Since the inception of the GFF, supporting health financing reforms has been a critical part of its mission. The core objectives of the GFF's health financing agenda are to increase both, the volume and efficiency of domestic public resources for health. The GFF strives to increase domestic allocation for health in countries where fiscal space exists, and to improve the efficiency of health funding in all countries that it supports. The macro-economic shocks from COVID-19 and the war in Ukraine have constrained already stretched budgets. They have increased the emphasis on efficiency and brought equity concerns to the forefront. Finally, primary health care (PHC) financing underpins the GFF's approach to health financing; PHC is not only efficient and effective, but also equitable.

As part of its country engagement model, the GFF helps countries identify needed health financing reforms, prioritize them through the development of national investment plans and national health strategies, and support reform implementation. The GFF has six core HF indicators to track country-level progress on the health financing agenda across the portfolio, and additional country-specific indicators depending on their specific health financing reforms.

The below graphs provide a visual narrative of the health financing situation in GFF countries. They are intended to strengthen the understanding of the health financing system in each country by comparing it with peers, and / or their trend over the last decade.

The first two blocks - on economic growth, and public expenditure & prioritization of health - indicate whether fiscal space exists to raise domestic health spending, and if that has translated to prioritization of health in the Government's budget. The next two blocks - on health expenditure and PHC spending - highlight the efficiency and equity of health financing systems. High share of out-of-pocket spending (OOPS) raises efficiency and equity concerns, while high share of external financing indicates sustainability issues. Finally, the last two blocks - efficiency of health spending and financial protection - focus on outcomes. The purpose is to show whether the health financing system (described by the first four blocks) translates to lower infant mortality and better financial protection.