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Rapid Assessment of the Effect of the Economic Crisis on Health Spending in Mongolia

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2010-12
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2013-05-29
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Sande Lie, Geir Sølve
Brenzel, Logan
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Abstract
This rapid assessment examines the effect of Mongolia's economic crisis on government health budgets and health expenditure, household out-of-pocket spending and donor health commitments. This study was part of a larger assessment conducted in four countries on the effects of the economic crisis on health spending. A standardized approach was developed for all country case studies and consisted of a desk review of internationally-available literature and databases, extensive in-country review of data and documents available in government and donor offices, and semi-structured interviews with government staff, health providers and development partners. This assessment in Mongolia reveals a substantial reduction in the government health budget: the 2009 national health budget was significantly lower than the previous year's, and then was further reduced by 10 percent in a subsequent budget amendment. At national level, budget cuts were concentrated in investment line items. Among recurrent line items, the pharmaceutical budget was hardhit, but salaries were largely preserved, and there were no retrenchments. Similar patterns were observed at sub-national level for hospital budgets, which depend on the central allocations, but not for primary care facilities, which are funded on a capitation basis. Compared to other sectors, the health sector was relatively protected during the economic crisis and the share of health in the total government budget was higher after the budget amendment than before. To protect households from the effects of the economic crisis on health spending, the government undertook specific policy measures to expand health insurance coverage to vulnerable groups. Donor commitments to the health sector during the crisis largely tracked previously planned commitments.
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Sande Lie, Geir Sølve; Bredenkamp, Caryn; Brenzel, Logan. 2010. Rapid Assessment of the Effect of the Economic Crisis on Health Spending in Mongolia. Health, Nutrition And Population (HNP) discussion paper;. © World Bank. http://hdl.handle.net/10986/13599 License: CC BY 3.0 IGO.
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