Health Financing Miano Munene

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    • Designing and Implementing Pro-poor
    • Financing Campaign
    • Miano Munene
    • HERAF
  2. 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.
  3. 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”
  4. 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
  5. 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”.
  6. 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
  7. 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.
  8. 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
  9. 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
  10. 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
  11. 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
  12. 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
  13. 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
  14. 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.
  15. 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)