Category: Health financing
‘They say we are money minded’ – exploring experiences of formal private for-profit health providers towards contribution to pro-poor access in post-conflict Northern Uganda
This paper seeks to understand how the private for-profit health sector continues to thrive in settings with high poverty levels and a history of conflict, such as Northern Uganda.
ReBUILD paper examining political economy factors behind adoption of results-based financing and shifts in influence & resources it may bring
Presentation outlining a Cochrane review on paying for performance to improve the delivery of health interventions in LMICs
Presentation outlining findings on performance-based financing design, implementation and applicability in different settings.
Health Financing Accelerator presentation: a review of Global Fund experience with facility-level financing
A presentation to the Health Financing Accelerator and the Global Fund in March 2021 on the challenges and opportunities for international agencies investing in performance-based financing
This paper argues that health financing and entitlement systems linked to employment can actually disadvantage women and explores how that happens
Summary of ReBUILD’s cross cutting and synthesis non peer-reviewed outputs, eg videos, briefs, infographics etc
These two papers, produced for the World Health Organization, look at health financing policy in fragile and conflict-affected settings – Health financing policy and implementation in fragile and conflict-affected settings and Health financing policy in fragile & conflict-affected situations
Performance-Based Financing, Basic Packages of Health Services and User-Fee Exemption Mechanisms: An Analysis of Health-Financing Policy Integration in Three Fragile and Conflict-Affected Settings
Research looking at whether and how performance-based financing is integrated with national financing strategies, especially in fragile and conflict-affected settings
Results-based financing as a strategic purchasing intervention: some progress but much further to go in Zimbabwe?
Research which empirically and systematically examines how results-based financing impacts on health care purchasing in Zimbabwe
Research from ReBUILD and partners on identifying evidence on effective health systems strengthening approaches in different contexts
Paper reflecting on undertaking a health systems strengthening review, drawing out suggestions on definitions and approaches to assessment, plus key conclusions
Presentation (video and slides) given by Professor Sophie Witter on a report on health systems strengthening
Political economy approaches to explore PBF’s adoption, adaption and implementation in fragile settings
Presentation given by Maria Bertone at the International Health Economics Association congress in Basel July 2019
Paper from ReBUILD looking at literature on health systems financing in fragile and conflict-affected settings and how it has changed in 2012-19
(How) does RBF strengthen strategic purchasing of health care? Comparing the experience of Uganda, Zimbabwe and the Democratic Republic of the Congo
Results-Based Financing has proliferated in health sectors of low and middle income countries, especially fragile and conflict-affected ones, and has been presented as a way of reforming and strengthening strategic purchasing. However, few studies have empirically examined how RBF impacts on health care purchasing in these settings. This article examines the effects of several RBF programmes on health care purchasing functions
the past decade.
Les systèmes de santé après un conflit – éléments probants en faveur de meilleures politiques et pratiques
Ces documents de synthèse décrivent les thèmes principaux issus des recherches de ReBUILD, ainsi qu’un aperçu du programme et de son large éventail de projets de recherche jusqu’en 2016.
Three presentations on performance-based financing filmed during the 2018 Fifth Global Symposium on Health Systems Research
A summary document giving an overview of the projects and research themes which have made up ReBUILD’s work.
Dr Maria Bertone speaks about performance-based financing for healthcare in Sierra Leone
Professor Sophie Witter speaks about health financing in fragile and conflict-affected states
Professor Sophie Witter speaks about performance-based financing as a way to build strategic purchasing in fragile and conflict-affected states.
This policy brief reviews key dimensions of sustainability and their relevance for crisis-affected settings, then presents lessons for encouraging sustainability in these settings.
The political economy of crisis-affected settings: what does it mean for investments in health systems?
This brief reviews key elements in the response to crises from a political economy perspective, evidence on the opportunities and challenges presented by crises, and lessons in how to best utilise those opportunities to promote investment in health systems.
How do different types of provider affect access to effective and affordable healthcare during and after crises?
This brief summarises the key characteristics of the different types of providers and the health services they offer, and discusses their involvement in health crises and possible interventions that can increase access to effective and affordable healthcare during and after crises.
This policy brief reviews the meaning of universal health coverage (UHC) and summarises lessons for achieving UHC in crisis-affected settings.
Institutions for strong and equitable health systems after conflict and crisis – lessons from ReBUILD research
This brief outlines the findings from ReBUILD’s phase 1 research informing the theme of institutions in post-conflict health systems.
This brief outlines the findings from ReBUILD’s phase 1 research on health financing policies in post-conflict settings and how these have affected access to health care for the most vulnerable populations.
The ReBUILD programme and emerging themes for health systems strengthening in post-conflict and post-crisis settings
This brief outlines the main themes on health systems in post-conflict and post-crisis settings which came from the first phase of the ReBUILD programme, and the range of research projects which gave rise to these findings and themes.
Les systèmes de santé pendant et après une crise : éléments probants en faveur de meilleures politiques et pratiques
Cette série de documents de synthèse, fruit des recherches menées par ReBUILD, aborde un nombre de questions clés concernant le renforcement des systèmes de santé dans les contextes affectés par un conflit ou une crise.
This briefing note presents findings from ReBUILD’s research in Cambodia on the demographic and distributional impacts of conflicts and implications for health systems.
Summary of ReBUILD’s cross cutting and synthesis non peer-reviewed outputs, eg videos, briefs, infographics etc
This series of ReBUILD briefing papers addresses some key questions related to health systems strengthening in settings affected by conflict or crisis.
Managing the Transition from Humanitarian to Development Aid: East African Symposium on Aid Effectiveness and Health Systems Development – Key messages brief
This brief document outlines the key messages highlighted by participants at the East African Regional Symposium on Aid Effectiveness and Health Systems, held on 15th/16th August in Kampala.
Webinar – Performance-based financing in fragile and conflict-affected settings: from research to practice
Recording of a webinar on the impact of PBF research on practice in fragile and conflict-affected settings
Performance-based financing as a way to build strategic purchasing in fragile and conflict affected settings: potential and pitfalls
Presentation given by Sophie Witter at a Satellite Session on “Payment for Performance, how, why, where and what?”, at the Fifth Global Symposium on Health Systems Research in Liverpool, on 9th October 2018.
A ReBUILD paper on the development of performance-based financing for healthcare in Sierra Leone
Presentation (French language) on the state of knowledge on health systems in fragile contexts, given by Professor Sophie WItter at an International Workshop at the Institute of Tropical Medicine in Antwerp on 16th October 2018.
Presentation given by Bandeth Ros at the 5th Global Symposium on Health Systems Research in Liverpool, on Wednesday 10th October 2018.
The bumpy trajectory of performance-based financing in Sierra Leone: agency, structure and frames shaping the policy process
Presentation given by Maria Paula Bertone at the 5th Global Symposium on Health Systems Reseach in Liverpool on Wednesday 10th October 2018.
Investigating results-based financing as a tool for strategic purchasing: comparing the cases of the Democratic Republic of Congo, Zimbabwe and Uganda
Presentation given by Maria Paula Bertone at a Satellite session of the 5th Global Symposium on Health Systems Reseach, on “Payment for Performance, how, why, where and what? Learning from research across income settings. Tuesday 9th October 2018.
Presentation given by Sophie Witter at a satellite session on “Health financing in fragile & conflict affected settings – controversies and innovations” at the 5th Global Symposium on Health Systems Research in Liverpool, on 8th October 2018.
Leaving no one behind; how can evidence-based approaches support progress towards UHC and global health goals during conflict and protracted crises?
This briefing paper has been produced ahead of an organised session at HSR2018, outlining the background context of health service delivery in conflict and protracted crises, current developments and initiatives to improve coordination and approaches to support both humanitarian and development objectives, and the challenges and issues for the use of evidence to support these efforts.
This brief presents key messages from and a summary of ReBUILD’s research into performance-based financing
Video of Maria Bertone of ReBUILD speaking on the consortium’s work on performance-based financing in fragile and post-conflict states
Are health systems interventions gender blind? Examining health system reconstruction in conflict affected states
This ReBUILD paper examines if and how rebuilding health systems affected gender equity in four post-conflict contexts.
Poster presented at the Fifth Global Symposium on Health Systems Research in Liverpool in October 2018 on the political economy of results-based financing
This summary of ReBUILD’s research projects from both the original phase and the short extension phase of the programme. It includes links to further information on the projects and their outputs.
Video of Tim Martineau of the ReBUILD Consortium speaking at a session on UHC in emergencies at the 2018 World Health Assembly
Internal contracting of health services in Cambodia: drivers for change and lessons learned after a decade of external contracting
ReBUILD paper on health contracting models in Cambodia since 2009. Includes lessons on the Special Operating Agencies model of contracting.
Presentation given by Professor Sophie Witter on 17th May 2018 for the American University of Beirut Global Health Institute’s Webinar series: “Global Health and Conflict”. This webinar theme: Health Systems in Situations of Fragility.
Changes in catastrophic health expenditure in post-conflict Sierra Leone: an Oaxaca-blinder decomposition analysis
A paper from ReBUILD examining how households’ exposure to financial risks through seeking healthcare evolved in post-conflict Sierra Leone.
A paper from ReBUILD’s study exploring how performance-based financing emerged and was adapted in three humanitarian settings.
This briefing note provides collective responses from three health systems research consortia to some key questions on health systems resilience raised by DFID advisors.
The human resource implications of improving financial risk protection for mothers and newborns in Zimbabwe
This 2013 paper examines implications for human resources for health of changes in user fees for maternal and newborn health services in Zimbabwe.
Context matters (but how and why?) A hypothesis-led literature review of performance based financing in fragile and conflict-affected health systems
Literature review from ReBUILD by on how context affects performance-based health financing in fragile and conflict-affected settings.
Resilience of health systems during and after crises – what does it mean and how can it be enhanced?
This policy brief summarises different aspects of health system resilience, its measurement, and strategies for enhancing resilience during and after crises.
Health financing in conflict-affected and post-conflict settings: Resources from ReBUILD’s work
This 2017 paper describes the findings from ReBUILD’s research in Cambodia as part of the health financing research strand
This ReBUILD paper reflects on why we need to focus on gender when moving towards Universal Health Coverage
This paper draws on ReBUILD’s research to understand key issues inhibiting health systems strengthening in fragile settings
This paper reports on some of the findings from ReBUILD’s quantitative research into post-conflict health financing policies in Cambodia.
Health worker experiences of and movement between public and private not-for-profit sectors – findings from post-conflict Northern Uganda
This paper looks at the experiences of health workers during and after the 20 years of conflict in northern Uganda, and the factors that influenced their movement between public and private not-for-profit sectors. The findings highlight the need to ensure balanced health labour market incentives which take into account not only the changing context but also needs at different points in individuals’ life cycles and across all core service delivery sectors.
Impact of user fees on health care seeking behaviour and financial protection during the crisis period in Zimbabwe: A life history approach
This report presents the findings and recommendations from part of ReBUILD’s qualitative health financing research in Zimbabwe, using the life histories approach.
These briefs outline the main themes which have come from ReBUILD’s research, as well as an overview of the programme, its research projects, and how the themes developed from these.
This brief is one of two briefs from ReBUILD’s research on health system financing and households’ coping strategies for health care needs in post-conflict northern Uganda.
First of two briefs from ReBUILD’s research on health system financing and households’ coping strategies for health care needs in post-conflict northern Uganda.
This brief outlines the key messages which have come from ReBUILD’s research on health financing, health workforce and aid effectiveness in post-conflict northern Uganda
From ReBUILD’s partners at Makerere University School of Public Health – an overview of the context and issues covered by the team’s research on the post-conflict health system in northern Uganda.
Presentation made by Sophie Witter at DFID lunchtime seminar 19th January 2016
Poster from ReBUILD’s cross-country study on people’s health needs and health seeking behaviour before, during and after conflict. This poster was presented at the 4th Global Symposium on Health Systems Research 16th-18th November, Vancouver, Canada
Poster from ReBUILD’s health financing study in Sierra Leone, presented at the 4th Global Symposium on Health Systems Research 16th-18th November, Vancouver, Canada
Becoming more effective actors for evidence-based health systems policy and practice; Experiences of research, research uptake and capacity-building from the ReBUILD research programme consortium
Poster on ReBUILD’s experiences of research uptake and capacity building at national and international levels, presented at the 4th Global Symposium on Health Systems Research 16th-18th November, Vancouver, Canada.
Resources from ReBUILD’s work on health worker incentives in Sierra Leone, and on health worker experiences during the Ebola outbreak
Details of all outputs from ReBUILD’s work on health worker incentives and remuneration in Sierra Leone, and on health worker experiences during the Ebola outbreak.
Can donors really build institutions? Reflections on recent health sector experiences in Sierra Leone
Presentation made by Dr Sophie Witter at World Bank Fragility Forum panel session on “Can donors really build institutions?”. The presentation was based on experiences and research findings from ReBUILD and others from Sierra Leone’s health sector. The 2016 World Bank Fragility Forum was held in Washington on 1st-3rd March 2016. You can access and… Read more
Presentation given by Joanna Raven on ReBUILD’s work on health systems in post-conflict states, at a Workshop on Rebuilding Health in Yemen after Conflict, 4th June 2016 in Liverpool
Free health care for under-fives, expectant and recent mothers? Evaluating the impact of Sierra Leone’s free health care initiative
This paper reports the findings of a study evaluating the impact of Sierra Leone’s 2010 Free Health Care Initiative (FHCI). It uses two nationally representative surveys to identify the impact of the policy on utilisation of maternal care services by pregnant women and recent mothers as well as the impact on curative health care services and out-of-pocket payments for consultation and prescription in children under the age of 5 years.
Health care seeking behaviour and impact of health financing policy on household financial protection in post conflict Cambodia: A life history approach
This 2015 ReBUILD working paper presents the findings and recommendations from qualitative health financing research in Cambodia
Contracting health services in Cambodia: From external to internal contracting models and its implications
ReBUILD poster from 2014 – Cambodian study of the shift from external to internal contracting models and their implementation
The challenges and opportunities of conducting ethical and trustworthy qualitative research in health systems in post-conflict and fragile contexts: Reflections from a learning community
ReBUILD poster presented at the Third Global Symposium on Health Systems Research in Cape Town 2014: A qualitative study exploring how to strengthen policy and practice related to health financing and human resource management in post conflict and fragile contexts
Equity in Maternal Health Care Services in post-conflict Northern and non-conflict East-Central Uganda: A Comparative Mixed Methods Multi-case study
ReBUILD poster presented at the Third Global Symposium on Health Systems Research in Cape Town 2014: Mixed method study comparing maternal health care in post-conflict and non-conflict regions of East Central Uganda
The Impact of Health Financing Policies on Household Spending: Evidence from Cambodia Socio-Economic Survey 2004 and 2009
ReBUILD Poster presented at the Third Global Symposium on Health Systems Research in Cape Town 2014: Cambodian study measuring the combined effects of user fee and health equity fund on household health expenditure
Health seeking behaviour and impact of health financing policy on household financial protection in post conflict Cambodia: A life history approach
Poster of ReBUILD’s qualitative research on health systems financing in Cambodia presented at the Third Global Symposium on Health Systems Research in Cape Town 2014
Despite gains in life expectancy and increased health expenditure, Cambodia still lags behind neighbours in many health indicators. This article aims to understand variations in efficiency of public health services, and the extent to which changes in efficiency are associated with key health policies that have been introduced to strengthen access to health services over the past decade.
Understanding contracting in Cambodia: findings from interviews with key informants and health service managers and providers
This research report describes findings from the qualitative component of ReBUILD’s research into health contracting in Cambodia Over the last two decades, Cambodia has implemented several policy initiatives and interventions to improve health service delivery. The contracting of services in the health sector has been happening since the late 1990s. Since 2009, an internal contracting… Read more
Understanding Contracting in Cambodia The performance of contracting and non-contracting districts in extending primary health coverage: analysis of secondary data
This research report describes findings from the quantitative component of ReBUILD’s research into health contracting in Cambodia.
Presentation on health financing in post-conflict settings given by Barbara McPake at Nossal Institute of Global Health in July 2015
This brief was produced for the Zimbabwe Health Research Forum on Evidence for Advancing Universal Health Coverage in March 2015, based on ReBUILD’s health systems financing research presented at that meeting.
This 2015 brief gives a brief outline of the range of ReBUILD’s research in Cambodia, and some of the emerging key findings.
ReBUILD, together with the REACHOUT and COUNTDOWN RPC, produced this joint submission of evidence in response to a call from the UK All Party Parliamentary Group on Africa’s Inquiry on community-led health systems and the Ebola outbreak.
Impact of Health Financing Policies on Household Spending: Evidence from Cambodia Socio-Economic Surveys 2004 and 2009
ReBUILD report into impact of fees, health equity funds, subsidies & vouchers on household health spending in Cambodia.
2015 policy brief outlines findings and proposals from ReBUILD’s Rebuilding the foundations for universal health coverage with equity in Zimbabwe
Report of a ReBUILD desk study to describe the organizational, institutional & governance aspects of health financing in Zimbabwe.
2013 ReBUILD literature review on healthcare purchasing arrangements between government & (i) local government & (ii) private providers in Zimbabwe.
This document contains all abstracts from presentations made at the National Research Forum: Evidence for advancing Universal Health Coverage in Zimbabwe, held on 19th/20th March 2015 in Harare, organised by ReBUILD’s Affiliate research partners in Zimbabwe. You can download the full report from this National Research Forum from the TARSC website.
Evidence for advancing Universal Health Coverage in Zimbabwe: Report of the National Research Forum, 19th/20th March 2015
Report of the National Research Forum: Evidence for advancing Universal Health Coverage in Zimbabwe held March 2015 in Harare
Background literature review to inform field work protocol to develop a resource allocation formula for public health resources in Zimbabwe.
Desk study presenting evidence on the funds pooled in and paid by semi-autonomous institutions funding health in Zimbabwe
ReBUILD desk study from 2014 on the collection, pooling, purchasing, monitoring & governance of tax-based health financing in several African countries
Catastrophic Payments and Poverty in Cambodia: Evidence from Cambodia Socio-Economic Surveys 2004-11
This 2015 ReBUILD paper estimates the incidence and intensity of catastrophic health payments and their impoverishment effects in Cambodia
Ebola in the context of conflict affected states and health systems: case studies of Northern Uganda and Sierra Leone
Ebola seems to be a particular risk in conflict affected settings. This paper compares the experience of Northern Uganda and Sierra Leone in the emergence and management of Ebola outbreaks in 2000-1 and in 2014-15 respectively, and how elements of these conflict affected societies affected the disease outbreak and the response.
Performance-Based Financing in the context of the ‘complex remuneration’ of Health Workers – Findings from a mixed-methods study in rural Sierra Leone
Presentation by ReBUILD Affiliate researcher Maria Paola Bertone given at the International Health Economics Association Congress in Milan 15th July 2015
Fragile and conflict affected states: report from the Consultation on Collaboration for Applied Health Research and Delivery
Fragile and Conflict Affected States present difficult contexts to achieve health system outcomes and are neglected in health systems research. This report presents key debates from the Consultation of the Collaboration for Applied Health Research and Delivery, Liverpool, June, 2014.
This narrative literature review is an output of collaborative work between ReBUILD and the Stockholm International Peace Research Institute (SIPRI) working group on gender, to explore the opportunities and challenges for building gender responsive health systems in post conflict contexts.
A 2011 ReBUILD analysis of thinking, approaches, themes and findings of writing on health financing in post-conflict or fragile health systems
A 2015 RBUILD report on the need to reach and maintain incentive environments for health workers to support access to equitable health services
Produced to coincide with Universal Health Coverage (UHC) day 2014, this briefing note outlines the importance of better understanding health systems in post-conflict settings, and how ReBUILD’s work in this area can contribute towards achieving UHC
This briefing note provides a summary update of ReBUILD’s progress across the whole range of its research themes and focus countries, as of February 2015.
Following on from ReBUILD’s study of health contracting arrangements in Cambodia, which concluded that a more robust evaluation of the Special Operating Agency model should be considered, this briefing outlines two options that could be considered for such an evaluation.
This brief provides a summary of ReBUILD’s research done on health contracting in Cambodia, and identifies key points relating to the impact of the Special Operating Agency (SOA) model on service coverage and equity.
Building gender responsive health systems in post-conflict contexts: Opportunities and challenges Presentation given at a Global Health, Policy and Practice session 7 March 2014 Read the full presentation
2015 presentation entitled ‘Current work of ReBUILD: Research for Building pro-poor health systems in the aftermath of conflict’
ReBUILD presentation from 2013 on health systems in conflict-affected states
ReBUILD consortium presentation from 2013 on contracting in conflict-affected settings: evidence from Cambodia
A REBUILD consortium Country Situation Analysis for Uganda from 2011
A REBUILD consortium Country Situation Analysis for Sierra Leone from 2011
In this paper published in Health Policy and Planning, ReBUILD researchers Sophie Witter, Haja Wurie and Maria Bertone explore the effects and implications for health staff of Sierra Leone’s introduction in 2010 of the Free Health Care Initiative (FHCI).
As part of ReBUILD’s wider work on health financing, this paper presents an exploratory literature review to analyse the themes and findings of recent writing on health financing in fragile and post-conflict settings.