Community health workers at the dawn of a new era: 4. Programme financing

Table 2 CHW programme costs and spending on PHC and on all health programming by governments and donors in the sub-Saharan African countries with available data (in 2019 US dollars)

Country	Column 1 Year CHW costs incurred	Column 2 Per capita spending on CHWs^a	Column 3 Per capita spending on PHC by government and external donors^b	Column 4 Per capita health spending by domestic government and external donors^b	Column 5 Ratio of spending on PHC by government and external donors to spending on CHWs	Column 6 Ratio of total health spending by government and external donors to spending on CHWs
Burkina Faso	2019	1.59	33.71	34.82	21.20	21.90
Liberia	2016	2.41	16.94	32.06	7.03	13.30
Rwanda	2019	2.61	42.02^c	45.68	16.10	17.50
South Africa	2017	12.18	102.67^c	288.62	8.43	23.70
South Sudan	2019	3.07	13.81	18.22	4.50	5.93
Zambia	2018	7.51	45.53	63.70	6.06	8.48
Median		2.84	37.86	40.25	7.7	15.4

^aData source: From Table 1
^bData source: https://apps.who.int/nha/database/ViewData/Indicators/en. For health expenditure by governments and donors, WHO only has data available until 2017. We imputed 2018 and 2019 values for government spending on health and donors’ contribution to health using their average growth rates between 2010 and 2017 (i.e., the average growth rate of government health spending, and average growth rate of donors’ contribution). South Sudan has data for 2017 only. We therefore used 2017 data. For PHC expenditure, WHO has data for only 56 countries in 2016 and/or 2017. We assumed the growth rate of PHC spending by government and donors to be the same as the growth rate of health spending by government and donors and imputed PHC spending by government and donors in 2018 or 2019
^cData source: https://improvingphc.org/explore-country-data Information on donor spending on PHC was not available for Rwanda and South Africa. We imputed the data for South Africa using (total health aid/total health expenditure) in the country. One study [28] shows that during 2010–2011, about 95% of funds for CHW programmes were from international donors. As available data show that 38% of funding of CHW programme were from governments between 2014 and 2015, we therefore assigned 62% to donors

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