Publication:
Pakistan Budget Execution in Health: From Bottlenecks to Solutions

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dc.contributor.authorHadi, Qurat ul Ain
dc.contributor.authorVerhaghe, Johan
dc.contributor.authorYunus, Hammad
dc.date.accessioned2025-07-15T19:21:52Z
dc.date.available2025-07-15T19:21:52Z
dc.date.issued2025-07-15
dc.description.abstractPakistan’s overall national health budget had a high rate of execution from 2016 to 2019, averaging 95 percent. However, execution rates between provinces as well as between categories of spending varied significantly. At the health facility level, execution of spending is notably challenging, particularly for non-wage expenditure. Good practices that facilitated better budget execution included strong integration of payroll and personnel records in most provinces as well as the contracting out of the provision of primary healthcare services to the private sector in Sindh, Baluchistan, and Punjab Provinces. This approach has facilitated more consistent budget execution rates and evidence of resources reaching the facility level. There remain challenges, however, with ensuring the accountability of how these resources are used. The main bottlenecks holding back the quality of budget execution include an inability to track primary, secondary, and tertiary healthcare budgets and their execution; systematic over-estimation of resources by the provinces; weaknesses in budget preparation processes; inefficiency in spending control processes; lack of autonomy for primary healthcare facilities; insufficient integration of vertical programs in local health systems; and lack of a process for capturing spending arrears.en
dc.identifierhttp://documents.worldbank.org/curated/en/099062325124532460
dc.identifier.doihttps://doi.org/10.1596/43460
dc.identifier.urihttps://hdl.handle.net/10986/43460
dc.languageEnglish
dc.language.isoen_US
dc.publisherWashington, DC: World Bank
dc.rightsCC BY-NC 3.0 IGO
dc.rights.holderWorld Bank
dc.rights.urihttps://creativecommons.org/licenses/by-nc/3.0/igo
dc.subjectGOOD HEALTH
dc.subjectBUDGET EXECUTION CHALLENGES
dc.subjectHEALTH FINANCING PERSPECTIVE
dc.subjectPUBLIC FINANCIAL MANAGEMENT
dc.titlePakistan Budget Execution in Healthen
dc.title.subtitleFrom Bottlenecks to Solutionsen
dc.typeWorking Paper
dspace.entity.typePublication
okr.date.disclosure2025-07-15
okr.date.doiregistration2025-07-17T02:11:10.056604Z
okr.date.lastmodified2025-06-26T16:05:32Zen
okr.doctypePublications & Research::Working Paper
okr.doctypePublications & Research
okr.docurlhttp://documents.worldbank.org/curated/en/099062325124532460
okr.guid099062325124532460
okr.identifier.docmidP506726-b1af48cd-9549-4ee4-b6ed-359b86e2e98d
okr.identifier.externaldocumentum40024271
okr.identifier.internaldocumentum40024271
okr.identifier.report202494
okr.import.id7963
okr.importedtrueen
okr.language.supporteden
okr.pdfurlhttps://documents.worldbank.org/curated/en/099062325124532460/pdf/P506726-b1af48cd-9549-4ee4-b6ed-359b86e2e98d.pdfen
okr.region.administrativeSouth Asia
okr.region.countryPakistan
okr.sectorFY17 - Health
okr.sectorHealth
okr.themeFY17 - Health Finance,FY17 - Health System Strengthening,FY17 - Health Systems and Policies,FY17 - Health Service Delivery
okr.themeFY17 - Human Development and Gender
okr.topicHealth, Nutrition and Population::Health Economics & Finance
okr.topicFinance and Financial Sector Development::Public & Municipal Finance
okr.topicHealth, Nutrition and Population::Health Systems Development & Reform
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