Office of the UN Secretary-General’s Special Envoy for Health MDG Financing and Malaria
New York, United States
Community Health Financing Support Unit Overview
In early 2015, UN Special Envoy Ray Chambers and Prime Minister Hailemariam of Ethiopia convened a high-level group to assess financing and scale-up of Community Health Worker (CHW) programs in Africa, given chronic underinvestment in this area. At the Financing for Development event in July, the group launched a report that outlined the case for investment in CHWs, existing and new CHW financing mechanisms, pathways for financing CHW programs, and principles of best-practice CHW systems.
The report recommended creation of a ‘Financing Support Unit’ to help countries access financing for CHW systems, given the complexity of the funding landscape, the challenges of utilizing domestic resources, and the difficulty of capitalizing on available funding opportunities. This support unit would need to tackle such issues as wage bill and domestic fiscal space limitations. This Financing Unit would also be charged with identifying and tapping into private sector financing and developing new, creative and ‘out of the box’ models of ‘blended’ financing that combine domestic and international support with private sources of capital, including from corporations.
The notion of a financing support unit has been subsequently broadened to also provide scale-up strategy support and serve in a knowledge management capacity. This technical support would be provided by senior global health and financing advisors contracted by the FSU, whose work would be overseen by FSU’s co-directors (Financing Director and Technical Support Director).
Current members of this initiative include the Governments of Ethiopia and Liberia, CHAI, UNICEF, Partners in Health, Last Mile Health, the World Bank, the Office of the UN Special Envoy for the Health MDGs, the MDG Health Alliance, and Johns Hopkins University. A Board of eminent global health leaders guides the FSU’s work and a Technical Advisory Group composed of the current members of the initiative provides leadership and guidance on the overall direction.
The FSU kicked off its activities in January 2016 with a pilot financing project in Liberia. During year one, the FSU also intends to provide scale up strategy support to 1-2 additional countries, develop thought leadership by conducting case studies on how countries such as Ethiopia and Nepal have financed their CHW programs in the past, document existing funding flows from donors and national governments into community health, and assess options to manage such challenges as ‘wage bill’ limitations. Details on the FSU and its year one activities have been elaborated in a business plan.