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Financing
Overview
Health financing is a core function of health systems that supports progress towards universal health coverage (UHC) by improving both service coverage and financial protection. It comprises three key functions: (i) revenue raising, including government budgets, prepaid insurance schemes, out-of-pocket payments and external assistance; (ii) pooling of funds to spread financial risk across populations; and (iii) purchasing of services, referring to how resources are allocated to health providers. These functions are operationalized through national health and social financing schemes, within which the inclusion of rehabilitation is essential to ensure sustainable access.
In many countries, rehabilitation remains insufficiently integrated into health financing arrangements. This often results in limited public investment, with a mismatch between available services and population needs. As a consequence, individuals frequently bear high out-of-pocket costs, making rehabilitation unaffordable for many who need it. In addition, reliance on external donor funding can further constrain the continuity and long-term sustainability of rehabilitation services.
Relevant resources
Rehabilitation in health financing: opportunities on the way to universal health coverage
Health financing is central to achieving UHC by enabling access to needed services, protecting people from financial hardship, and supporting quality care. Yet, how health financing can be effectively applied to rehabilitation remains insufficiently understood. This resource responds to that gap by examining the distinctive features of rehabilitation services, reviewing current financing approaches, and identifying key challenges and opportunities. It offers practical, policy-relevant guidance to support countries in strengthening the financing of rehabilitation within their health systems.
Despite substantial and growing need, rehabilitation is often underprioritized in health financing arrangements, resulting in limited public investment, gaps in service availability, and high out-of-pocket costs for individuals. The resource explores how rehabilitation can be better integrated across the core functions of health financing, revenue collection, pooling and purchasing, and draws on evidence and country experience to inform action. It is designed to support both health financing and rehabilitation stakeholders to make informed decisions that improve access to affordable, quality rehabilitation services.
Tracking rehabilitative care expenditure under the System of Health Accounts 2011
A strong foundation for decision-making on rehabilitation financing is knowing what is financed, by whom, and how much. Tracking rehabilitative care expenditure under the System of Health Accounts 2011 is a Technical Note developed as a supplement to the SHA 2011 framework to support this critical early step. It provides additional guidance to improve the identification, classification and measurement of ‘Rehabilitative Care’ expenditure, building on the existing HC.2 classification. Aimed primarily at national and subnational health accounts teams, and also relevant to rehabilitation stakeholders, including ministry of health focal points, it promotes closer collaboration to strengthen the precision and standardization of rehabilitative care expenditure data. The note clarifies definitions and boundaries, addresses common challenges, and offers practical approaches to data collection, mapping and analysis. By improving the accuracy, consistency and policy relevance of expenditure tracking, it supports more informed planning, resource allocation and monitoring of rehabilitation within health systems.
Using the Package of interventions for rehabilitation in Georgia
The Package of interventions for rehabilitation (PIR) outlines the most essential interventions for rehabilitation for 20 health conditions, together with information on the required material resources and workforce that is usually skilled to deliver these interventions. As such, the PIR presents an indispensable resource for countries when planning for and budgeting the integration of rehabilitation services into their health systems. This report illustrates the use of the PIR in developing a first rehabilitation service package in Georgia. It demonstrates how the PIR was used to prioritize the target population for this service package, as well as how information on interventions for rehabilitation was used to define the service package, and how the costing of it was informed. Insights into the steps that were taken to implement the service package are also described. Together with the lessons learned from these processes, this report provides valuable information on how countries can use the PIR when developing a rehabilitation service package and the practical aspects to be considered during implementation.