The document presents an overview of funding mechanisms and strategic purchasing practices in Burkina Faso, focusing on the Gratuité program, public subsidies, community mutuals, employment-based schemes and the launch of the Universal Health Insurance Scheme (RAMU). It describes the procurement functions: governance, financial management, service specification, contractual arrangements, provider payment and performance monitoring. The Gratuité program covers free care for women and children under five, and uses the e-Gratuité platform built on DHIS2 to track and reimburse providers, with independent audits. Subsidies to public establishments and municipalities are managed by the Ministry of Health’s Administration and Finance Department, and remain constrained by line item budgets. Community mutuals and employment-based schemes offer voluntary coverage financed by contributions, with local governance. The text highlights progress, including explicit benefit packages and performance-linked payments, but identifies limitations: fragmentation of schemes, low purchaser capacity, rigid public management rules, predominantly fee-for-service payments and non-integrated information systems. It proposes to reduce fragmentation, consolidate public purchasers, improve incentives through more efficient payment methods, integrate information systems and leverage UHIP to rationalize purchasing and strengthen accountability towards universal health coverage. Local and international partners are mobilized to support these necessary sustainable transformations.