Fixing the Foundations: Reflecting on common mistakes that Countries in Africa make on costing Primary Health Care

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Effective Primary Health Care (PHC) costing is not just a technical initiative, it is a strategic enabler to budget credibility, smarter purchasing and predictable financing for strengthening delivery of health services. When well applied, PHC costing empowers purchasers to align available resources with service delivery goals, negotiate better value from providers and build trust with citizens and partners through transparent, evidence-based budgeting.

This policy brief identifies five common mistakes that continue to undermine the utility of costing across African countries, despite existence of costing tools, growing interest and technical support. Drawing on a targeted literature review and insights from the International Primary Health Care Conference (ICPC 2025) held in Ethiopia from 6-10 October 2025.