Beyond Production: Using Health Financing Information to Inform Decisions that Improve Health Systems

The project collaborates with health stakeholders to protect families from catastrophic health care costs, expand access to priority services, and ensure equitable population coverage. Key strategies employed by the HFG project include improving financing by mobilizing domestic resources, reducing financial barriers, expanding health insurance, and implementing provider payment systems. The project also enhances governance for better health system management and greater accountability and transparency. Additionally, it improves management and operations systems to advance the delivery and effectiveness of health care, and advances techniques to measure progress in health systems performance, especially around universal health coverage. The HFG project is funded by the U.S. Agency for International Development (USAID) and is led by Abt Associates in collaboration with several other organizations. The project's Advances in Health Finance & Governance series is designed to highlight learning and lessons from the HFG project in nine core areas, including domestic resource mobilization, strategic health purchasing, and health financing strategies. Health financing information is a critical component of decision-making in health systems, but it is often underutilized. This information is essential at all stages of the decision-making cycle, including diagnosing the financial condition of the health system, conceptualizing different solutions, understanding the cost and impact of different solutions, refining the chosen solution, and monitoring whether chosen actions are achieving their intended objectives. Decision makers such as health and finance ministry officials, health insurance authorities, and health providers make decisions in complex environments, often under time pressure. They must consider various factors, including political demands, stakeholder interests, available resources, and personal interests and perceptions, when making decisions. The use of health financing information is influenced by the degree of country involvement in defining the need for information, producing it, and analyzing it. Strong country ownership in the process and strategic packaging of information to reach specific audiences are key elements in ensuring the use of health financing information for decision-making. The HFG project has supported over 100 activities that generated or used health financing information, including resource tracking studies, costing exercises, and studies to strengthen health purchasing mechanisms. The project's lessons focus on health financing information but echo principles of data for decision-making more broadly. The project interprets decision-making broadly, from decisions about day-to-day management of resources for health to high-level decisions about health financing policy and strategy. The project's findings highlight the importance of empowering countries to define the need for information, produce it, and analyze it, as well as the need for strategic packaging of information to reach specific audiences. In Haiti, information from an HFG study on hospital cost drivers was put to good use by hospital managers, who worked to make staff aware of the cost implications of their daily clinical decisions. Similarly, in Ghana, analyzing claims data helped the National Health Insurance Authority to recognize a problem with high proportions of claims spending on drugs, leading to a 30% reduction in drug prices. These examples demonstrate the potential of health financing information to inform decision-making and improve health outcomes.