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Primary Healthcare Spending: Striving for Equity under Fiscal Federalism

Okore Apia Okorafor

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The geography of healthcare financing is important in addressing inequities and inequalities in population health. This is particularly true in developing countries where there are significant disparities in socioeconomic and health status between regions. Many countries, however, are adopting a fiscal federal system, in which decision-making about the use of state financial resources is granted to lower levels of government. What impact does this have on the equitable distribution of resources to primary health care? Decentralization has the potential to improve the efficiency of health service delivery and speed up the response to community needs, but are sufficient funds being allocated to where they are most needed?

This book highlights key factors that can help to achieve equity in the allocation of primary healthcare resources within fiscal federal systems and decentralized health systems in general. It explores a wide range of ways of spending found in fiscal federal systems around the world and how they influence the equitable distribution of primary healthcare resources. Although South Africa is used as a case for discussion, the issues raised in the book are relevant to all countries operating under a fiscal federal system and those that operate a decentralized health system.

Primary Healthcare Spending is an important reference for policymakers in health organizations, researchers in the field of health policy and health economics, agencies involved in providing support to health systems, and students in the area of health administration and health policy.

The author

Okore Apia Okorafor is a health economist currently working in the private medical industry (Medi-Clinic Southern Africa). He completed his PhD at the University of Cape Town, South Africa, where he was a lecturer and researcher in health economics for several years. He also has experience in providing technical support around equitable resource distribution to various ministries of health in Africa.