The World Bank Group has supported countries in advancing wide-ranging health financing reforms. These engagements combine financing, technical assistance, and policy dialogue to raise domestic resources for health. Based on the context, they help reduce out-of-pocket spending, expand social and financial protection, increase efficiency and value for money and institutions – complementing broader health policies to achieve universal health coverage.
Colombia
Colombia, with World Bank support, has successfully expanded its use of health taxes to both reduce consumption of harmful products and mobilize domestic resources. Health taxes include excise taxes for tobacco, alcohol, and sugar-sweetened beverages (SSBs). For this work, Colombia leveraged a series of Development Policy Operations (DPOs) between 2017 and 2025 and received technical help to design and implement these excise taxes. Between 2019 and 2022, the share of children aged 2–17 drinking at least one sugary drink dropped from 24% to 18%. Tax revenues are expected to reach 0.2% of GDP by 2025.
Morocco
In Morocco, a major health financing reform supported by policy dialogue, technical assistance and Development Policy Financing from the World Bank has expanded compulsory health insurance nationwide. By March 2025, coverage reached 75% of the population. The reform replaced a fragmented system and gives the poorest people equal access to benefits, including private services. Additional changes centralized insurance management under the National Social Security Fund and created new regulatory agencies to improve quality, equity, and transparency.
Cambodia
The World Bank is supporting Cambodia’s Health Equity Fund (HEF) to reduce catastrophic out-of-pocket health spending and strengthen financial protection. This includes $113 million in financing for the Health Equity and Quality Improvement Project, which expands HEF coverage, improves service quality through performance-based financing, and increases access for poor and vulnerable groups. The World Bank also provides technical and analytical support to enhance HEF implementation, assess private pharmacy practices, study beneficiary health-seeking behavior, and develop an action plan to reduce out-of-pocket costs. These efforts support the country’s UHC Roadmap goal of reducing out-of-pocket spending from 60% to 35% by 2035
Egypt
In Egypt, after the 2011 revolution, the World Bank supported a dialogue around inequalities and social justice in health which eventually culminated in the launch of the Universal Health Insurance Law (UHIL) in 2018. The transformative Law mandates health insurance for all Egyptians and re-organizes the health sector to deliver its benefits nationwide. The World Bank is supporting this ambitious UHIS reform of the Government of Egypt with a project and advisory services to increase the coverage of health insurance and strengthen UHIS-related processes and institutions, The IFC also supports this effort by helping to set up contracts with private providers and by investing in hospitals and services.
Côte d’Ivoire
In Côte d’Ivoire, the national health insurance scheme quickly grew to cover 68% of the population in less than two years (2023-2024), thanks to government leadership and World Bank support. Daily enrollment rose from 200 to over 30,000 using decentralized, biometric, and mobile systems. Mandatory enrollment and the introduction of a social security number are now widely used. World Bank projects support the roll-out of performance-based financing across all districts and facilities expanding rural coverage and lower fees in urban areas. The surge in enrollments in the health insurance scheme has already resulted in a fourfold increase in the utilization of health services, particularly in rural areas. Digital tools were added to many health centers, new jobs created for young people, and subsidies introduced to encourage informal workers to join the insurance scheme. The World Bank Group is also helping create a public-private partnership for diagnostic services.
Uganda
In Uganda, World Bank financing has helped more than quadruple the government’s financing for local health services – from $70 million per year in 2017 to over $300 million in 2024 – despite a period of severe fiscal stress. A $190 million program of the International Development Association (IDA) helped leverage the budget needed, with every $1 from the Bank bringing $6 more from the government. The number of local governments meeting health workforce standards rose from 37% to 65% and 312 health facilities were improved. Around 3.3 million people now get quality health services annually. The program also improved the management of resources and their allocation in line with needs, illustrating overall how Public Finance Management matters for service delivery.