Table 1 Future HIV financing options for PNFPs
Option | Current status | Government action required | PNFP action required |
|---|---|---|---|
Direct Government funding of services and/or centralized HIV/AIDS Fund [2, 6, 10] | Inadequate resources and inadequate budget allocation | • Streamlined, transparent public- private partnership (PPP) frameworks for health • Long term budget commitment • Engagement of donors for medium term budget support • Innovative tax/revenue collection and allocation measures • Stronger accountability and performance/quality measurement systems | • Systems to meet minimum public private partnership guidelines • Less vertical /“silo” based programs • Health system wide capacity building • Quality Assurance and Performance measurement systems |
In discussion | • Stakeholder involvement; generating a consensus on nature and scope of coverage • Fund management capacity • Governance, accountability and confidence building • Legislation and regulation | • Definition and implementation of systems to meet minimum NHIS requirements for PNFP providers • Capacity building for NHIS compliance • Quality Assurance and Performance measurement systems | |
Out-of-Pocket Service | Currently funds 50 % of health care [32] | • Stronger accountability and performance/quality measurement systems • Direct cash transfers | • Quality Assurance and Performance measurement systems |
Very low coverage, inadequate regulation | • Stronger Regulation • Stronger accountability and performance/quality measurement systems | • Creating an attractive business proposition for private insurance firms • Creating systems to meet minimum private health insurance company requirements | |
Community Health Insurance Schemes [11] | Very low coverage, inadequate regulation | • Legislation and regulation | • Community engagement and confidence building • Community accountability mechanisms • Differentiated care for scheme members |
Co-Payment to subsidize overall costs of care | Used mainly by faith based organizations and NGOs, but little documentation on coverage and best practices | • No additional legislation and/or regulation | • Creating capacity to manage and report separate (paying and non-paying client) income streams • Mobilizing paying and non-paying client support • Mobilizing external stakeholder (eg donor and government) support • Maintenance of standard quality care for all clients |