Closing the domestic health financing gap in low- and middle-income countries

Achieving the health-related Sustainable Development Goals (SDGs) will require significant increases in financial resources from many different sources, including domestic resource mobilization (DRM). In this pilot project, we are partnering with the Duke Center for International Development to examine the role of DRM for health in India (in Assam, Karnataka, and Uttar Pradesh) and Ethiopia. The project takes a holistic” public financial management (PFM) approach—one that integrates analysis of taxation, allocation, efficiency, and insurance —and applies it to mobilizing domestic resources for health. 

Ipchita Bharali, Center for Policy Impact in Global Health
Indermit Gill, Duke Sanford School of Public Policy
Graham Glenday, Duke Center for International Development
Ziyuan Wang, Duke Center for International Development

Working paper: Kelly R, Hemming R, Glenday G, Bharali I, Alebachew A. Public financial management perspectives on health sector financing and resource allocation in Ethiopia. The Center for Policy Impact in Global Health. Duke Global Working Paper Series: number 18, 2020. Available at:

Report: Glenday G, Bharali I, Wang Z. Enhancing Domestic Revenues: Constraints and Opportunities: A cross-country comparative study of tax capacity, effort and gaps. The Center for Policy Impact in Global Health. Report: 2019. Available from:

Policy Brief: Gill IS, Glenday G, Bharali I. Domestic revenue mobilization: estimating the gaps between ability and effort. The Center for Policy Impact in Global Health. Policy brief: 2019. Available from:

Blog: Brookings Future Development, Measuring the gap between ability and effort in domestic revenue mobilization

This focus area is part of a larger project, Designing innovative policy solutions to close global health financing gaps that was funded by the Bill & Melinda Gates Foundation.

Questions? Please contact Ipchita Bharali.

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