Government Finance
better systems, better health
i nfo@HealthSystems2020.org w w w. H e a l t h S y s t e m s 2 0 2 0 . o r g
Public Budgeting and Expenditure
Management in Three Nigerian States:
Challenges for Health Governance
April 2012
IntroductIon
Financial data and management are critical to effective health governance. Access to, and use of, timely and accurate health budgeting and expenditure data are key to public health officials’ capacity to make future investment decisions, understand the effectiveness of current allocations for health, and act as effective stewards of the health system. once decisions are made about how to allocate resources, the managerial processes for ensuring that resources arrive in the right place, are used for the correct purposes, and are reported on accurately and transparently, also form an integral element of health governance. Available and transparent financial data in turn enable the exercise of accountability. these data support accountability relationships within government
– for example between health ministries and legislatures, and between federal and local levels of government – and relationships between government and citizens. consistent internal financial control mechanisms, effective budget and expenditure reporting, and citizen monitoring all contribute to ensuring accountability. Several tools exist that can help analysts and decision makers to review funding and spending flows and management, and to identify resource uses and leakages. these include assessment instruments such as Public
Expenditure tracking Surveys, which follow the flow of funds from the central government down to decentralized levels and to service providers, and Quantitative Service delivery
Surveys, which examine the efficiency of frontline service delivery. A Public Expenditure
Management review (PEMr) combines elements of both surveys and examines the overall governance environment of public expenditure management by studying both how health resources
i nfo@HealthSystems2020.org w w w. H e a l t h S y s t e m s 2 0 2 0 . o r g
Public Budgeting and Expenditure
Management in Three Nigerian States:
Challenges for Health Governance
April 2012
IntroductIon
Financial data and management are critical to effective health governance. Access to, and use of, timely and accurate health budgeting and expenditure data are key to public health officials’ capacity to make future investment decisions, understand the effectiveness of current allocations for health, and act as effective stewards of the health system. once decisions are made about how to allocate resources, the managerial processes for ensuring that resources arrive in the right place, are used for the correct purposes, and are reported on accurately and transparently, also form an integral element of health governance. Available and transparent financial data in turn enable the exercise of accountability. these data support accountability relationships within government
– for example between health ministries and legislatures, and between federal and local levels of government – and relationships between government and citizens. consistent internal financial control mechanisms, effective budget and expenditure reporting, and citizen monitoring all contribute to ensuring accountability. Several tools exist that can help analysts and decision makers to review funding and spending flows and management, and to identify resource uses and leakages. these include assessment instruments such as Public
Expenditure tracking Surveys, which follow the flow of funds from the central government down to decentralized levels and to service providers, and Quantitative Service delivery
Surveys, which examine the efficiency of frontline service delivery. A Public Expenditure
Management review (PEMr) combines elements of both surveys and examines the overall governance environment of public expenditure management by studying both how health resources