Financing Primary Health Care in Low-Income Countries: Models and Best Practices.

Abstract

Low-income countries in Africa and Asia face a health crisis due to limited access to care, high infant and maternal mortality, and the prevalence of infectious diseases, exacerbated by socio-economic factors and inadequate health personnel. The study analyzes the effectiveness and sustainability of primary healthcare (PHC) financing models, often reliant on external aid, and confronted with limited public budgets and high out-of-pocket payments. The objective is to analyze primary healthcare financing models in low-income countries and identify best practices to ensure universal and equitable access to care. A mixed-methods approach based on literature review was adopted to conduct this research. Some examples from the findings include:

• In Haiti, approximately 60% of health expenditure is financed by international donors;


• Around 40 to 60% of health expenditure in sub-Saharan Africa comes from direct patient payments;


• Community-Based Health Insurance (CBHI) in Ethiopia: Covers 80% of medical costs, allowing low-income households access to care in exchange for affordable contributions.

The main financing models (international aid, out-of-pocket payments, public funding, health insurance, PPPs, PBF) each present drawbacks. The discussion confirms that universal health coverage improves access, dependence on aid undermines sustainability, and a larger national budget improves quality. In conclusion, sustainable and equitable financing of PHC requires a mixed approach combining increased state commitment, expanded social protection, and coordinated international cooperation.