Table 2.

The Commission's vision of financing functions and arrangements for PHC that is people centred and equity driven

	Mobilisation	Pooling	Allocation	Purchasing
People-centred characteristics	Resource requirements for PHC should be estimated based on what is needed for each person to access; PHC that is people centred as defined in the country's context	Everyone is included in the pool	Resources are allocated based on population needs for PHC that is people centred (rather than on facilities, inputs, or vertical programmes)	Purchasing arrangements and provider payment mechanisms are linked to making PHC that is people centred available to people and flexible enough to accommodate different modes of delivery; funds flow to and are managed by frontline providers as defined in the country context
Equity and progressive universalism characteristics	Revenue-raising mechanism is defined based on ability to pay and is progressive	Cross-subsidisation occurs between poor and wealthy populations and healthy and sick populations; use of pooled funds prioritises making PHC accessible, with financial protection and subsidies directed to the poor	The mechanism used to allocate public funds prioritises the needs of the poorest segments of population, and areas (geographical or health) of greatest need	Per capita payment (capitation) is the starting point, which makes the same amount of funds available to providers to deliver the PHC package for each person (adjusted upward or downward according to health needs)
Practical implications and anticipated outcomes	Reduces out-of-pocket expenditure; progressive taxation policies	Merge or consolidate existing pools into larger pools (including formal and informal sectors, poor and rich; coverage dominated by public financing); who and what are covered by the pool expands in the most equitable and PHC-centric way; progressively move to universal health coverage according to the macro-fiscal capacity of the country, starting with access to PHC for all and financial subsidies directed to the poorest and most vulnerable; access to more services beyond PHC and subsidies for more population groups can expand as macro-fiscal capacity expands	Budgeting is based on needs-based per capita allocations to enable access to PHC that is people centred (rather than to facilities, inputs, or vertical programmes); protect resources going to PHC through existing policy tools, such as programme budgets, resource allocation formulae, conditional grants or statutory rules; define a benefit package that prioritises coverage of the needs of poorest segments of population; ensure resources reach frontline providers (through direct facility financing, for example) and improve public finance management systems more broadly; organise service delivery to pull resources to PHC, for example by creating new cadres of frontline PHC providers, defining explicit service standards, or instituting effective referral systems	Establish a blended payment model with capitation at its core: start with a baseline capitation payment . The payment amount should be determined using a formula that links the payment parameters (base per capita rate, number of enrolees linked to the provider, and any individual or provider-level adjustments) to a defined package of PHC services; define a PHC package; adjust the risk level to prioritise those in greatest need

PHC=primary health care.