Key Policy Issue #2: Where will the money come from?
The issue of the source of financial resources will be addressed differently in accordance with the level of wealth of a country. In high-income countries, domestic resources will likely be the only source of funding. Options available to policy-makers are:
- to use existing public revenues, by shifting resources within the health or education sectors, for instance from costly hospital services to education, or from other sectors to the education of health professionals;
- to look for efficiency gains, for instance by increasing the utilization of mid-level and community workers, by reducing attrition (GHWA, 2008:72), and by making savings in the current educational system to increase its productivity;
- to generate revenue through higher taxes;
- to mobilize private funds through fees paid by students or creating incentives for the opening or expansion of private educational institutions, which are largely funded by student fees; and
- a combination of the former.
Whatever the choice, the process will be politically sensitive because of vested interests and particularly difficult in the context of economic and financial crisis in many countries. In lower income countries, the same domestic options exist, but they are unlikely to yield sufficient resources and external aid will be needed.