Action by KfW Entwicklungsbank

Strengthening healthcare systems

Four women with their children are sitting in front of a building. Behind them is one woman standing alone.

Improving access to health services, particularly for poor groups of the population, is an important approach to strengthening healthcare systems. Source: Dr Dirk Müller

As a prerequisite for economic growth, health is a key element in the fight against poverty. On behalf of the German Government, KfW Entwicklungsbank supports developing countries in their efforts to improve the health of their people. The health sector is a priority area of development cooperation in 16 partner countries. Additionally, health activities are being conducted in almost 40 countries. To promote the health sector in the partner countries, KfW Entwicklungsbank is making available more than 1.3 billion euros in health projects currently under implementation. This commitment aims to improve poor people's access to health services.

Strengthening the healthcare systems of the partner countries and developing new approaches are priorities in these activities. In order to achieve this jointly with the partner countries, KfW is active specifically in the following areas:

  1. Health financing: Demand-side financing, which includes voucher systems that enable expectant mothers to have a safe childbirth and healthcare for their newborn baby, and support in expanding health insurance systems;
  2. Healthcare infrastructure: Construction, repair, expansion and equipment of new and existing hospitals and health stations, including the related capacity development, for instance through staff training;
  3. Sexual and reproductive health and rights: Promotion of rights based family planning and HIV prevention in integrated country-specific or regional approaches, such as through social marketing, and promotion of safe motherhood and childbirth attended by health professionals;
  4. Disease prevention and control: Immunisation programmes, tuberculosis, malaria and poliomyelitis control in country-specific approaches and regional projects;
  5. Cross-cutting tasks: HIV mainstreaming

For the implementation of these measures KfW Entwicklungsbank uses a whole range of different instruments: classic programme financings and complementary basic and advanced training measures, social marketing and social franchising approaches, sector budget and basket funding co-financed with other donors and innovative demand-side financing instruments.

Main Concerns of KfW Entwicklungsbank

By combining high-quality infrastructure with effective financing and maintenance structures, medical staff training and the development of an efficient management, KfW Entwicklungsbank sets standards that encourage the partner countries and the partner organisations to address the issue of quality in the health sector.

KfW Entwicklungsbank also contributes to strengthening healthcare systems under programme-based approaches by supporting partner countries in designing, budgeting and implementing their healthcare policy.

The involvement of private healthcare providers, particularly in rural areas, has proven to be an effective approach for increasing the availability of health services. Under a voucher programme, for example, accredited private providers - as well as public services - are reimbursed for for healthcare services administered. In the area of family planning and HIV prevention, private providers are trained under so-called social franchising approaches or assigned to tasks aimed at raising public awareness and the distribution of contraceptives under social marketing approaches.

Health systems require sustainable financing and must be affordable for the users even in partner countries without developed health insurance systems. Here KfW Entwicklungsbank supports new financing approaches that promote healthcare for expectant mothers and medically assisted births, for instance in the form of voucher systems.

With the aim of improving maternal and child health, KfW Entwicklungsbank supports an integrated approach to promoting sexual and reproductive health services, including family planning and HIV prevention. KfW Entwicklungsbank attaches great importance to gender sensitivity in the design of the measures.

Further Information

Last updated: December 2011