Ethiopia implemented the Health Financing Progress Matrix, WHO’s standardized qualitative assessment of health financing systems, to contribute to the refinement of health financing policies and strategies with the aim of accelerating progress to UHC. A first assessment was initiated using version 1.0 in 2019, with subsequent updates based on version 2.0 released in December 2020. This summary report of findings and recommendations, highlights current areas of strength and weakness in Ethiopia’s health financing system, together with priority areas where shifts need to be made to accelerate progress to UHC.

The UHC Partnership (UHC-P) is a collaborative agreement between WHO, several donors (namely: the EU, the Grand Duchy of Luxembourg, Irish Aid, the Government of Japan, the French Ministry for Europe and Foreign Affairs, Germany, Canada, Belgium and the UK Department for International Development) and a number of partner countries (currently, 125 partner countries across all six WHO regions) to support policy dialogue on national health policies, strategies, and plans (NHPSPs) and UHC -and it is part of the WHO Special Programme on Primary Health Care (SP-PHC). Its overall objective being to improve health sector results in concerned countries, it aims at building country capacities (and strengthening country processes) for the development, negotiation, implementation, monitoring and evaluation of robust and comprehensive NHPSPs with a view on promoting UHC; health in all policies; and people-centered primary care -as indeed, investments in quality primary health care (PHC) will be the cornerstone for achieving UHC around the world. The purpose of this publication is to document accomplishments of the UHC-P in 2022 for the 125 partner countries. The annual UHC-P report serves as a single report to all nine donors supporting the Partnership. It will provide a synthesis of activities and results achieved in all the participating countries; present a range of country examples related to the major areas of work; and also elaborate on how the UHC-P achieved sustainable buy-in of partners and stakeholders at the country level in the different countries concerned.

This document outlines the background to and design of the Health Financing Progress Matrix (HFPM), WHO’s standardized qualitative approach to assessing country health financing systems. Primarily qualitative in nature, but drawing on extensive quantitative indicators, the HFPM assesses a country’s health financing institutions, processes, policies and their implementation, against good practice in the context of universal health coverage (UHC). Benchmarks are defined in terms of nineteen desirable attributes, which crystallize evidence about what works in health financing in order to make progress to UHC. The paper also details a number of processes which govern the implementation of the HFPM in countries, to ensure the results are objective and credible. While health financing is only one of the core functions of a health system, it significantly influences both the extent to which the population can access health services, as well as the extent to which they face financial hardship in the process. Through a forward-looking design, the HFPM not only assesses the current situation in a country, but also makes clear recommendations of priority directions for policy and implementation, both accelerating progress towards UHC, and helping to build resilience across the health systems.

This report summarizes the findings of the Health Financing Progress Matrix assessment for Zambia. Recognizing the remarkable progress towards UHC made by the country over the past twenty years, the report also highlights weaknesses in the current health financing system and, extending from this, those priority issues to be addressed in order to further accelerate Zambia’s progress towards universal health coverage (UHC). Specifically, the report notes the importance of sustaining levels of public funding for health, progressively reducing reliance on external funding, and reinforcing the provision of free services in primary care facilities. Further recommendations include the need to accelerate the shift from passive to strategic purchasing, and institutionalizing shifts in the public financial management system to ensure that adequate operational funds reach frontline service providers in a timely fashion. Finally, the duplication in benefits across the budget-funded EPHS, the National Health Insurance Scheme, and some services provided through vertical disease programmes need to be addressed, for example through the establishment of a unified benefits framework. The latest information on Zambia’s performance in terms of UHC and key health expenditure indicators are also presented. This report is intended both to inform current health financing policy, and to provide a baseline for the future monitoring of Zambia’s progress in developing and implementing UHC-oriented health financing reforms.

This report provides a concise summary of the Health Financing Progress Matrix assessment in Georgia, where WHO has a long engagement on health financing issues. The report was conducted using a highly participatory process, including robust discussion with the MoH. In addition to identifying strengths and weaknesses in Georgia’s health financing system, priority areas are highlighted in order to drive progress towards UHC. The latest data on key health expenditure, financial protection, and service coverage indicators are presented. The final report will be released with the date 2023. Detailed responses to individual questions are available on the WHO HFPM database of country assessments or upon request.