Blended Finance for Universal Health Coverage
The Africa Health Agenda International Conference (AHAIC) is an African-led biennial global health convening hosted by Amref Health Africa. The conference brings together diverse stakeholders to accelerate progress toward Universal Health Coverage (UHC) and collectively chart a course forward by highlighting and seeking to address Africa’s most pressing health challenges. The second two-yearly conference took place this year from March 8-10, virtually. Amref Netherlands, in collaboration with Total Impact Capital and the Health Finance Coalition organised an interactive session about Blended Finance for UHC. An overview was given of the importance of blended finance, how it can be structured and how it can contribute to improving healthcare for all. Following the introduction, concrete case studies highlighted different innovative financing solutions.
Africa faces a massive health financing gap. US$240 billion additional global spending is needed annually to achieve SDG 3 (good health & well-being) and UHC. It is no surprise that there is a critical need to step-up long-term investments in healthcare to accelerate the pace towards achieving UHC. Many African countries, however, have limited capacity to make these investments. Where private sector innovations (for profit and not–for–profit) can bring the capacity to improve healthcare service delivery, innovative financing structures, incorporating private return seeking capital, can bring the capacity to finance them.
There are multiple barriers to blended finance that must be overcome so private capital can help achieve UHC. Potential partners like governments, donors, investors, and operators have different targets, agendas and processes. It is key to align and construct an impactful deal to meet sustainable health goals. There is a need to target lower, risk-adjusted returns to serve segments of the market where the need is the greatest. The high impact and high-risk profile of inclusive healthcare projects require innovative blending of different sources of financing.
African Private Healthcare Initiative
One of the case studies was presented by the Medical Credit Fund: ‘The Open Doors African Private Healthcare Initiative.‘ The Health Finance Coalition mobilized a US$19.7 million loan guarantee facility unlocking US$35.5 million in emergency loans for 1,600 small and medium enterprise (SME) healthcare providers in Ghana, Kenya, Nigeria, Tanzania, and Uganda through the Medical Credit Fund. 5.1 million patients are benefitting from this initiative, with 56% of patients reached being in the low, or very low-income segment.
Partnership for Primary Care
Another case study was the Partnership for Primary care, a collaboration between the Kenyan Government, FMO, Amref Health Africa, and Royal Philips. This partnership aims to revolutionize the delivery of public primary care in a financially sustainable manner. A 12-year public-private partnership contract structures for long term collaboration, sharing risks and responsibilities. The model will be financed with a blend of government budget, equity, a loan, and donor funding to close the viability gap.
Within the FINISH Mondial programme, we work with a multi–stakeholder approach. Local financiers, local governments, entrepreneurs, and communities all partner for safe sanitation. By mobilising the supply side of sanitation while integrating financial resources into the value chain, the programme raises awareness on and creates a demand for sanitation services amongst end-users. Since the start of the programme in India (2009) and Kenya (2013), 5.6 million people have enjoyed the benefits of safe sanitation, with households investing €165 million in sanitation improvements. About half of sanitation loan clients are first time bankers, and more than half are women.