some of the “how-to” of design and implementation. Yet five years later, only three development impact bonds have launched.