How to establish the funding flow

Health Financing
Establishing the funding flow can give you a better understanding of how money flows through the health system and where there might be bottlenecks preventing money from reaching health facilities.

WHAT is it?

The Funding Flow tool (download available below) will enable you to develop an illustration of the sources of funds, the financing and management agents (those who manage the funds) and the providers of health services, which shows the directions of flows and the interactions between them.

The accompanying training slides (download available below) will help you to understand the key concepts in health financing, identify how a health financing system is structured, and explore examples of different funding flow maps.

The coalitions that E4A support have mapped funding flows to develop a better understanding of their context, facilitate discussions with stakeholders in the health sector and identify bottlenecks that require advocacy.


HOW do I do this?

You need:

  • The Funding Flow tool or a pen and paper
  • Connections with decision-makers, health workers, other organisations and/or the community to ask questions
  • An idea of what you want aspect of the funding flow you want to focus on.


Useful tips for you:

  1. Define your focus.
  2. Conduct a desk review to answer key questions.
  3. Hold discussions with key stakeholders.
  4. Map the funding flow using the tool provided or with a pen and paper.
  5. Use the funding flow map to facilitate further discussion with stakeholders on bottlenecks and to inform advocacy.


WHEN do I do it?

The best time to map a funding flow is when you are about to start engaging in advocacy in the health sector. However, it is never too late – a funding flow map can be prepared at any time during your budget advocacy engagement. It is a useful activity to do before developing your health budget advocacy plan, so you can identify your target audiences and advocacy messages. We have found that the coalitions we support find it helpful to revisit this mapping regularly as part of maintaining an up-to-date understanding of the political economy of their context. They then use this to routinely adapt and update their planned advocacy interventions.


WHAT can I do with the information?

Take the funding flow map you have developed and share it with stakeholders, making it clear that it is not final and is only intended to facilitate discussion. Ask the following questions:

  1. Does this funding flow map reflect your experience of how funds flow in the health sector? If not, could you show us the changes you would make?
  2. If you look at the funding flow, where do you think there are bottlenecks that prevent funds getting from the source to the health provider? Why is this a bottleneck (what is the cause)?
  3. What do you think we can do to help mitigate these bottlenecks?


By asking these questions to a range of stakeholders, you will continue to develop an understanding of whether the different stakeholders perceive funding flows differently, which may contribute to bottlenecks. In addition, by asking stakeholders what the bottlenecks are, and where they are on the map, you can inform your advocacy. This information will help you to identify the problem, the solution and the target audience for your efforts.