Reports and Publications

Will the European Semester bring health equity? Findings from the Recovery and Resilience Plans in eight Member States

Each year, EuroHealthNet performs an analysis of the annual cycle of the European Union’s (EU) economic and social policy coordination, known as the European Semester, the use of the EU Recovery and Resilience Facility and its impact on health equity and wellbeing.

Find EuroHealthNet’s work on the European Semester analysis here.




Economics of Healthy and Active Ageing Series

In this series, The European Observatory on Health Systems and Policies investigate key policy questions associated with population ageing, bringing together findings from research and country experiences. It reviews what is known about the health and long-term care costs of older people, and consider many of the economic and societal benefits of healthy ageing. Some key publications in the series are:

WHO technical manual on alcohol tax policy and administration

The WHO technical manual on alcohol tax policy and administration is a practical guide and a call to action for policymakers and others involved in alcohol tax policymaking to develop strong policies considering each country's unique market structure, tax administration capacity, and political economy. It also includes country case studies and summaries of evidence on alcohol tax globally.

Find the manual here.






Financing Health Promoting Services: an Information Guide

In September 2019, EuroHealthNet first launched an information guide for financing health promoting services. It demonstrates how to make transitions from spending on cures and treatments to investing in preventative approaches for better health and wellbeing. It explores how resources and capacities can be mobilised to help finance these transitions and contribute to an ‘economy of wellbeing’.


This publication served as a base for the development of this e-guide.


Find the full guide here.





Investing in Effective, Inclusive and Resilient Health and Social Care Systems in Europe

In July 2021, EuroHealthNet contributed to a technical brief "Investing in Effective, Inclusive and Resilient Health and Social Care Systems in Europe" published by the Council of Europe Development Bank. This brief argues that a more integrated approach to healthcare investments would increase the effectiveness, inclusiveness and resilience of European healthcare systems.


Find the full guide here.





Health Sector Study EU Final Report

Health Sector Study EUThis EU-wide Health Sector Study was designed to support the European Investment Advisory Hub, the EIB and the European Commission’s Directorate General for Health and Food Safety (DG SANTE), in promoting sustainable investment in Europe’s healthcare sector. The study looked to discover and evaluate optimal approaches, tools and financing schemes for investments to support the implementation of priority EU healthcare policies and reforms. The defining purpose of the study is an exploration, across EU Member States, of the gaps in healthcare investment, the barriers leading to those gaps and the reasons why the health sector investment needs and priorities are not being appropriately addressed.


This report focuses on the health care sector, but provides lessons that are also useful for public health, health promotion and disease prevention professionals.


The full report can be found here




Study on the benefits of using social outcome contracting in the provision of social services and interventions


Authors: Luka Klimavičiūtė (PPMI), Veronica Chiodo (Politecnico di Milano), Benedetta De Pieri (Politecnico di Milano), Vaida Gineikytė (PPMI)


Study on the benefits of using social outcome contracting in the provision of social services and interventions Social outcome contracts (SOCs) is a relatively new type of mechanism in public service procurement. It focuses on harnessing the resources of the public, private, philanthropy and civil society sectors, with the goal of jointly implementing effective interventions in the public domain.Nevertheless, little empirical research exists that compares SOC models with traditional financing mechanisms such as subsidies, grants, fee-for-service contracts, block contracts and in-house delivery.


The study therefore aims to assess the effectiveness and efficiency of outcomes-based contracts in comparison to interventions delivered under traditional financing, as well as evaluating the outcome measurement methods applied to determine their impact. The study focuses exclusively on social services rather than public services more generally. The annex details 15 selected social outcomes contracting schemes


The full report can be found here




Tying funds to results: a primer in results-based finance to support a just COVID recovery and foster impact driven economies


Authors: Sebastián Welisiejko, Julieta Bertolini, Amel Karboul, Jared Lee, Milena Castellnou, Alasdair Maclay, Joseph Arey


‘Tying funding to results’ is an action guide from The Global Steering Group for Impact Investment (GSG) and the Education Outcomes Fund designed to equip National Advisory Boards (NABs) better and amplify their efforts to achieve more and better outcomes to pressing social and environmental issues through results-based financing. Education, labour market development and health are the issue considered to be the most important to our efforts to build back better from the COVID crisis. This publication is the first phase of a wider workstream focused on implementing results-based finance solutions globally.


The full report can be found here.




Use of social impact bonds in financing health systems responses to noncommunicable diseases: scoping review


Authors: Emily Susannah Grace Hulse, Rifat Atun, Barbara McPake, John Tayu Lee


Use of social impact bonds scoping reviewThis is the first scoping review that explores the evidence of Social Impact Bonds (SIBs) for non-communicable diseases (NCDs) and their key characteristics and performance. A total of 11 SIBs implemented in eight countries worldwide were analysed. Three SIBs focused on diabetes, two SIBs on mental health and two SIBS on cancer, while the rest of the SIBs had a different NCD focus including hypertension, asthma and long-term conditions. The review revealed a lack of empirical evidence on SIBs for NCDs. Overall, there is a need for more high-quality studies, particularly economic evaluations and qualitative studies on the benefits to target populations, and greater transparency from the private sector, in order to ensure improved SIBs for preventing NCDs.


The full report can be found here




Social Impact Investment in the EU. Financing strategies and outcome oriented approaches for social policy innovation: narratives, experiences, and recommendations

In view of the changes in the structure, governance and modes of implementation of EU investment programmes, this study explores the further development of a social impact investment market. The analysis sets the ground for future research directions on how to finance strategies and outcomes-oriented approaches for a new generation of innovative social policies.

Outcomes based investment with third-party certification of measurable health impact, satisfy the private sector need for return with social interest objectives.


The full report is available here.




European Structural Investment Funds for Health

The ESI Funds for Health project mapped and assessed more than 7,000 health-related projects supported by the European Structural and Investment (ESI) Funds during the first four years of the 2014-2020 spending period. This report contains a summary of the key outcomes emerging from this 2-year project. It has been produced by a consortium including EuroHealthNet. 


The full report can be found here.



Financing across sectors for sustainable development

Developed by the United Nations Development Programme (UNDP) and the London School of Hygiene and Tropical Medicine-supported STRIVE Research Consortium (STRIVE) with support from the Government of Japan, ‘cross-sectoral co-financing’ or simply ‘co-financing’ offers a new and more efficient way to budget for high-value/impact interventions that deliver benefits across multiple sectors, SDGs and SDG targets simultaneously.


The full report can be accessed here.



Boosting Investment in Social Infrastructure in Europe

The High-Level Task Force (HLTF) on Investing in Social Infrastructure in Europe was initiated by the European Long-Term Investors Association (ELTI). Its mission was to raise political attention to the crucial role of social infrastructure and related services, aiming to enhance public and private investments in this sector. Long-term, flexible and efficient investment in education, health and affordable housing is considered essential for the economic growth of the European Union (EU), the well-being of its people and a successful move towards upward convergence in the EU.


This final report contains a comprehensive collection of facts and figures on social infrastructure and social services and the related financing needs. Based on the conclusions and results, the report formulates concrete recommendations aimed at enhancing current financing tools as well as for future schemes and initiatives in the social sector.


The full report is available here.




How to make the case for sustainable investment in well-being and health equity

Urgent action is needed to address the growing health, inequity, economic and environmental challenges that threaten the wellbeing of present and future generations. Current investment policies and practices are unsustainable and result in high human, social, economic and environmental costs. There is already a clear commitment and concerted action, across the WHO European Region and globally, to tackle these pressures and to drive sustainable development and prosperity for all. National and local governments can play a major role in this.


This guide outlines the step-by-step process of how to synthesize, translate and communicate public health and health economics evidence into policy and practice, making the case for sustainable investment in well-being and health equity. It is intended to help key stakeholders, advocates for health and  equity, civil servants and other health and non-health professionals who have a role in informing, influencing or shaping national and sub-national policy and practice.


The full guide is available here.




Banking for health: the role of financial sector actors in investing in global health

Authors: Rüdiger Krech, Ilona Kickbusch, Christian Franz, Nadya Wells


This paper analyses the investment opportunity in health. Evidence that health conditions directly affect the profitability of the firm demonstrates financiers and investors should incorporate this into their models. Insurance companies who are already experts at including environmental and health risks in their pricing models could provide valuable insights into how to incorporate these measures into other financial sector business models and reporting.


The paper is available here.




Banking for health: opportunities in cooperation between banking and health applying innovation from other sectors

Authors: Ilona Kickbusch, Rüdiger Krech, Christian Franz & Nadya Wells


This paper examines the challenge of making sustainable investment structures in global health more attractive for mainstream financial markets. The objective is a framework for targeted future debate with financial sector actors. Four case studies of innovative sustainable investment mechanisms are analysed, elaborating potential transfer of green and impact investment models in order to channel additional private sector funds to health.

Outcomes based investment with third-party certification of measurable health impact, satisfy the private sector need for return with social interest objectives.


The paper is available here.




The Social Protection Committee: A Voluntary European Quality Framework for Social Services


The Voluntary European Quality Framework for Social Services provides guidance on how to define, provide, assess and improve social services (2008). Many of the criteria are touched upon throughout our e-Guide.


The full report is available here.