Domestic resources are by far the biggest source of financing for health services in all countries, regardless of income level. Most low- and lower-middle-income country governments have pledged to increase public expenditure on health as a share of overall public expenditure to 15%. Progress towards this target is vital: government spending on health is below this level in many countries, mostly in Africa and Asia.136
The Africa Health Budget Network recently analysed the 2015 Open Budget Survey. Looking at 27 countries in sub-Saharan Africa, it found the majority were reasonably transparent about health budgets, but far fewer were transparent about actual spending – or outcomes. And while half the countries communicated budget information well, only Kenya, Rwanda and South Africa allowed the public to participate in the budgeting process.
The Global Financing Facility (GFF) in support of EWEC was launched in 2015 by the UN, in partnership with the World Bank Group (see Box 4). It is the financing arm of EWEC, and aims to close the financing gap for reproductive, maternal, newborn, child and adolescent health and nutrition (RMNCAH-N) by making more efficient use of existing resources, raising additional domestic resources (public and private) and further mobilizing and better coordinating external assistance. By the end of 2016, 16 of 62 eligible countries were receiving GFF support.