Using Evidence to Design Health Benefit Plans For Stronger Health Systems: Lessons from 25 Countries

New report from the USAID Health Finance and Governance (HFG) Project.

Low- and middle-income country governments face competing health priorities as they try to increase their populations’ access to affordable healthcare with limited resources. Faced with difficult choices, how can governments align their spending with health system objectives? One common policy instrument governments are using is the health benefit plan (HBP), defined here as a pre-determined, publicly managed list of guaranteed health services. Based on country experiences, the authors of this report argue that using evidence improves the potential for HBPs to achieve and balance countries’ objectives for equity, efficiency, financial protection, and sustainability in the health sector.

Governments using—or considering—HBPs as part of their pathway to UHC are faced with complex questions as they prepare to design new HBPs or update existing ones to address technological, epidemiological, economic, or other changes. This report is intended to serve as a resource for these governments. Through a review of 25 countries examining the types of evidence used to design and update HBPs, this report identifies actionable lessons for designing HBPs that advance health systems objectives in a sustainable way.

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