This research project investigates how governments can generate more of their own national resources for health and reduce their dependence on donor funding, which can be both unstable and unsustainable.
Case studies in Nigeria, South Africa and Kenya, document country experiences of increasing the effectiveness of their tax collection services and investigate how this has contributed to increased health sector spending.
Governments in Kenya, Lagos State (Nigeria) and South Africa have increased domestic tax revenue by expanding the tax base and improving the efficiency of tax collection systems. Specific efforts have been made to reach the informal sector by taxing businesses (in Kenya) and reaching informal trade associations (in Nigeria). Political support to tax policy reforms and the tax collection agencies led to additional funding for their operations and strengthened human resource capacity.
Despite achievements in raising tax revenue, the share of government spending allocated to the health sector has not increased. A critical challenge for Ministries of Health is to make a better case for health during budget negotiations, and to demonstrate the social and economic benefits of health investments.
Read the full key findings sheet
Publications and resources
- RESYST Working Paper 1 (2012): Fiscal Space for Health
- Topic overview (2013): Fiscal Space for Health
- Research overview: Increasing domestic public funding for health
- RESYST Working Paper 6 (2014): Increasing tax revenue and its impact on financing public health care in South Africa
- Policy brief (2015): Raising domestic resources for health: can tax revenue help fund Universal Health Coverage?
- Webinar (2016): Can improved tax collection systems boost public funding for health?