FINANCING ARCHITECTURE IN MOZAMBIQUE: BETWEEN RUPTURES AND CONTINUITIES THE CASES OF PROSAÚDE AND GFF
Based on the binary comparison method this Research Brief aims to analyze two funding mechanisms in the Mozambican health sector: PROSAÚDE – based on the Sector Wide Approach (SWAp) and Global Financing Facility (GFF) based, on Result-based financing. The comparison is not intended to find the “best model” between the two, but rather to find the mutual learning lines from the contextualized experiences of implementing these two funding modalities. The analysis is based on two comparison parameters: adherence and implementation. This paper underlines that: (i) PROSAUDE results from the need to trigger the fragmentation of aid to the health sector and reduce MISAU’s transaction costs, while the GFF was precipitated by a particular context of debt crisis and, above all, from the erosion the credibility of multi-stakeholder coordination mechanisms, with particular focus on PROSAUDE; (ii) as regards implementation, PROSAÚDE hinges on a more holistic approach to financing, i.e. health system financing as a whole, while GFF is essentially centred on Investment Case (CI) funding, i.e. is a specific beam of MISAU’s priorities. Meanwhile, PROSAÚDE as well as GFF reproduce the logic of centralizing domination, which ultimately posed a huge risk to the effectiveness of the sector financing architecture.
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