Book excerpt: One of the most urgent development challenges facing many low and middle income countries is the need for adequate financing systems to pay for health care provision to the estimated 1.3 billion impoverished people living in rural areas or working in the informal sector in urban areas. This publication considers ways of improving the financing of health care at low income levels, as part of a global strategy for increased investment in health and poverty reduction. Topics discussed include: global and regional trends in healthcare financing; strengths and weaknesses of community-based health financing, and experiences in Asia and Africa; country case studies using household survey analysis from Senegal, Rwanda, India and Thailand; deficit financing; and the impact of risk sharing on achieving health system goals.