Table 4 Measures those national authorities should take to mitigate any negative effects of possible reduction in funding for health

Reinforce external partnership for resource mobilization

(a) Mobilize more external resources for health; (b) the government needs to be more proactive by working with donor/partners to estimate the possible effects of the global financial crisis achievement of the Millennium Development Goals; (c) the sector should engage global health initiatives to expand the scope of their funding to health systems development.

Reinforce domestic resource mobilization

(a) Explore other complementary financing mechanisms, e.g. social health insurance, community based health insurance; (b) households contributions through available schemes; (c) introduce standard fee for medication, while consultation remains free of charge at the point of delivery; (d) the need for government to improve upon tax revenue collection, especially major source of funding for National Health Insurance Fund is tax revenues, e.g. Ghana; (e) the sector should explore avenues for non traditional sources of funding by engaging more in public-private partnership at global and national levels; (f) request for banking credit to implement health priority health programmes that cannot be postponed.

Enhance advocacy

(a) Respect the Abuja Head of State commitment to allocate at least 15% of national budget to health; (b) advocacy for sustaining, if not increasing funding for health, which is necessary prerequisite for economic development.

Improve safety nets for health services

Continue to subsidize medicines

Improve planning, budgeting, monitoring and evaluation

(a). Money allocated to health should be available and utilized for health; (b) Monitor implementation of the poverty reduction strategy.

Improve efficiency

(a) Focus on priority public health interventions at primary level, including scaling up of health promotion and prevention; (b) reprioritize the use of funds; (c) reallocate resources from low priority sectors to high priority sectors like health; (d) focus on crucial health system inputs, e.g. health workforce, medicines, equipment maintenance; (e) halt new constructions or upgrades of infrastructure; (f) improve technical and allocative efficiency within the sector to ensure that the ministry gets value for value for all the limited resources spent; (g) pooled procurements.

Strengthen health facility management

Improve management capacities for health facilities at all levels