Global Health Watch 1 in one file

to raise an amount of tax revenue that is at least 20% of their GDP. Success
in mobilizing public finance for health will then depend on the negotiating
skills and credibility of the Ministry of Health, as well as an ability of social
movements and other non-government actors to make effective demands on
the political system. Civil society must also be encouraged and supported to
monitor government budgetary allocations.
Financing health for all Health financing policies should aim to create a
single national pool of funds, with the capacity for cross-subsidization between
Box B1.8 Millennium Development Goals for the financing of
health care systems
The health-related MDGs have mostly been formulated in terms of outcome
indicators. These are important, but do not chart a path to achieve the outcome
goals. The following suggested targets for health systems financing
may serve to explore how to map out such a path:
• countries to raise the level of tax revenue to at least 20% of their GDP;
• public health expenditure (including government and donor finance) to
be at least 5% of GDP;
• government expenditure on health to be at least 15% of total government
expenditure;
• direct out-of-pocket payments less than 20% of total health care expenditure;
• expenditure on district health services (up to and including Level 1 hospital
services) at least 50% of total public health expenditure, of which
half (25% of total) should be on primary level health care;
• expenditure on district health services (up to and including Level 1
hospital services) at least 40% of total public and private health expenditure;
• a ratio of total expenditure on district health services in the highest
spending district to that of the lowest spending district of not more than
1.5.
These indicators would complement service output and outcome indicators
such as immunization coverage, rates of skilled attendance at
deliveries, TB completed-treatment rates, and maternal, peri-natal and
child mortality rates.
Approaches to health care
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