Community Health Financing (CHF) Assessment Toolkit

An evidence-based self-assessment tool to aid stakeholders in developing innovative & equitable financing strategies for community health.  

To view the tool online, scroll, click and see automated recommendations in the toolkit on the right! →

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Overview 

The Community Health Financing (CHF) Assessment Toolkit helps policymakers, funders, and implementers identify sustainable financing pathways for community health programs. This comprehensive toolkit allows users to assess their current financing landscape, explore innovative funding mechanisms, and develop evidence-based strategies to strengthen community health systems. 

Guided by global best practices in health financing, the CHF Assessment Toolkit provides a structured framework to evaluate: 

  1. Alignment with local health needs and integration with broader health systems 
  2. Revenue raising aspects including funding sufficiency and diversification 
  3. Innovative financing opportunities tailored to the local context 

The CHF Assessment Toolkit has 3 main components: 

  1. Context Assessment – Evaluates program alignment, coverage, governance, and gender considerations 
  2. Revenue Raising Analysis – Examines current funding streams, gaps, and barriers 
  3. Innovative Financing Analysis – Explores new funding mechanisms and partnerships 


Key Features: 

  • Automated recommendations based on user inputs to guide strategy development 
  • Gender-responsive approach to ensure equitable and inclusive financing 
  • Action planning framework to translate insights into concrete next steps 
  • Customizable to both small-scale and national community health worker programs 

The toolkit combines multiple choice questions with open-ended sections, allowing users to tailor the assessment to their specific context. Upon completion, it generates a summary of key issues and actionable recommendations to optimize community health financing. 

Request the Toolkit 

Use the button below to request access to the CHF Assessment Toolkit or contact the Financing Alliance for Health team directly. To use the tool, simply open the pdf in Google Chrome, Microsoft Edge, Safari or Mozilla Firefox. 

Request Toolkit  

By leveraging this toolkit, stakeholders can develop innovative, contextually relevant financing strategies to build robust and sustainable community health systems – a critical step towards achieving universal health coverage (UHC). 

For any other queries related to the toolkit, reach out to Partnerships@financingalliance.org 

Testimonials & Case Studies

 

The CHFA tool made it possible to assess the current situation of community health financing in Senegal for the first time, to identify bottlenecks, to propose strategies for developing community health interventions and to enable different stakeholders to better define priorities and other programmatic aspects of interventions. Thanks to technical and financial support from FAH, the country has developed and is implementing a five-year action plan 2024-2028 to improve community health financing.

Ms Amy Mbacke, Community Health Specialist, Ministry of Health and Social Action, Senegal

Country Case Studies

This section will be updated soon. Reach out to us for more details or to collaborate on piloting this tool in your country!
partnerships@financingalliance.org or sshukla@financingalliance.org 

References

  1. Agyepong, I. A., Aryeetey, G. C., Nonvignon, J., Asenso-Boadi, F., Dzikunu, H., Antwi, E., … & Arhinful, D. K. (2014). Advancing the application of systems thinking in health: Provider payment and service supply behaviour and incentives in the Ghana National Health Insurance Scheme – a systems approach. Health Research Policy and Systems, 12(1), 35.
  2. Ballard, M., Bonds, M., Burey, J., Dini, H. S. F., Foth, J., Furth, R., … & Yembrick, A. (2018). Community Health Worker Assessment and Improvement Matrix (CHW AIM): Updated Program Functionality Matrix for Optimizing Community Health Programs. USAID.
  3. Domapielle, M. K., Sumankuuro, J., & Bebelleh, F. D. (2022). Revisiting the debate on health financing in low and middle-income countries: An integrative review of selected models. The International Journal of Health Planning and Management, 37(6), 3061-3074.
  4. El-Kalaawy, F., et al. (n.d.). Promoting gender responsive policies and programmes for CHWs: A gender analysis framework. World Health Organization.
  5. Financing Alliance for Health. (2015). Investment case for community health workers: Evidence for a 10:1 return on investment. FAH.
  6. Gottret, P., Schieber, G., & Waters, H. (2008). Good practices in health financing: Lessons from reforms in low- and middle-income countries. World Bank.
  7. Hussein, S., Kiarie, H., Mutembei, K., Githinji, S., Kabia, E., & Karanja, S. (2021). Institutionalizing community health services in Kenya: A policy and practice journey. Global Health: Science and Practice, 9(Suppl 1), S25-S31.
  8. Jowett, M., Kutzin, J., Kwon, S., Hsu, J., Sallaku, J., & Solano, J. G. (2020). Assessing country health financing systems: The health financing progress matrix. World Health Organization.
  9. Kigume, R., & Maluka, S. (2018). Decentralisation and health services delivery in 4 districts in Tanzania: How and why does the use of decision space vary across districts? International Journal of Health Policy and Management, 8(2), 90-100.
  10. Kutzin, J. (2013). Health financing for universal coverage and health system performance: Concepts and implications for policy. Bulletin of the World Health Organization, 91(8), 602-611.
  11. Lagarde, M., & Palmer, N. (2011). The impact of user fees on access to health services in low‐ and middle‐income countries. Cochrane Database of Systematic Reviews, 2011(4), CD009094.
  12. Lu, C., Schneider, M. T., Gubbins, P., Leach-Kemon, K., Jamison, D., & Murray, C. J. (2010). Public financing of health in developing countries: A cross-national systematic analysis. The Lancet, 375(9723), 1375-1387.
  13. Masis, L., Gichaga, A., Zerayacob, T., Lu, C., & Perry, H. B. (2021). Community health workers at the dawn of a new era: 4. Programme financing. Health Research Policy and Systems, 19(3), 107.
  14. Mupara, L. M., Mogaka, J. J. O., Brieger, W. R., & Tsoka-Gwegweni, J. M. (2023). Community health worker programmes’ integration into national health systems: Scoping review. African Journal of Primary Health Care & Family Medicine, 15(1), e1-16.
  15. Perry, H., Sierra-Esteban, F., & Berman, P. (2014). Financing large-scale community health worker programs. In Developing and strengthening community health worker programs at scale: A reference guide and case studies for program managers and policymakers. USAID.
  16. Simen-Kapeu, A., Reserva, M. E., & Ekpini, R. E. (2021). Galvanizing action on primary health care: Analyzing bottlenecks and strategies to strengthen community health systems in West and Central Africa. Global Health: Science and Practice, 9(Supplement 1), S47-64.
  17. The Lancet Global Health Commission. (2021). The Lancet Global Health Commission on financing primary health care: putting people at the centre. The Lancet Global Health.
  18. World Health Organization. (2010). Monitoring the building blocks of health systems: A handbook of indicators and their measurement strategies. WHO.
  19. World Health Organization. (2017). Developing a national health financing strategy: A reference guide. WHO.
  20. World Health Organization. (2020). Health financing progress matrix. WHO.
  21. World Health Organization. (2021). Step-by-step guide to conducting a cross-programmatic efficiency analysis. WHO.

Websites:

  1. Advancing Partners & Communities. https://www.advancingpartners.org
  2. Community Health Impact Coalition – CHW AIM. https://joinchic.org/resources/chw-aim/
  3. Community Health Roadmap. https://www.communityhealthroadmap.org
  4. Financing Alliance for Health – Community Health Financing Compendium. https://financingalliance.org/community-health-financing-compendium/
  5. Johnson & Johnson Center for Health Worker Innovation – Living Goods Performance Management Guidebook. https://chwi.jnj.com
  6. World Vision International – CHW S-AIM Tool. https://www.wvi.org/publications/chw-s-aim-tool