Revenue generation

Purpose

Revenue generation strategies identify resources to be mobilized to enhance sustainability. These approaches also help to build resilience.

Revenue generation in health systems focuses on developing detailed investment cases to advocate for additional funding, providing a detailed analysis of the imposition of a particular charge or tax. Funding could be from within countries’ own available funding or from external sources.

When a country is experiencing an economic downturn, a strong case may need to be made that budget cuts within other government departments are not applied with the same vigour in the health system. Revenue generation should also ensure that patients payments for medicines and other services are captured completely within the existing finance systems.

UNDP’s approach

To support revenue generation for health programmes, UNDP does the following:

  • It supports ministries of health to build political commitment to improve financial revenue generation for health programmes.
  • It works closely with the World Health Organization (WHO) and the Joint United Nations Programme on HIV/AIDS (UNAIDS) to support the development of investment for increased funding to the health sector, and specific disease programmes. This includes through the development of investment cases for non-communicable diseases and expanding innovative financing for HIV and health.
  • It works with in-country partners to consider the best “blend” of financing to deliver services and consider the options for government financing and partners, to make the optimal investment in national programmes.
  • It looks at existing and future sourcing for health finance, and together with partners, prepares detailed analyses of the impact of: health insurance; a disease-specific payroll tax; sugar and/or tobacco consumption taxes; and/or out of pocket charges as a deterrent to accessing services.
  • It works with governments and civil society organizations to develop systems and processes that increase the accountability and transparency within a health system or project. This can directly result in enhancing the ability to attract and work with donors and partners, to build the confidence of decision makers and parliamentarians and increase accountability to the general public and end users.
  • It develops capacities of national entities in fragile settings to sustainably manage domestic and international health financing and to deliver health programmes.

Suggested capacity development indicators

Suggested indicators to monitor activities to enhance revenue generation include:

  • A resource mobilization plan has been developed
  • Policies for new revenue streams have been developed and approved
  • A plan to ensure the sustainable funding of health reform is approved
  • Domestic financing for health increases by a certain percentage.

Key resources

Earmarking for Health: From Theory to Practice
World Health Organization
This checklist can guide when earmarking might be useful and how to structure an earmarking policy to ensure positive results and minimize distortions.
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