Innovative, Sustainable Financing of Primary Health Care through Social Health Insurance

The session will convene high-level policymakers, country implementers, technical partners and development actors to examine how Social Health Insurance can be designed and implemented to provide predictable, equitable and sustainable financing for PHC and community health services. It will move beyond broad advocacy to identify concrete reforms in pooling, benefit design, strategic purchasing, provider payment, digital systems and accountability that countries can adapt to strengthen PHC as the foundation of UHC.

3. Specific Objectives

      i.         Reframe PHC and community health financing as a strategic investment in UHC, equity, health security and human capital.

     ii.         Showcase country-level reforms in Social Health Insurance. Highlight how Kenya, Rwanda, Tanzania, Senegal and Ethiopia are adapting SHI frameworks to finance PHC and community health services, with attention to practical innovations and measurable outcomes.

    iii.         Explore mechanisms that advance equity in community health delivery. Examine how benefit package design, subsidization, governance and provider payment can ensure poor, rural and informal-sector populations are included and protected from out-of-pocket costs.

   iv.         Examine pooling, purchasing and payment reforms. Discuss how countries are reducing fragmentation, integrating PHC into insurance pools, and using strategic purchasing to finance CHW remuneration, supervision, commodities, referrals and performance-based incentives.

     v.         Assess the role of digital tools and accountability systems. Explore how household registration, claims processing, expenditure tracking, supply chain systems and performance data can strengthen transparency, scale and resilience.

   vi.         Draw cross-country lessons for scale and institutionalization. Identify transferable strategies for embedding PHC and community health as explicit, contracted and sustainably financed services within SHI, and agree on practical next steps for policymakers, financiers and implementing partners.