Title: Assessment of the health care financing and budgeting system in the Southern Nations, Nationalities, and Peoples' Region, USAID / BASICS / ESHE, April 10, 1997.

POPLINE Document Number: 125344

Author(s):

Fabricant SJ

Source citation:

Arlington, Virginia, Partnership for Child Health Care, BASICS, 1997. [5], 22, [7] p. (Report|USAID Contract No. HRN-6006-Q-20-3032-00)

Abstract:

This trip report pertains to a consultant's visit to the Southern Nations, Nationalities, and Peoples' Region (SNNPR) of Ethiopia to assess the planning and budgeting processes and their effect on financing of the health sector. The assessment aims to indicate how the BASICS/ESHE project can contribute to health financing initiatives in SNNPR and nationally. The consultant spent four days in Addis Ababa reviewing documents and several days in SNNPR with a team from the Ministry of Finance and Ministry of Development and Cooperation that were studying the health and education budgets as part of a USAID project. There were meetings with officials from the regional, zonal, and woreda levels. Visits were made to health facilities to observe approaches to cost recovery and community participation. It is concluded that the planning and budgeting processes are not working very well. Part of the problem is the lack of uniformity in the system and insufficient trained manpower for improved efficiency. Ineffective budgeting and inefficiencies are mainly due to gross deficits in the recurrent budget, lack of control over capital investment at the regional level, and priorities. Capital investment tends to be overbudgeted and returned to the Ministry of Finance, and service delivery suffers from shortages of funds. There is an imbalance caused by central control of finances and decentralized planning. A new health care financing strategy for Ethiopia is awaiting approval. BASICS could assist by testing some of the theoretical assumptions that the new strategy relies on. Rapid appraisal methods for assessing incomes in rural areas would be useful for assessing the ability of people to pay, particularly among the rural poor. Other revenue sources should be tested. There is a need to evaluate the currently operating cost recovery schemes. The role of the private sector in urban areas should not be ignored.

Keywords:

Ethiopia
Technical Report
Recommendations
Financial Activities
Delivery of Health Care
Program Evaluation
Program Design
Developing Countries
Africa, Eastern
Africa, Sub Saharan
Africa
Economic Factors
Health
Programs
Organization and Administration