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Mechanisms of financial sustainability of third sector integrated care: contracting and financial flows


Tatyana Svetlovich ,

Belarus Red Cross, BY
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Tatyana Haplichnik

Swiss Red Cross, BY
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Introduction: In 2019 in Belarus, the average life expectancy was 74.4 years. The proportion of the population aged 65 and over was 15.2%. According to the World Bank experts’ estimation, the number of the population in need of long-term care is about 600,000. 

The Belarus Red Cross (BRC) is a non-governmental organization and the main provider of integrated home-based care for people in need. The number of BRC nurses decreased from 1’000 (being paid from the state budget) to about 100 in the early 2000's due to budget cut.

Aims, Objectives, Theory or Methods: For more than 10 years, the BRC has been working on increasing the financial sustainability of home-based medico-social care through diversifying its sources of funding.

The BRC was one of the initiators of the state social contracting mechanism (SSC), which enables the involvement of non-state organisations in the provision of social and medical services based on competitive selection. Contracting is funded from local budgets.

Professional in-country fundraising – another potential source of funds. Based on the results of the 2018 market study, BRC developed its Fundraising Strategy focused on attracting and retaining regular supporters of the medico-social service.

Highlights or Results or Key Findings: More than 320 SSC contracts were executed by the BRC between 2013 and 2020. In 2020, state local budgets covered 34.2 percent of the costs for home-based medico-social care provision.

Since 2020 the regular giving program – F2F campaign “Direct dialogue” – has been functioning in Belarus Red Cross. About 2,350 active supporters have been engaged. Total monthly income (including newly engaged supporters) reaches about 50,000 BYN (18 ,115 CHF).

According to the F2F financial model, with current and planned investments by 2024, the BRC could attract 31,500 regular supporters with a monthly income of CHF 240,000.

Thanks to various sources of funding, more than 1,350 needy citizens – lonely older people with multiple chronic morbidity and disabilities – in 70 regions of Belarus were provided home-based care in 2020. The beneficiaries’ average age is 82 years; 44 per cent of the beneficiaries have severe limitations on mobility and self-care).

Conclusions: The BRC involvement in implementation of the SSC, as well as increased investment in fund raising system infrastructure and the involvement of supporters, combined with full reinvestment, will ensure the sustainability of the medico-social service, as well as increased coverage of the older people in need of home-cased long-term care.

Implications for applicability/transferability, sustainability, and limitations: The BRC is working to secure its position as a reliable partner for the state in provision of home-based medico-social care. Increased financial sustainability of the BRC Medico-Social Service will allow to scale-up the services and advocate for integrated home-based care institutionalization with established financial mechanisms at the national level.
How to Cite: Svetlovich T, Haplichnik T. Mechanisms of financial sustainability of third sector integrated care: contracting and financial flows. International Journal of Integrated Care. 2022;22(S3):252. DOI:
Published on 04 Nov 2022.


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