Introduction: As one of the avenues for implementing universal health coverage, healthcare verification for financing health facilities is receiving increased attention. Verification is the process of ensuring that healthcare services provided to users meet the predetermined criteria for billing and payment. The objective of this article was to examine the Burundi health system practices in healthcare verification for financing health facilities in order to identify strengths, limitations, and potential solutions for more advancement in universal health coverage implementation. Methods: A critical case study was used as the overall methodological approach and a narrative review design to draw conclusions about the case. Results: The results show that verification helps visualise the country’s level of progression in implementation of universal health coverage. While it promotes efficiency in healthcare service reimbursement by allowing payment for quality care services, verification has proven to be a resilient function to fraud, abuse, and waste in the demand for, and supply of, healthcare services. However, verification has some limitations in terms of services and population targeting, and technical effectiveness of the verification team. The most important way identified for alleviating these limitations is to separate the demand for, and supply of, healthcare services. Conclusions: More investments in research are required to recognise verification as an essential sub-function of health financing for universal health coverage implementation.

Background Regardless of its form, financing health in isolation will never raise sufficient funds to lead to universal health coverage. Achieving this goal which is not a pure health policy, requires multisectoral collaboration to support financing mechanisms. Within this framework, the World Health Organization has created the Health Financing Progress Matrix to assess a country’s progress in health financing. The World Health Organization calls for multisectoral support for health financing systems to achieve universal health coverage. This paper aims to explain how health diplomacy can be defined and implemented to influence and facilitate multisectoral participation in fighting against fragmentation and increase necessary budget to internalize the health financing progress matrix in Burundi. Main text Burundi’s health financing system is characterized by multiple fragmentation of resources and services, which reinforces economic and health inequities, referred to as de-universalization of universal health coverage. The health financing system in Burundi is inadequate to meet the health needs of the population. Different people with different needs form different segments, and coverage may be inconsistent, duplicative, or incomplete. Health diplomacy can alleviate this situation by appointing health finance attachés in each of the 19 sectors that make up the life of the country. Health finance attachés may have three main tasks:1) promoting confidence building, 2) seeking consensus, and 3) building solidarity for universal health coverage. The practices of health finance attachés can help to improve budget for more coverage. Following the World Health Organization’s progress matrix on health financing, internalization can be achieved in four ways: (i) raising the profile of health diplomats to be accredited in non-health sectors, (ii) establishing offices of health finance attachés in each sector, (iii) creating means by which sectors benefiting from internalization act, (iv) operationalizing proportionate universal health coverage. Conclusion Health diplomacy holds an ethical practice (representation approach) for internalizing the matrix. Measuring the size of the health gap and the steepness of the health gradient determines the degree of matrix internalization. Health diplomacy needs to be included in all health financing agendas to achieve proportionate universal health coverage in poor countries like Burundi.