Use of social impact bonds in financing health systems responses to non-communicable diseases: scoping review

In with the good, out with the bad - Investment standards for external funding of health?

In recent decades, external financing of health systems in low- and middle-income countries has helped achieve remarkable improvements across the world. However, these successes have not come without problems. There are a growing number of areas where external assistance can cause harm and even undermine the development of national health systems. Recent decades have seen a surge of knowledge on investing in health systems. We propose the setting up of investment standards for external assistance that aim to incentivize a more efficient evidence-based investment in a country's health system, led by decision-makers in country. Using a more standardized process would lead to a better use of precious external assistance resources. The long-term goal would be fully functioning health systems with all the necessary essential public health functions in all countries.

Quantitative revenue estimates and qualitative assessments of innovative fundraising sources for treating rare diseases in Colombia

Background: Like many developing countries, Colombia faces difficulties in financing health-care services as well as programs for health promotion and health education and there is evidence that its health-care system is underperforming. Objective: To provide evidence-based estimates of potential funding levels and assess the strengths, weaknesses, and viability of innovative funding mechanisms with a focus on treating rare diseases in Colombia. Methods: The strategy involved evidence-based projections of potential funding levels and a qualitative viability assessment using an expert panel. Results: Crowdfunding, corporate donation, and social impact bonds (SIBs) were deemed to be the most viable of numerous potential strategies. Expected funding levels over 10 years for rare diseases in Colombia from crowdfunding, corporate donations, and SIBs were roughly $7,200, $23,000, and $12,400, respectively. Conclusions: Based on the combination of projected funding potential along with expert consensus regarding viability and operability, crowdfunding, corporate donations, and SIBs, especially in combination, have the potential to substantially improve funding for vulnerable patient populations in Colombia.

Evidence-Based Analysis of Social Impact Bonds for Homelessness: A Scoping Review

Social impact bonds (SIBs) have emerged as an innovative financial instrument designed to support the social service sector in delivering innovative social programs. In particular, SIBs can be used to finance prevention of homelessness among those regarded as vulnerable. There is little evidence that outcomes from SIB-funded programs are significantly different compared to more traditional programs. This is the first scoping review of academic and gray literature that explores the main features and outcomes from all SIBs for homelessness based on evidence, addressing an important gap in the literature. The scoping review provides a transparent and comprehensive approach for mapping areas of this research. A total of 73 studies and articles were found eligible for inclusion. These concerned 32 SIBs for homelessness implemented in the United Kingdom, the United States, Australia, and Belgium. The review found that academic papers on SIBs for homelessness lack evidence-based analysis, while gray literature lacks transparency, especially in evaluation method and outcome. We found that fourteen projects met their target outcomes. The common features of these SIBs were a navigator intervention model, effective partnership working, and use of Special Purpose Vehicles. Our findings show that it is necessary for the managers of SIBs to improve outcome metrics and evaluation methods, support target groups fairly, and attract more private investors to finance SIBs for better addressing homelessness.

'Implementability' matters: using implementation research steps to guide and support non-communicable disease national planning in low-income and middle-income countries

The 'implementation gap' between national plans and successful implementation is a central theme in addressing non-communicable diseases (NCDs). It is a factor that has undermined Sustainable Development Goal 3.4, which aims to achieve a one-third reduction in premature mortality from four major NCDs by 2030. Responding to the potential of implementation research to support low-income and middle-income countries to effectively advance their strategies, we describe ways to make NCD plans more robust by including implementation steps. These steps are (1) choosing some (but not all) effective and cost-effective options; (2) tailoring interventions and their scale-up to national capacity; and (3) making the priorities implementable. We illustrate with examples from several countries.