Health Financing Innovations in the Caribbean: EHPO© and the National Health Fund of Jamaica

This report examines the experience of Jamaica, which after years of macroeconomic difficulties, constraints on fiscal resources for health and debate on alternative financing, established the National Health Fund in 2003. With a view to eliciting critical lessons for future actions and for other countries, the paper focuses on the policy context and the process of decision-making, the challenges of design and implementation and the early operational results. It begins by reviewing the desired features of a health financing system and the health policy context in Jamaica. This is followed by a description of the concept and operational features of the NHF and a discussion of the economic issues in designing the NHF, the development of the Evaluating Health Policy Options (EHPO) model and the implementation experience. The report closes by identifying some major lessons of experience for Jamaica and the Caribbean as well as other countries facing the challenges of national health financing.