Institute of Tropical Medicine and International Health, Charité - Universitätsmedizin Berlin, Augustenburger Pl. 1, 13353, Berlin, Germany.
Evidence-Based Public Health, Centre for International Health Protection, Robert Koch Institute, Nordufer 20, 13353, Berlin, Germany.
Global Health. 2023 Jun 20;19(1):39. doi: 10.1186/s12992-023-00942-9.
Over the past three decades, there has been an unprecedented growth in development assistance for health through different financing models, ranging from donations to results-based approaches, to improve health in low- and middle-income countries. Since then, the global burden of disease has started to shift. However, it is still not entirely clear what the comparative effect of the different financing models is. To assess the effect of these financing models on various healthcare targets, we systematically reviewed the peer-reviewed and gray literature. We identified 19 studies and found that results-based financing approaches have an overall positive impact on institutional delivery rates and numbers of healthcare facility visits, though this impact varies greatly by context.Donors might be better served by providing a results-based financing scheme combining demand and supply side health-related schemes. It is essential to include rigorous monitoring and evaluation strategies when designing financing models.
在过去的三十年中,通过不同的融资模式,包括从捐赠到基于成果的方法,为改善中低收入国家的卫生状况提供了前所未有的发展援助。从那时起,全球疾病负担开始转移。然而,不同融资模式的相对效果仍不完全清楚。为了评估这些融资模式对各种医疗保健目标的影响,我们系统地回顾了同行评议和灰色文献。我们确定了 19 项研究,发现基于成果的融资方法对机构分娩率和医疗设施就诊次数有总体积极影响,但这种影响因背景而异。提供一个将需求和供应方与健康相关的方案结合起来的基于成果的融资方案,可能会使捐助者受益更多。在设计融资模式时,必须包括严格的监测和评估策略。