[In this blog via USAID-funded Local Health System Sustainability Project (LHSS), R4D’s Heather Viola shares insights from the Joint Learning Network for Universal Health Coverage-LHSS Health Budget Execution Learning Exchange — which R4D facilitates — on how we’re supporting countries to make health budgets more effective.]
Public budgets continue to make up the vast majority of government funding for health, making them a cornerstone of financing for universal health coverage (UHC). Even for countries that have contribution-based insurance systems, government budgetary support is significant. So, it is critical that health budgets be formulated, executed, and accounted for in a way that directs funds to national health priorities and supports effective and efficient health service delivery. Deviations from this undermine the ability of governments to make progress toward UHC objectives and ultimately ensure greater health and well-being to their populations.
Budget execution — the actual release of budget funds to spending entities — is a critical phase in the budget cycle that ultimately determines which services, activities, and providers receive funding and how they receive it. Budget execution in the health sector relates not only to timeliness and compliance with annual allocations but also to budget adequacy — the assurance that funds are spent and accounted for to achieve priority health outcomes without sacrificing the quality or efficiency of service delivery. Because of the greater complexity of health financing relative to other sectors, the deliberate design and implementation of the health financing functions — revenue generation, pooling, and purchasing — is required. These functions govern how funds flow through the health system and are used by frontline providers and other budget units to achieve service delivery objectives.
Poor budget execution – money not spent or not spent in alignment with priorities — results in inefficiencies that undermine the ability of health agencies to improve access to needed health services and improve population health. Yet, billions of dollars in unexecuted health budgets are returned to treasuries every year.
To read the full blog, click here.
Photo © David Stanley
