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Health Financing Miano Munene
- Added: May, 12th 2011
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- HEALTH FINANCING
- Designing and Implementing Pro-poor
- Financing Campaign
- Miano Munene
- HERAF
- Importance of Students Involvement
- In a democracy, citizens have a right
- To know what money is being spent on,
- What decisions their elected representatives make on their behalf.
- It is only with this knowledge that elected officials can be held accountable for their budget planning, allocations and implementation.
- Monitoring government budgets is also conducive to better decision-making within government.
- It provides a forum for purposeful and concrete engagement between the executive, the legislatures and civil society around critical choices and outcomes.
- Budget Process and Systems
- An in-depth knowledge of the budget decision-making process - leads to greater influence & participation
- Stronger focus on openness and transparency in budget process is a prerequisite for independent analysis
- Growth in budget process work also reflects the changing nature of reforms to the budget process e.g “The role of Parliament and the budget”
- Budget Trainings
- Training materials can be developed for entire budget process or certain areas of the budget
- Can be used to build an audience & allies, and developing capacity within the organization
- Training courses introduce participants to an organization and enhance credibility as a future source of information
- Participating Budgeting process ...
- Is an innovative approach to budget decision making that began at municipal level in Brazil in 1989 - generated widespread interest
- Involves general public directly in making policy decisions
- Allows for open forums during budget process - opportunity for public to allocate resources, prioritize broad social policies and monitor public spending
- Breaks the tradition that the budget process should exclusively occur in the executive with inputs from budget technicians and few politicians
- Examples CSOs in Kenya have regular public forums (Pre & Post Budget Hearings)
- Kenya - “Mwananchi’s Budget’’
- South Africa’s “People’s Budget”.
- Understanding Budget Policies
- Analysis of Executive Budget Proposals
- Thorough and broad assessment of the budget when it is released by the executive
- Sector Analysis
- Focuses on an important area or sector of the economy or the government
- Reviews a sector in relation to other sectors, the entire economy or its historic levels of support
- Might include cross-country, Sectors, Ministries, departments etc comparisons. Also Recurrent vs Development vote
- Understanding Budget Policies
- Budget and Economic and Social Rights
- All economic and social rights can not be achieved immediately and all at once, but they can and should be realized progressively over time
- Examine how to operationalize rights by turning policy rhetoric or legal commitments to certain rights into budget allocations
- Examine if budgets are consistent with rights conventions
- Analysis of Effects on Different Population Groups
- Effects on different income groups: examine the spending devoted to programs and projects that assist the poor
- Effects on a particular group not defined by income: examine the impacts of the budget on a racial or ethnic minority, women, children, the disabled, people living with HIV/AIDS etc.
- At Planning & Formulation Stage
- At the Planning stage, students can;
- Collaborate with policy makers to make budget input
- Contribute in preparation of District Health Plans - DHSF
- Participate in Sector Working Groups – Health, Education etc
- Generate Proposals for Consideration for budget formulation
- Participate in Public Hearings
- Implementation Stage: What to do
- At this Stage, students can;
- Scrutinize the implementation schedule and timeframe
- Disbursement of funds
- Financial Resources management
- Human Resource management
- Documentation and records
- Procurement and use of materials
- Participation
- Impact assessment
- Health Care Financing & Budgetary Allocations Trends
- Issues
- Preventive Vs. Curative Health?
- Development Vs. Recurrent Expenditure
- Referral Vs Lower level facilities
- Disproportionate allocation to HIV/AIDS
- Challenges & Priorities in Access to Health Care Services
- Policies and institutional challenges
- Mismatch between government priorities as outlined in key policy framework and resource allocation
- Lack of Adequate Personnel
- Decentralizing Health Care
- Challenges & Priorities Access to Health Care Services
- Inequalities in access to health care
- Weak linkages between environmental factors and health
- Widening disparities:
- Inequalities in access to health care
- Constraints & Challenges
- Weak & inadequate legal/ institutional involvement
- Secretive nature of the process
- Lack of capacity to effectively engage
- Lack of inclusive & cross sectoral information
- Inherent suspicion between stakeholders
- Inadequate understanding of national policies, procedures, institutional arrangements, f/works, etc
- Lack of co-ordination /synergy for discernable reforms
- Lack of information pool (sharing)
- New Budget format – GFS
- Entry Points- Options & Strategies
- Advocacy & Lobbying
- Networking and Building Alliances
- Use of Information and Communication
- Public Education and Information outreach
- Research capacity building
- Creation of technical support team
- Demand that all disbursements to spending units to be gazetted to enable easy tracking by interest groups.
- CSO Strengths
- CSO have a host of strengths
- Simplifying budgets and deepening the debate around budget policies and decisions
- Collating and disseminating budget information in user-friendly formats
- Providing independent critical analysis
- Bringing new information to the debate
- Providing training in budget analysis and advocacy
- Helping to build a culture of accountability
- Advocating for more access to budget decision-making
- Mobilizing stakeholders, interest groups and citizens
- Providing input into budget decisions through existing channels of access (for instance submissions to parliamentary committees, SWGs)
- THANK YOU
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