Decision rules for allocation of finances to health systems strengthening

Alec Morton*, Ranjeeta Thomas, Peter C. Smith

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review


A key dilemma in global health is how to allocate funds between disease-specific “vertical projects” on the one hand and “horizontal programmes” which aim to strengthen the entire health system on the other. While economic evaluation provides a way of approaching the prioritisation of vertical projects, it provides less guidance on how to prioritise between horizontal and vertical spending. We approach this problem by formulating a mathematical program which captures the complementary benefits of funding both vertical projects and horizontal programmes. We show that our solution to this math program has an appealing intuitive structure. We illustrate our model by computationally solving two specialised versions of this problem, with illustrations based on the problem of allocating funding for infectious diseases in sub-Saharan Africa. We conclude by reflecting on how such a model may be developed in the future and used to guide empirical data collection and theory development.

Original languageEnglish
Pages (from-to)97-108
Number of pages12
JournalJournal of health economics
Early online date24 Jun 2016
Publication statusE-pub ahead of print - 24 Jun 2016

Bibliographical note

© 2016 The Author(s). Published by Elsevier B.V.


  • Cost effectiveness analysis
  • Economic analysis
  • Global health
  • Health systems strengthening
  • Resource allocation

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