Publication: Sierra Leone Public Expenditure Review 2021: Improving Quality of Public Expenditure in Health
Loading...
Published
2021-06-01
ISSN
Date
2021-11-02
Author(s)
Editor(s)
Abstract
Sierra Leone is a low-income, small West African country of approximately 7.65 million population. Over the past decade, the country has made gains on several health indicators, but it faces huge challenges. Infectious diseases remain the leading causes of morbidity and mortality, but non-communicable diseases appear to be trending upward. Critical skills and competencies in public financial management, procurement, and monitoring and evaluation (M&E) require strengthening to deliver health improvements. The objective of this Public Expenditure Review (PER) was to assess public expenditure on health to inform policymakers of the effectiveness, efficiency, and equity of health expenditures in Sierra Leone.
Link to Data Set
Citation
“World Bank. 2021. Sierra Leone Public Expenditure Review 2021: Improving Quality of Public Expenditure in Health. © World Bank. http://hdl.handle.net/10986/36451 License: CC BY 3.0 IGO.”
Digital Object Identifier
Associated URLs
Associated content
Other publications in this report series
Journal
Journal Volume
Journal Issue
Collections
Related items
Showing items related by metadata.
Publication Sierra Leone - Public Expenditure Review : From Post-Conflict Recovery to Sustained Growth(Washington, DC, 2004-08-31)This Public Expenditure Review is to assist the Government of Sierra Leone in repositioning itself for sustained growth and poverty reduction in the long-run as opposed to the short-term expediencies needed during the present post-conflict phase. The report focuses on the period 2001-2003 for history and 2004-2006 for the future. A review of older historical data at the aggregate level is done in the macroeconomic section for the period 1998-2003 in order to demonstrate the contrast between the war and post-war years. The report covers the fiscal policies of Government in aggregate and goes deeper for three sectors: security, agriculture and education. All three are critical to growth and poverty reduction. It also proposes a number of changes in the budget process. It reviews the budgets and capacity of the security service ministries, departments and agencies (MDAs). The maintenance of security is fundamental: without it, there is little incentive to invest for future growth. The report examines the budgets and capacities of the agricultural MDAs. Finding ways to increase agricultural growth is equally critical, especially since the majority of the population still lives in rural areas. The education sector is also examined in depth, due to its central contributions to the long-run productivity of the workforce - and because of its large impact on the fiscal stance of Government.Publication United Republic of Tanzania - Public Expenditure Review 2011(Washington, DC, 2012-07)The 2011 Public Expenditure Review (PER) is divided into two parts. The first describes recent developments in fiscal policy, with a particular focus on the adjustment announced in November 2011 as well as short and long term prospects. The second part assesses government performance in the health sector, which accounts for about 10 percent of the total budget. The objectives of the budget analysis chapter are to: 1) document fiscal and macro developments since November 2011, after the government made adjustments to the budget under the International Monetary Fund (IMF) Policy Support Instrument (PSI). Government reduced the fiscal deficit in the budget to approximately 6.6 percent of Gross Domestic Product (GDP) from approximately 8.0 percent of GDP in the initially approved budget for 2011/12. 2) Take stock of budget execution in 2010/11 and strategic budget allocation in 2011/12 in relation to Government strategic objectives of economic growth and poverty reduction as envisaged in MKUKUTA (Mpango wa Kukuza Uchumi na Kupunguza Umaskini Tanzania-Tanzania's National Strategy for Growth and Reduction of Poverty) and Five Year Development Plan (FYDP). 3) Highlight a number of priorities that Government needs to take into account in formulating its fiscal policy both in the short and longer terms. In 2011, the recurring domestic energy crisis negatively affected the level of private sector activities. The Bank of Tanzania's tighter monetary policy is aimed at reducing the inflation rate, which reached 16.8 percent and 19.8 percent in September and December 2011, respectively.Publication Angola : Public Expenditure Review, Volume 1. Policy Briefing(Washington, DC, 2007-12-20)This report concerns about policy briefing and outlines the main findings and policy options associated with the analysis of public spending in terms of equity and allocative efficiency. This Public Expenditure Review (PER) covers the sectors of Education, Health, Agriculture, and the area of decentralization. The main objective of this Public Expenditure Review is to examine the allocative efficiency and equity of public spending in Angola. Five cross-cutting messages are drawn from the analysis of public spending and fiscal management in the context of this Public Expenditure Review: (i) the need to prepare public spending plans within a multiyear perspective; (ii) the need to improve the efficiency of public spending; (iii) the need to improve the quality of the data on social indicators and on the budget; (iv) the need to observe equity considerations in the preparation of the budget ; and (v) the need for steady progress with decentralization. The first volume, a policy briefing, outlines the main findings and policy options associated with the analysis of public spending in terms of equity and allocative efficiency. The second volume presents a fuller assessment of each sector and on decentralizationPublication Moldova Public Expenditure Review : Capital Expenditures - Making Public Investment Work for Competitiveness and Inclusive Growth in Moldova(Washington, DC, 2013-06)This public expenditure review (PER) for Moldova is the result of a body of programmatic fiscal work. This PER focuses on capital expenditure. It supports the first pillar of the country partnership strategy (improving economic competitiveness) and complements the 2012 development policy operation. In the context of economic recovery and stabilization, government requested World Bank assistance in improving its capital allocation mechanism, as its fiscal consolidation program attempted to create space for critical infrastructure whilst gradually reducing the state's footprint in the economy. This report recommends ways to strengthen public investment processes, institutions, and sector policies to achieve better outcomes for public capital expenditures in Moldova. This report suggests reforms in public investment management and sector policies to raise cost-effectiveness and allocative efficiency of capital expenditures. Three key areas of reform are: (i) raise the quality of new projects by improving preliminary screening and project appraisal mechanisms; (ii) improve selection of new projects and ensure continuity of funding for ongoing projects through better prioritization and budgeting processes; and (iii) strengthen monitoring of project implementation for cost efficiency and timely delivery of public services. The report has four chapters. The first chapter presents the macroeconomic outlook and its implications for fiscal policy, particularly with respect to the capital budget. The second chapter presents the structure and classification of the capital budget as well as recent trends in capital expenditure levels and execution, and reviews the adequacy of resource allocations and utilization across sectors, given investment needs, national priorities and implementation capacity. The third chapter reviews public investment management processes and presents recommendations to improve the efficiency of public capital expenditure in Moldova. The fourth chapter discusses specific sector challenges and offers recommendations for improving capital expenditure outcomes.Publication Samoa Public Expenditure Review Notes : Taking Stock of Expenditure Trends from FY06-FY12(Washington, DC, 2014-03)Samoa's fiscal position and the structure of its budget have evolved markedly in recent years. Samoa had built up sufficient fiscal space in the early to mid-2000s to be able to respond to a major exogenous shock. The objective of the public expenditure review (PER) notes is to assist the Government of Samoa (GoS) in taking stock of the evolving expenditure trends in recent years and to strengthen the analytical basis for the management of public expenditure. Financial management information systems (FMIS) data was consistently classified and supplemented with project grant and loan related data from ministry of finance accounts to compile a full database of domestically and externally funded expenditure. The analysis of the public wage bill combines FMIS data with data from the payroll system. It also incorporates payroll data from the accounts of the largest public agencies to present approximate estimates of payroll trends for the whole government for the first time. This note will look backwards to take stock of the factors that accounted for fiscal expansion since FY2006, and look ahead to highlight the impact of cyclone Evan on the fiscal position from 2013 onwards. The first part of the note will review trends in public expenditure, revenues, grants, financing, and budget execution to provide insight into which aspects resource allocation have changed the most in real terms from 2006 to 2012, and decompose trends to identify the main drivers of growth in the budget. The second part of the note focuses on the impact of cyclone Evan on Samoa's fiscal position from 2013 onwards, and presents projections of the fiscal path in long-term in light of higher deficit and debt levels.
Users also downloaded
Showing related downloaded files
Publication Using Immunization Coverage Rates for Monitoring Health Sector Performance : Measurement and Interpretation Issues(World Bank, Washington, DC, 2000-08)Immunization against childhood diseases such as diphtheria, pertussis, tetanus, polio and measles is one of the most important means of preventing childhood morbidity and mortality. Despite the low cost of basic childhood immunizations, nearly 3 million children still die each year from vaccine-preventable diseases. Achieving and maintaining high levels of immunization coverage must therefore be a priority for all health systems. In order to monitor progress in achieving this objective, immunization coverage data can serve as an indicator of a health system's capacity to deliver essential services to the most vulnerable members of a population. This note discusses the use of trends in immunization coverage data, and argues that immunization is a health output with a strong impact on child morbidity, child mortality and permanent disability. This note discusses measurement and interpretation issues for coverage data collected through surveys and administrative records.Publication Global Economic Prospects, January 2025(Washington, DC: World Bank, 2025-01-16)Global growth is expected to hold steady at 2.7 percent in 2025-26. However, the global economy appears to be settling at a low growth rate that will be insufficient to foster sustained economic development—with the possibility of further headwinds from heightened policy uncertainty and adverse trade policy shifts, geopolitical tensions, persistent inflation, and climate-related natural disasters. Against this backdrop, emerging market and developing economies are set to enter the second quarter of the twenty-first century with per capita incomes on a trajectory that implies substantially slower catch-up toward advanced-economy living standards than they previously experienced. Without course corrections, most low-income countries are unlikely to graduate to middle-income status by the middle of the century. Policy action at both global and national levels is needed to foster a more favorable external environment, enhance macroeconomic stability, reduce structural constraints, address the effects of climate change, and thus accelerate long-term growth and development.Publication The Container Port Performance Index 2023(Washington, DC: World Bank, 2024-07-18)The Container Port Performance Index (CPPI) measures the time container ships spend in port, making it an important point of reference for stakeholders in the global economy. These stakeholders include port authorities and operators, national governments, supranational organizations, development agencies, and other public and private players in trade and logistics. The index highlights where vessel time in container ports could be improved. Streamlining these processes would benefit all parties involved, including shipping lines, national governments, and consumers. This fourth edition of the CPPI relies on data from 405 container ports with at least 24 container ship port calls in the calendar year 2023. As in earlier editions of the CPPI, the ranking employs two different methodological approaches: an administrative (technical) approach and a statistical approach (using matrix factorization). Combining these two approaches ensures that the overall ranking of container ports reflects actual port performance as closely as possible while also being statistically robust. The CPPI methodology assesses the sequential steps of a container ship port call. ‘Total port hours’ refers to the total time elapsed from the moment a ship arrives at the port until the vessel leaves the berth after completing its cargo operations. The CPPI uses time as an indicator because time is very important to shipping lines, ports, and the entire logistics chain. However, time, as captured by the CPPI, is not the only way to measure port efficiency, so it does not tell the entire story of a port’s performance. Factors that can influence the time vessels spend in ports can be location-specific and under the port’s control (endogenous) or external and beyond the control of the port (exogenous). The CPPI measures time spent in container ports, strictly based on quantitative data only, which do not reveal the underlying factors or root causes of extended port times. A detailed port-specific diagnostic would be required to assess the contribution of underlying factors to the time a vessel spends in port. A very low ranking or a significant change in ranking may warrant special attention, for which the World Bank generally recommends a detailed diagnostic.Publication Business Ready 2024(Washington, DC: World Bank, 2024-10-03)Business Ready (B-READY) is a new World Bank Group corporate flagship report that evaluates the business and investment climate worldwide. It replaces and improves upon the Doing Business project. B-READY provides a comprehensive data set and description of the factors that strengthen the private sector, not only by advancing the interests of individual firms but also by elevating the interests of workers, consumers, potential new enterprises, and the natural environment. This 2024 report introduces a new analytical framework that benchmarks economies based on three pillars: Regulatory Framework, Public Services, and Operational Efficiency. The analysis centers on 10 topics essential for private sector development that correspond to various stages of the life cycle of a firm. The report also offers insights into three cross-cutting themes that are relevant for modern economies: digital adoption, environmental sustainability, and gender. B-READY draws on a robust data collection process that includes specially tailored expert questionnaires and firm-level surveys. The 2024 report, which covers 50 economies, serves as the first in a series that will expand in geographical coverage and refine its methodology over time, supporting reform advocacy, policy guidance, and further analysis and research.Publication Global Economic Prospects, June 2025(Washington, DC: World Bank, 2025-06-10)The global economy is facing another substantial headwind, emanating largely from an increase in trade tensions and heightened global policy uncertainty. For emerging market and developing economies (EMDEs), the ability to boost job creation and reduce extreme poverty has declined. Key downside risks include a further escalation of trade barriers and continued policy uncertainty. These challenges are exacerbated by subdued foreign direct investment into EMDEs. Global cooperation is needed to restore a more stable international trade environment and scale up support for vulnerable countries grappling with conflict, debt burdens, and climate change. Domestic policy action is also critical to contain inflation risks and strengthen fiscal resilience. To accelerate job creation and long-term growth, structural reforms must focus on raising institutional quality, attracting private investment, and strengthening human capital and labor markets. Countries in fragile and conflict situations face daunting development challenges that will require tailored domestic policy reforms and well-coordinated multilateral support.