Over the past six years, Amref Health Africa has positioned itself as a leading voice in health financing across the continent, with a particular emphasis on strategic health purchasing (SHP) as a critical lever for achieving Universal Health Coverage (UHC). Through the Strategic Purchasing Africa Resource Centre (SPARC)—an initiative jointly implemented with Results for Development (R4D) and supported by the Bill & Melinda Gates Foundation—Amref has played a catalytic role in driving meaningful reforms and strengthening health systems in more than 14 African countries.
As the SPARC project officially comes to a close, Amref Health Africa recently convened a high-level meeting with key partners and stakeholders from the health financing ecosystem.
Participants included representatives from Ministries of Health, Amref country offices, technical partners, academic institutions and the Gates Foundation. This gathering was both a moment of reflection and a strategic launchpad for Amref’s expanded work in health financing, signalling a renewed commitment to strengthening national systems and scaling best practices across Africa.
From its inception in 2018, SPARC was envisioned as a hub for generating and sharing knowledge on SHP, offering technical assistance and fostering collaboration across countries. What began as a simple idea has grown into a robust, continent-wide network of experts, institutions and policymakers working collectively to improve how health resources are allocated and utilised. Through this effort, Amref and its partners have built a consortium of 11 leading learning and research institutions including Makerere University in Uganda, KEMRI-Wellcome Trust in Kenya, the Ifakara Health Institute in Tanzania, the University of Ghana, the Centre for Research in Human Reproduction and Demography in Benin, the Health Policy Research Group in Nigeria, the University of Cape Town, the University of Kinshasa, and others. These institutions, together with Amref country offices in countries such as Zambia, Malawi, Senegal and South Sudan, have supported Ministries of Health to design and implement reforms aligned with strategic purchasing principles.
These efforts have led to substantial achievements. Since its launch, SPARC has directly supported reforms in over 14 countries and influenced many more through regional engagements. More than 500 professionals have been trained in strategic health purchasing and health financing, many of whom are now leading national reform processes. Over 100 peer-reviewed publications—mostly authored by African researchers using local evidence—have been published and disseminated in global and regional health policy dialogues, serving as reference materials for policymakers. The Strategic Health Purchasing Progress Tracking Framework, developed through the project, has offered governments an objective tool for assessing the status and maturity of SHP reforms.
The impact of SPARC has extended beyond Africa, with several countries in Southeast Asia—such as Indonesia, Thailand, and Vietnam—drawing insights from the Centre’s approaches and tools. Across Africa, policy conversations around health financing have become more focused, with governments exploring reforms in benefit package design, purchaser–provider contracting, tariff reviews, and the adoption of output-based provider payment mechanisms.
The SPARC community has played a central role in catalysing these changes through a mix of formal and adaptive learning models, rooted in strong technical collaboration and peer-to-peer exchange.
The recent partner meeting offered an opportunity to take stock of these accomplishments while setting the stage for the next phase of Amref’s health financing work. As countries continue to navigate the complex transition from external aid to increased domestic financing, Amref is committed to supporting them in strengthening the core health financing functions—revenue raising, pooling, and purchasing. Moving forward, three priority areas will guide Amref’s engagement: enhancing pre-payment mechanisms to reduce out-of-pocket expenditure, advancing strategic health purchasing as a means of improving health system efficiency and accountability, and strengthening public financing systems to ensure more equitable access to essential health services.
Amref will also continue to work closely with strategic partners including WHO-AFRO, Africa CDC, regional economic communities, and the Gates Foundation to scale successful models and approaches. Partnerships with academic and research institutions will remain vital in generating policy-relevant evidence and promoting innovation in health financing. To ensure continuity of SPARC’s knowledge and momentum, Amref is actively exploring new funding and technical collaboration opportunities. These will support the transition of SPARC’s core functions into long-term, government-embedded technical assistance models that prioritise country ownership and sustainability.
The legacy of SPARC lies not just in the tools developed or the policies influenced, but in the capabilities built, the systems strengthened, and the regional movement it has ignited. The project has demonstrated that with the right partnerships, evidence, and commitment, countries can transform how health resources are managed—ultimately improving the lives of millions.
As Amref looks to the future, it remains unwavering in its ambition to make health financing a central pillar of its Health Systems Strengthening strategy. The integration of strategic purchasing into this broader agenda will ensure that health financing remains a driving force behind progress toward UHC across the continent. SPARC may have closed as a project, but its impact continues to grow—laying a strong foundation for the next generation of health financing reforms in Africa.
By Boniface Mbuthia, Health Finance Expert, Amref Health Africa