Towards a new compact for health financing in Lao People's Democratic Republic.

Abstract

Inadequate or ineffective health financing poses a significant challenge to the Government of Lao People's Democratic Republic's goal of achieving universal health coverage by 2030. Here we explore possible application in the Lao context of the Center for Global Development's New Compact approach, including locally-led evidence-informed prioritisation, domestic financing and consolidated supplementary aid. Using WHO's political economy analysis guide we identify opportunities and barriers and propose a road map towards implementation of the New Compact. This includes firstly, increasing local capacity and systems to generate and use evidence in policy and resource allocation decisions, starting with specific use cases related to the Essential Services Health Package and vaccines portfolio. Secondly, shifting available domestic resources to highest priority services, including at the primary health care level, based on deeper understanding of existing funding and where efficiency, cost-effectiveness and equity can be optimised. Thirdly, improving government and donor coordination aligned to national priorities and gradually increasing funds pooling as feasible.