Publication: Brazil - Governance in Brazil's Unified Health System : Raising the Quality of Public Spending and Resource Management
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2007-02-15
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2012-06-11
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This report on governance in Brazil's unified health system assesses resource allocation and management, planning and budgeting functions, and budget execution at different levels of government for public expenditures on health services. The emphasis is on understanding the incentives generated for service providers, and the overall soundness of the accountabilities established in the public health services expenditure system. The analysis seeks to identify weaknesses of accountabilities for service provision that stem from the structure and process of intergovernmental and provider funding flows and related managerial practices. The paper draws on and enhances an accepted governance tool, public expenditure tracking, in both tracking funding and analyzing the governance and corresponding managerial challenges that impede effective public sector financing. The tracking instrument was applied to a sample of states, municipalities and healthcare facilities in the country in 2004.
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“World Bank. 2007. Brazil - Governance in Brazil's Unified Health System : Raising the Quality of Public Spending and Resource Management. © World Bank. http://hdl.handle.net/10986/7754 License: CC BY 3.0 IGO.”
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Publication Brazil - Governance in Brazil's Unified Health System : Raising the Quality of Public Spending and Resource Management(Washington, DC, 2007-02)This report on governance in Brazil's unified health system assesses resource allocation and management, planning and budgeting functions, and budget execution at different levels of government for public expenditures on health services. The emphasis is on understanding the incentives generated for service providers, and the overall soundness of the accountabilities established in the public health services expenditure system. The analysis seeks to identify weaknesses of accountabilities for service provision that stem from the structure and process of intergovernmental and provider funding flows and related managerial practices. The paper draws on and enhances an accepted governance tool, public expenditure tracking, in both tracking funding and analyzing the governance and corresponding managerial challenges that impede effective public sector financing. The tracking instrument was applied to a sample of states, municipalities and healthcare facilities in the country in 2004.Publication Brazil - Raising the Quality of Public Spending and Resource Management in the Health Sector(World Bank, Washington, DC, 2007-09)The report assesses how the processes of allocation, transfer, and utilization of resources are conducted at the different levels of the system. The study provides valuable information regarding the reality of the executing units of the system and how these relate to the central levels. It also seeks to identify problems related to financial flows, analyze how resources are used at the local level, and estimate their impact on the efficiency and quality of health services in general. In this respect, the study provides a basis for improving the entire cycle of public resource management processes (i.e., planning, budgeting, budget execution, input management, and health service production) in the health sector, which together help to bolster good governance in health care delivery. This report referenced in this note assesses resource allocation and management, planning and budgeting functions, and budget execution at different levels of government for public expenditures on health services. The emphasis is on understanding the incentives generated for service providers, and the overall soundness of the accountabilities established in the public health services expenditure system. The analysis seeks to identify weaknesses of accountabilities for service provision that stem from the structure and process of intergovernmental and provider funding flows and related managerial practices.Publication Republic of Congo : Enhancing Efficiency in Education and Health Public Spending for Improved Quality Service Delivery for All(Washington, DC, 2014-06)The development of a wealthier, literate, and healthy society is a fundamental goal of Congo's national development plan (NDP) 2012-16 and poverty reduction strategy paper (PRSP) 2012-16. Appropriate funding allocations and efficient use of funds in education and health are fundamental for the development of the sectors. This public expenditure review (PER) of the Congolese education and health sectors aims at providing inputs to improve efficiency and equity in spending in these sectors. 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The overarching message in this report is that, despite the relative contraction of the public sector wage bill, Rwanda has not only protected the health sector, but has succeeded through decentralization and the introduction of performance-based financing in linking salaries to performance in the health sector. The decentralization of budgets, along with the implementation of the performance-based grants scheme, has had two major effects. First, it has increased the resource envelope available for hiring health workers since there is a lot of flexibility in how the performance based grants can be used. Second, it has linked payments to health workers with performance, since the salary top amounts paid out of the grants are linked to service delivery results.
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