The Central African Republic (CAR) Government has made important strides in improving the health of its people over recent years. However, persistent challenges remain: a shortage of health workers, a limited number of health facilities – especially in rural areas – and constrained funding continue to hamper access to essential health services. The burden of communicable diseases such as malaria, respiratory infections, and diarrheal diseases remains high, with children and vulnerable populations bearing the brunt. Maternal and child mortality rates are still among the highest in the region.
To address these challenges, the Ministry of Health and Population (MOHP) of CAR has launched a series of evidence-based reforms focused on strengthening the primary health care (PHC) system, with an emphasis on improving Sexual, Reproductive, Maternal, Neonatal, Child, and Adolescent Health (SRMNCAH) services. A key partner in this journey has been the Financing Alliance for Health (FAH), which has supported CAR in driving systemic change and aligning financing with health priorities.
Enhancing Resource Mobilization for PHC and SRMNCAH
In collaboration with FAH, the MOHP undertook several critical initiatives aimed at improving the financial foundation of the health system:
Costing Analysis for HIV, TB, and Malaria
FAH supported a comprehensive costing exercise for Global Fund-supported diseases to inform integrated screening and diagnostic campaigns. Evidence from similar settings suggests that such integration could generate $42 billion in cost savings and a return on investment of 1:19, strengthening the case for continued donor and domestic investment in PHC.
Operational Planning and Partners Coordination Manual
To enhance strategic alignment across stakeholders, FAH helped develop a procedure manual that embeds the “One Plan, One Budget, One Report” approach and Lusaka Agenda guiding principles. The manual also provides a structure for a new Health Resource Tracking (HRT) system to improve transparency in funding flows, and resources allocation and use.
Assurance Maladie Universelle (AMU) design
FAH supported the drafting of a concept note for establishing a health insurance scheme (AMU) aimed at financially protecting 2.4 million vulnerable people - approximately 37% of CAR’s population. This initiative is expected to increase access to RMNCAH services and reduce maternal and child mortality.
Strengthening Planning, Resource Allocation, and Monitoring
In 2024, FAH played a central role in aligning CAR’s national and district-level health plans with performance-based goals:
- 2025 National Action Plan: FAH supported the development of the MOHP’s 2025 Action Plan, anchored in the Prime Minister’s “Letter of Performance.” At the subnational level, FAH also facilitated the creation of district operational plans under the Global Fund framework to ensure locally grounded, priority-driven strategies.
- Health Resource Tracking System: As most of the health funding (about 85%) are still flowing “off budget”, FAH has been instrumental in designing and institutionalizing a digital HRT system to provide real-time insight into financial flows, enabling better resource allocation and performance monitoring.
Improving Policy Dialogue and Priority-Setting
Policy coherence and stakeholder coordination are vital to effective health system strengthening:
- Revitalizing National Coordination Platforms: FAH supports the Strategic Committee for PHC and community engagement, enhancing communication and joint action across the health sector.
- Decentralized Coordination: FAH facilitated coordination between the national PHC directorate and four districts (Bangui I, II, III, and Begoua), ensuring local strategies reflect national priorities and promoting knowledge exchange across regions.
Strengthening Data Systems and Use for SRMNCAH program
Robust data systems are the backbone of sound decision-making:
- FAH assisted in the development of 2 study protocols and materials for (1) targeted research on maternal mortality (MM) and (2) rapid assessment to evaluate the impact of matron training on MM outcomes to inform evidence-based interventions towards achieving 30% MM rate reduction by 2030.
- A national Quality Improvement (QI) policy for expanding SRMNCAH services was also developed to ensure services at the PHC level meet established standards of care.
Looking Ahead
Through its strategic partnership with the Ministry of Health and Population, the Financing Alliance for Health (FAH) is helping build a more efficient, equitable, and sustainable health system in CAR. The goal is clear: a resilient health sector capable of meeting the needs of women, children, and communities – ultimately driving progress toward Universal Health Coverage (UHC). By focusing on governance, financing, data systems, and community engagement, CAR is laying the groundwork for long-term impact and healthier futures.
About the Authors
Dr. Parfait Uwaliraye
Dr. Parfait Uwaliraye is the Health Financing Manager – Francophone at the Financing Alliance for Health, where he leads country engagement and supports health financing reforms across Francophone Africa. A public health and HSS expert, he brings over a decade of leadership experience from Rwanda’s Ministry of Health, with deep expertise in policy analysis, HRH, and program design. His work is grounded in evidence-based planning and a strong commitment to strengthening primary health care systems.
Pascal Birindabagabo
Pascal Birindabagabo is the Health Financing Technical Advisor for the Central African Republic at the Financing Alliance for Health. With over a decade of experience, he specializes in health financing, policy development, and domestic resource mobilization across national and decentralized systems. An MPH graduate in Health Economics and GNHE alumnus, Pascal has worked with the African Union Commission and led key reforms in community-based health insurance, performance-based financing, and public financial management.
Wendy Wakhusama
Wendy is a seasoned partnerships, fundraising, and strategic communications professional with over a decade of experience mobilizing resources and building transformative collaborations across the public, private, and philanthropic sectors. She currently serves as Partnership and Grant Management Associate - CH4UHC at the Financing Alliance for Health.
