Assessment of Health Financing Landscape for Global Fund Investment

Description of the Project:

The Global Fund developed a new approach to Domestic Financing for Health (DFH) aimed at mobilizing increased resources to complement donor funds, engaging governments to boost domestic health financing, and supporting country health financing systems for sustainability. The DFH focuses on strengthening health financing systems, supporting national health financing strategy development, providing technical assistance to improve health financing efficiency and effectiveness, and investing in innovative financing mechanisms.

By increasing domestic health financing, the Global Fund aims to support Nigeria in achieving Universal Health Coverage (UHC), ensuring access to quality healthcare for all, including the poor, vulnerable, and those with high needs such as people living with HIV and TB patients. The Global Fund is also supporting the development of a national health financing strategy to increase domestic resources. For effective implementation, it was necessary to assess Nigeria’s health financing landscape to assist the Global Fund in determining it’s contribution to health insurance coverage in Nigeria.

The objectives of the project:

The primary objective of the landscape analysis was to gather programmatic intelligence for the design of an evidence-driven intervention as part of the Global Fund Grant Cycle 7 (GC7) of Nigeria’s RSSH for 2024-2026.

Interventions: PGS worked with partners (State, Federal, CCM, PR, GIZ BACKUP Health, and GF Sec) to develop a project implementation plan that detailed the project scope, delivery plan, budget, stakeholder responsibilities, milestones, and timelines for delivery. PGS led the landscape assessment in Anambra, Ebonyi, Gombe, and Kwara State by conducting a series of consultative sessions with the key actors in each state to:

1. Analyse the state health insurance governance system and structure.
2. Review state health insurance scheme against the following illustrative components – enrolment (formal, informal, vulnerable), M&E and accountability system, financing sources, benefits packages (essential or comprehensive), provider payment mechanisms, contributing population and level of compulsion, pooling of funds and Claims management.
3. Determine the number of people living with HIV (including Paediatrics), MDR TB, and PMTCT for premium insurance cover.
4. Disaggregate facilities providing HIV, PMTCT, and DR TB services (by LGA, facility type, and empanelment status under the social health insurance service scheme. Also, map IPs supporting these services in the empanelled facilities.
5. Determine the existing referral mechanism within the State Health Insurance Scheme (HIS)
6. Determine health insurance premiums/plans and any variations for those living with HIV and MDR TB.
7. Review the performance monitoring system and level of utilization for decision-making based on agreed health finance and services indicators.

Related Activities: Monitoring and Evaluation, Landscape Analyses, Capacity Development Program Management, Financial Management, Vulnerability, HIV and TB, Malaria