Development partner influence on domestic health financing contributions in Senegal

A mixed-methods case study

Datos Bibliográficos

ID16762875
AutoresFrederik Federspiel (0000-0002-4295-0827, Department of Global Health and Development, London School of Hygiene and Tropical Medicine , 15-17 Tavistock Place, London WC1H 9SH,, autor de correspondencia), Josephine Borghi (0000-0002-0482-5451, Department of Global Health and Development, London School of Hygiene and Tropical Medicine , 15-17 Tavistock Place, London WC1H 9SH,), Elhadji Mamadou Mbaye (Université Gaston Berger), Henning Tarp Jensen (0000-0003-4526-458X, Department of Global Health and Development, London School of Hygiene and Tropical Medicine , 15-17 Tavistock Place, London WC1H 9SH,), Melisa Martinez-Alvarez (0000-0003-4020-7527, London School of Hygiene & Tropical Medicine), Melisa Martínez Álvarez (Department of Global Health and Development, London School of Hygiene and Tropical Medicine , 15-17 Tavistock Place, London WC1H 9SH,)
Año2025
Volumen40
Número3
Páginas300-317
Fecha de publicación2025-03-07
Peer ReviewedSí
Open AccessSí
TipoARTICLE
RevistaHealth Policy and Planning (JOURNAL)
Identificadores de la revistaISSN: 0268-1080 • E-ISSN: 1460-2237
EditorialOxford University Press (PUBLISHER • GB)
DOI10.1093/heapol/czae110
PMID39570321
OpenAlexW4404572392
IdiomaEN
Citas recibidas2
Referencias citadas73

Sustainable and equitably contributed domestic health financing is essential for improving health and making progress towards Universal Health Coverage (UHC) in low- and middle-income countries. In this study, we explore the pathways through which development partners influence the combination of domestic health financing sources in Senegal. We performed a qualitative case study that comprised 32 key stakeholder interviews and a purposive document review, supplemented by descriptive statistical analysis of World Health Organization and Organization for Economic Cooperation and Development data on health financing sources in Senegal. We developed a novel framework to analyse the different mechanisms and directions of development partner influence on domestic health financing contributions. We identified development partner influence via four mechanisms: setting aims and standards, lobbying/negotiation, providing policy/technical advice, and providing external financing. Overall, development partners worked to increase tax-based government contributions and expand Community-Based Health Insurance (CBHI), which is seemingly equity enhancing. Fungibility and intrinsic equity issues related to CBHI may, however, limit equity gains. We encourage stakeholders in the health financing sphere to use our framework and analysis to unpack how development partners affect domestic health financing in other settings. This could help identify dynamics that do not optimally enhance equity and support progress towards UHC to help achieve more coherent policy-making across all domains of development partner activities in support of UHC. Future research should investigate the role of international creditors, lending, and loan conditionalities on domestic health financing in recipient countries, including equity implications

Business · Developing country · Economic growth · Economics · Public economics · Finance · Global Health Care Issues · Global Maternal and Child Health · Healthcare Systems and Reforms