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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,…
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HEALTH FINANCING Designing and Implementing Pro-poor 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 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 Financial Resources management Human Resource management Documentation and records Procurement and use of materials Health Care Financing & Budgetary Allocations Trends 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 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) Entry Points- Options & Strategies 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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