On 10th March 2025, Financing Alliance for Health (FAH) hosted a compelling pre- conference side event during the 7th African Health Economics and Policy Association (AfHEA) Scientific Conference in Kigali, Rwanda, under the theme: “Strengthening Community Health Systems for Universal Health Coverage in Low-Resource Settings.”
This event brought together policymakers, researchers, donors, private sector actors, community health workers, and implementing partners to examine one of the most pressing questions in global health: How can countries transition from donor-reliant health systems to sustainable, country-led financing for community health to achieve UHC?
Country Experiences: Progress and Gaps
Discussions showcased how countries such as Kenya and Senegal have made strides in formalizing and financing community health systems.
- In Kenya, participants reflected on major reforms, including the formalization of Community Health Promoters (CHPs), equipping them with standardized kits, digitizing service delivery through the electronic Community Health Information System (eCHIS), and passing legislation to support CHP payments. Despite these milestones, challenges in sustainable financing and capacity building remain key barriers.
- In Senegal, the Government had implemented bold reforms such as the expansion of community-based health insurance (mutuelles) to cover informal sector workers and rural populations. Free healthcare policies for vulnerable groups and the development of a National Health Financing Strategy (NHFS) were highlighted as crucial steps toward sustainable, equitable funding.
Key takeaways from the discussions included:
- Donor transitions require more than funding; they require more partnerships, planning and prioritization. Sudden withdrawal of donor resources without a corresponding increase in domestic investment was seen to create service gaps. Stakeholders emphasized the need for carefully sequenced, multi-year transition plans to ensure gains are sustained.
Coordination matters as much as resources are concerned. Fragmented funding streams were noted to undermine system resilience. Participants advocated for integrated and sustainable funding and for better allocation and use of available resources.
- There is a high need to professionalize Community Health Workers. CHWs were recognized as vital to delivering PHC, but often lacked formal recognition, legal protections, and sustainable pay structures. Institutionalizing CHWs within national health systems was emphasized as a top priority.
- The narrative must shift from “Who will fund us next?” to “How do we finance smarter?” There was consensus on the need to explore diversified models such as performance-based financing, public-private partnerships, and leveraging social health insurance to finance community health sustainably.
- Quotes from panelists:
- “If we fail to live our vision, we live at the comfort of the system” – Dorothy Mwengei – Senior Technical Advisor, Health Financing – Financing Alliance for Health
- “Advocate, collaborate, integrate, institutionalize! – “Madame Amy Mbacke Community Health Specialist – Ministry of Health and Social Action, Senegal
Looking Ahead
The conversations at AfHEA 2025 made it clear:
- The future of community health in Africa depends not just on more funding, but on better, smarter, and more coordinated investments.
- FAH was honored to contribute to this critical dialogue and reaffirm its commitment to supporting countries in developing sustainable financing solutions for community health systems to build resilient health systems as highlighted by 2025 AfHEA conference main theme.
Thank you to all partners, co-hosts, and participants who joined us for this important event. We look forward to building on the momentum to advance universal health coverage through resilient community health systems.