This issue paper is part of an overall programme of work to identify and address inefficiencies
across health programmes within the overall health system. The idea for this programme of work
emerged from analysis that World Health Organization (WHO) conducted in eastern Europe in
the mid-2000s. The decision to clearly define this approach and expand its application came
from discussions at a meeting on Fiscal space, public financial management and health financing
convened by WHO between 9-11 December 2014. The methods and initial findings from country
pilots have been presented and discussed widely, both within WHO, as well as in countries and
other international forums
