3. How you can get started

EuroHealthNet Guide for Financing Prevention and Health Promotion

How you can get started

This section provides practical guidance and tools to help you conceptualise and implement alternative financing approaches for health promotion and disease prevention.

There is no single model that fits all contexts. Instead, this section draws on the experience of the Invest4Health consortium to present a flexible pathway that can be adapted to different settings, capacities, and policy environments. It introduces Smart Capacitating Investment (SCI) and outlines how it can be applied in practice to move from ideas to implementation.

What is Smart Capacitating Investment (SCI)?

Smart Capacitating Investment (SCI) involves unconventional investments, financial or non-financial, in health promotion and disease prevention (HPDP). These investments may consist of new resources or resources reallocated towards enhancing health promotion and disease prevention. All forms of SCI aim to enhance individual and community capacity for healthier behaviours, address health determinants, and promote sustainable change while reducing health inequalities.

Smart Capacitating Investment models can be broadly grouped into financial and non-financial approaches. While financial models mobilise capital to deliver measurable social and economic value, non-financial models strengthen the social fabric and build capacity for long-term change. Both are essential and complementary in transforming health promotion and disease prevention.

3. types of smart capacitating investments — Image: Classification of SCI models for Health Promotion and Disease Prevention (HPDP), adapted from Rutten-van Mölken, M., Whiteley, H., Babarczy, B. et al. (2025)

Financial Smart Capacitating Investment

These approaches mobilise financial resources to deliver both social and economic value. They can be grouped by their primary motivation:

Financial return with social impact

Outcome-based contracts (Social Impact Bonds/Social Outcomes Contracts): Investors provide upfront capital, repaid only if outcomes are achieved.
Loan-based models: Institutions like the European Investment Bank (EIB) or Council of Europe Development Bank (CEB) lend to governments or regions for social infrastructure and innovation.

Social impact primarily, with financial return

Philanthropic innovation: Foundations or philanthropists fund initiatives, such as Portugal’s Social Prescribing Network, supported by a private foundation.
Pooling of resources: Government departments pool budgets across sectors (health, housing, education) to address shared goals.

Non-financial Smart Capacitating Investment

These models do not generate financial returns but create high social value through trust, networks, and shared responsibility. Example: in-kind contributions or mobilising community assets (e.g. social prescribing, where communities pool time, skills, and spaces).

A practical pathway to applying Smart Capacitating Investment

Implementing SCI requires rethinking how resources are mobilised, allocated, and outcomes measured. Rather than a linear process, these stages are interconnected and may be revisited as your initiative develops.

The following stages are key:

Stage 1

Is this approach right for you?

Reflect on your organisation’s readiness to adopt new ways of working, including cross-sector collaboration, outcome-oriented approaches, and new financing mechanisms. Consider potential ethical risks - for example, whether introducing new financing mechanisms could unintentionally increase inequalities or shift accountability away from the public sector.

Stage 2

Define the health problem and choose the right intervention

Define the issue you aim to address, its root causes, and the long-term outcomes you want to achieve (e.g. youth mental health, healthy ageing). Frame prevention and health promotion as investments that generate multiple forms of value (economic, social, environmental), while ensuring a strong equity focus and avoiding perverse incentives.

Stage 3

Build cross-sectoral alliances

Identify and engage together stakeholders within and across sectors (health, finance, social care, education, and beyond). Clarify roles, contributions, and expected benefits, and actively manage differences in priorities and power imbalances between public, private, and community actors to enable effective collaboration.

Stage 4

Connect what partners value to outcomes worth investing in

Analyse what motivates each stakeholder and how value, risks, and responsibilities are distributed. Translate shared goals into aligned incentives and define how different actors contribute and benefit. Explore suitable financing approaches and governance arrangements, ensuring transparency and ethical safeguards.

Stage 5

Attract and engage investors

Identify suitable financing approaches and investor types (public institutions, private impact investors, philanthropic organisations, or blended finance platforms). Clarify how resources will flow, how outcomes will be rewarded, and how risks will be shared. Build a credible investment case by making the value of the initiative explicit for different stakeholders.

Stage 6

Measure outcomes and impact

Define indicators, data sources, and monitoring systems to track progress and outcomes over time. Generate evidence on health, social, and economic impacts, including value for money, and use this to strengthen accountability, and support continued or increased funding.

Stage 7

Scale and sustain intervention

Integrate successful approaches into policies, budgets and institutional practices. Strengthen organisational and system capacity to replicate, adapt, and expand effective models.

Real world examples

Portugal’s projeto família social impact bond

The Projeto Família Social Impact Bond in Portugal supports at-risk children by helping them remain safely in their family homes and preventing institutionalisation. Funded through a Social Impact Bond, the programme provides intensive family support and parenting guidance, with investors repaid only if agreed outcomes are achieved.

The Brabant Outcomes Fund

To scale social impact in the Netherlands, the Brabant Outcomes Fund uses Social Outcomes Contracting to finance social enterprises working on issues such as employment, empowerment, and inclusion. The approach links public repayment to the achievement of agreed social outcomes, including job creation and improved social participation.

ADIE’s social impact contract

Developed to address rural unemployment in France, ADIE’s Social Impact Bond expands access to microcredit for job seekers and aspiring entrepreneurs in rural areas. It provides loans and business support to help participants start businesses or find employment, with investor repayment linked to measurable social and economic outcomes.

Section 3 was developed under the Horizon Europe-funded Invest4Health project (Grant Agreement 101095522). UK participants in Horizon Europe Project Invest4Health are supported by UKRI: Bangor University (Grant number 10065737); University of Oxford (Grant number 10065737); Hywel Dda University Health Board (Grant number 10063637).

The project developed alternative business and finance models for health promotion and disease prevention, including new ways of creating value, financing, governing, collaborating, and scaling. Together, the seven briefs aim to support policymakers, practitioners, and investors in understanding and applying Smart Capacitating Investment (SCI) to expand prevention and strengthen population health.

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