1
Presented at IFC seminar on innovative nancing for preservice education, March 31, 2010.
2
Ibid.
Concessionary lending
Donors can set up subsidized loan programs to help establish
or expand health professional schools. For example, through its
Health in Africa program, the IFC offers concessionary loans to
schools (IFC 2010).
Diaspora
The global diaspora, especially the health diaspora, is a rich
source of potential investment in health schools. Either large
donations from individuals or collected donations from
diaspora organizations such as the Association of Nigerian
Physicians in the Americas can be sought. For example, the
Garden City Nursing School in rural Ghana was founded
completely with the donations of a single Ghanaian physician
from that region. The West African College of Surgeons is
another institution that has provided the diaspora a vehicle
through which they can give back to their societies (Bode,
Nwawolo, and Giwa-Osagie 2008).
Diverting existing nancial streams
Currently many countries spend large sums of money in
training health workers overseas. If this money were instead
invested in founding health professional schools in-country, the
same number of health workers could be trained more
efciently. For example, Ghana was spending $500,000 per year
to train dentists in the UK, of which only 10% returned. The
government decided to divert this scholarship funding stream
into founding the rst dental school in Ghana. The school was
started with a total investment cost of $750,000 and has now
trained 200 dentists, the majority of whom are still practicing
in-country
1
. This plan reaped triple benets: not only was
Ghana able to train more dentists more cost-effectively, but
these dentists are more familiar with the pathology and
resources found in Ghana, and more of them are actually
practicing in Ghana and contributing to the health of
communities. In another example, the government of Botswana
spends $2 million a year sending patients to other countries for
medical care that could not be received in-country. Now that
the government is in the process of founding a medical school,
this care can be provided more cost effectively in-country.
Donations and endowments
Donations and endowments are large nancing contributions
to a school. The entire medical school at the University of
Chicago was established by way of a collection of endowments
by a number of donors (Anonymous 1916). Donations tend to
be spent immediately whereas endowments are invested to
provide permanent income streams to the school. Even in
countries with relatively low gross domestic products, there
are wealthy people in-country or in the diaspora who are
interested in making a permanent and visible contribution to
their country. Smaller donors can also be sought via fundraising
campaigns. Tapping into the potential of donations and
endowments requires having a donor development ofce. In
addition, school board members are often required to make
personal donations as well as to engage potential large donors.
Gifts-in-kind
Signicant contributions can be made to health science schools
as gifts-in-kind. Important gifts-in-kind can include land on
which to site a school, or buildings, or access to buildings (for
example, using an apartment block as a dorm). Gifts-in-kind
can also come from the community, such as community
members allowing students to stay in their homes in the
absence of dorms. Other gifts-in-kind may include faculty time
and medical and teaching equipment. For example, at the
Amoud Medical School in Somaliland, 35% of the faculty
teaches as volunteers. Botswana’s rst university was founded
through the “One man, one beast” campaign, which raised
money from the people of Botswana in the form of cash, cattle,
grain, eggs and other unique contributions
2
.
Health insurance funds
A number of countries have health insurance schemes that are
run by the public sector, or in partnership with the private
sector. A portion of the revenue from the health insurance
industry can be allocated to the education of health workers,
who will later contribute to the delivery of services for those
who are covered by insurance. For example, in the US Medicare
and Medicaid provide approximately $11.5 billion for graduate
medical education (Dower 2012).
Local development funds
The community-based medical schools of the Training for
Health Equity Network (THEnet) have had success in persuading
local governments to use development funds to support the
establishment of medical schools. The founding of a new
medical school in a district capital or rural town has signicant
implications for job generation, local health, and educational
opportunities. In addition, having a medical school and its
associated hospital located in their community makes it easier
for local leaders to attract other businesses and professionals.
The University of Northern Ontario conducted an analysis of
the economic impact of the new school on the city in which it
was located, and revealed that the province’s investments had
been returned threefold (Northern Ontario School of Medicine
2010). Local development funds can also be used to provide
scholarships to local students, with agreements stipulating a
required number of years of return service.
Matching funds
Schools can work with large donors to set up matching funds
that challenge other donors to make donations. The matching
donations may be made by the universities themselves as an
incentive for external organizations to make the original
contribution (UCSF n.d.). Donors are attracted to matching
funds because it allows them to leverage the funding of other
donors and effectively double the impact of their money.
Matching funds are good at attracting both large and multiple
small donations. CapacityPlus is setting up a matching fund
with the Methodist Church to help scale up the production
of health workers in Methodist health professional schools
in Africa.
Microdonations
The relative large sums needed to educate health workers
compared to other public health interventions, such as buying a
bed net or vaccinating a child, have discouraged small donors.
However, through mechanisms such as GlobalGiving.org,