Publication: Myanmar Improving Public Financial Management for Health Services: Challenges and Opportunities for Improving Service Delivery in the Wake of COVID
Loading...
Date
2020-08-27
ISSN
Published
2020-08-27
Author(s)
Editor(s)
Abstract
Myanmar exhibits poor health outcomes and lags regional peers. Myanmar’s Human Capital Index (HCI) score is 0.47, compared to a regional average of 0.60. Every year, 2,000 pregnant women and 50,000 children die from preventable causes, and 29 percent of children under age 5 are stunted. While there are many reasons for these poor outcomes, the effective coverage (access, utilization, and quality) of service delivery in the health sector plays a fundamental role. Budget execution remains prominent among PFM challenges in the health sector, demonstrated by several roadblocks to spending on time and on target. There is an urgent need to better understand the PFM bottlenecks that affect frontline service delivery. Budgeted expenditure for the Ministry of Health and Sports (MoHS) has been increasing, but actual spending has been declining. Budgeted expenditure increased for the MoHS from 0.86 percent of gross domestic product (GDP) in 2014-15 to 1.15 percent of GDP in 2017-18. However, actual expenditure by MoHS has declined from 1.0 percent to 0.8 percent of GDP in the same period. The increase in resources available through the budget allocation process had helped expand access and availability of health services to some extent, but it has not been able to address significantly the major health challenges and achieve better outcomes at population level. This is partly due to weaknesses at several points along the chain of financial management within MoHS and at the point of service delivery. The main objective of this report on PFM in the health sector is to improve service delivery and the efficiency of health financing at all levels of health care in Myanmar. This will be achieved by identifying and analyzing relevant PFM bottlenecks and providing recommendations to address them. Secondary objectives are to deepen the understanding of PFM arrangements in Myanmar’s health sector, including the PFM reforms required under the health financing reforms for UHC, and strengthen the communication and coordination between MoHS and MOPFI to ensure sustainability of reforms going forward.
Link to Data Set
Citation
“World Bank. 2020. Myanmar Improving Public Financial Management for Health Services: Challenges and Opportunities for Improving Service Delivery in the Wake of COVID. © World Bank. http://hdl.handle.net/10986/36133 License: CC BY 3.0 IGO.”
Associated URLs
Associated content
Other publications in this report series
Journal
Journal Volume
Journal Issue
Collections
Related items
Showing items related by metadata.
Publication Morocco - Public Financial Management Performance Report (PEFA) : Assessment of Public Financial Management Systems, Procedures, and Institutions(World Bank, 2009-05-01)This Public Financial Management Performance Report (PFM-PR) assesses the current performance of financial management in Morocco's public sector. The Public Expenditure and Financial Accountability (PEFA) framework applied for this review uses an assessment tool based on a set of high-level indicators that provide reliable information on the performance of PFM systems, processes and institutions. The purpose of using this tool is to measure performance for five PFM areas in Morocco as compared to international standards. The Kingdom of Morocco is a medium-income country with a population of 31 million and per capita income of European Union (EU) 2,300 (2007). Average life expectancy has significantly improved to 72.4 years in 2007, reflecting a progressive improvement in living standards. Nonetheless, major social challenges remain, in particular the economic insecurity of a large segment of its residents. Despite a considerable improvement in poverty indicators during this century (the incidence of poverty fell from 15.3 percent in 2001 to 9 percent in 2007), more than a quarter of the population in 2007 remained economically vulnerable. The report covers public expenditure at the central government level, including central government's financial relationships with local and regional governments and with public enterprises (PE). Morocco has a relatively large public sector that accounts for 53 percent of gross domestic product (GDP) (2007), comparable to that for other Magreb countries.Publication Public Financial Managment in Aceh : Measuring Financial Management Performance in Aceh's Local Governments(Washington, DC, 2007-03)This economic report holds that capacity in financial management varies widely across local governments in Aceh. While some local governments achieve reasonable outcomes in financial management capacity, others are lagging far behind. Capacity in key aspects of financial management also varies within individual local governments. Average outcomes indicate particular weaknesses in accounting and reporting, cash management and external audit.Publication Capacity Constraints and Public Financial Management in Small Pacific Island Countries(World Bank, Washington, DC, 2012-12)Drawing on Public Expenditure and Financial Accountability assessment scores from 118 countries, this paper provides the first comparative analysis of public financial management performance in small Pacific Island Countries (PICs). It applies a Tobit regression model across the full cross-country sample of Public Expenditure and Financial Accountability scores and country variables to identify potential causes for the observed underperformance of Pacific Island countries relative to other countries of similar income. First, the analysis finds small population size to be negatively correlated with Public Expenditure and Financial Accountability scores, with the "population penalty" faced by small Pacific Island countries sufficient to explain observed underperformance. Second, through application of a new capacity index of Public Expenditure and Financial Accountability dimensions, it finds strong evidence in support of the hypothesis that small population size impacts scores through the imposition of capacity constraints: with a limited pool of human capital, small countries face severe and permanent challenges in accessing an adequate range and depth of technical skills to fulfill all functions assessed through the Public Expenditure and Financial Accountability framework. These findings suggest that approaches to strengthening public financial management in small Pacific Island countries should involve: i) careful prioritization of public financial management capacity toward areas that represent binding constraints to development; ii) adoption of public financial management systems that can function within inherent and binding capacity constraints, rather than wholesale adoption of "best practice" imported systems; and iii) consideration of options for accessing external capacity to support public financial management systems on a long-term basis, from regional agencies, the private sector, or donors.Publication Getting Better : Improving Health System Outcomes in Europe and Central Asia(Washington, DC: World Bank, 2013-06-10)This report is about how to improve health system outcomes in countries in the Europe and Central Asia (ECA) region. Long-term historical trends indicate substantial room for improvement, especially when ECA's health outcomes are compared to those of the Austria, Belgium, Denmark, Finland, France, Germany, Greece, Ireland, Italy, Luxembourg, the Netherlands, Portugal, Spain, Sweden, and the United Kingdom (EU-15). Instead of catching up with their Western neighbors, many countries in ECA have been falling behind. This report, which explores the development challenge facing health sectors in ECA, identifies three key agendas for achieving more rapid convergence with the world's best-performing health systems: (i) the first is the health agenda, in which the main imperative is to strengthen public health and primary care interventions to help achieve the 'cardiovascular revolution' that has taken place in the west in recent decades; (ii) the second is the financing agenda, in which growing demand for medical care must be satisfied without imposing an undue burden on households, by achieving better financial protection, or on government budgets, by ensuring a more efficient use of resources; and (iii) the third agenda relates to broader institutional arrangements. Here, a few key reform ingredients are identified, each of which is common to most advanced health systems but lacking in many ECA countries.Publication Zambia Health Sector Public : Accounting for Resources to Improve Effective Service Coverage(Washington, DC: World Bank, 2009)Over the past few years, three nagging problems have bedeviled Zambia's health sector: the country is falling off-track from reaching the Millennium Development Goals (MDGs), it is facing severe financing constraints on the government front, and the health and HIV/AIDS sector is increasingly being fragmented by the reemergence of global disease initiatives. This health sector pubic expenditure review (PER) seeks to assist the Government of the Republic of Zambia (GRZ) and its development partners take stock of the resources in the health sector and how these resources can be better used to produce better health services. The results of the PER are expected to be the used for a variety of purposes, including the preparation of the health sector strategic plan, and succeeding rounds of the global fund request for proposals. Policy dialogue between the Bank and GRZ, both at the macro and sector levels, can also be enriched by the PER. The PER also provides critical inputs into the Medium-Term Expenditure Framework (MTEF) process, and in the assessment of the Poverty Reduction Strategy Paper (PRSP). Likewise, the PER can provide inputs to fine-tune the process of the pooled basket funding mechanism under the sector-wide approach (SWAp).
Users also downloaded
Showing related downloaded files
Publication Digital Progress and Trends Report 2023(Washington, DC: World Bank, 2024-03-05)Digitalization is the transformational opportunity of our time. The digital sector has become a powerhouse of innovation, economic growth, and job creation. Value added in the IT services sector grew at 8 percent annually during 2000–22, nearly twice as fast as the global economy. Employment growth in IT services reached 7 percent annually, six times higher than total employment growth. The diffusion and adoption of digital technologies are just as critical as their invention. Digital uptake has accelerated since the COVID-19 pandemic, with 1.5 billion new internet users added from 2018 to 2022. The share of firms investing in digital solutions around the world has more than doubled from 2020 to 2022. Low-income countries, vulnerable populations, and small firms, however, have been falling behind, while transformative digital innovations such as artificial intelligence (AI) have been accelerating in higher-income countries. Although more than 90 percent of the population in high-income countries was online in 2022, only one in four people in low-income countries used the internet, and the speed of their connection was typically only a small fraction of that in wealthier countries. As businesses in technologically advanced countries integrate generative AI into their products and services, less than half of the businesses in many low- and middle-income countries have an internet connection. The growing digital divide is exacerbating the poverty and productivity gaps between richer and poorer economies. The Digital Progress and Trends Report series will track global digitalization progress and highlight policy trends, debates, and implications for low- and middle-income countries. The series adds to the global efforts to study the progress and trends of digitalization in two main ways: · By compiling, curating, and analyzing data from diverse sources to present a comprehensive picture of digitalization in low- and middle-income countries, including in-depth analyses on understudied topics. · By developing insights on policy opportunities, challenges, and debates and reflecting the perspectives of various stakeholders and the World Bank’s operational experiences. This report, the first in the series, aims to inform evidence-based policy making and motivate action among internal and external audiences and stakeholders. The report will bring global attention to high-performing countries that have valuable experience to share as well as to areas where efforts will need to be redoubled.Publication Empowerment in Practice : From Analysis to Implementation(Washington, DC: World Bank, 2006)This book represents an effort to present an easily accessible framework to readers, especially those for whom empowerment remains a puzzling development concern, conceptually and in application. The book is divided into two parts. Part 1 explains how the empowerment framework can be used for understanding, measuring, monitoring, and operationalizing empowerment policy and practice. Part 2 presents summaries of each of the five country studies, using them to discuss how the empowerment framework can be applied in very different country and sector contexts and what lessons can be learned from these test cases. While this book can offer only a limited empirical basis for the positive association between empowerment and development outcomes, it does add to the body of work supporting the existence of such a relationship. Perhaps more importantly, it also provides a framework for future research to test the association and to prioritize practical interventions seeking to empower individuals and groups.Publication Mobile Money and the Economy(Published by Oxford University Press on behalf of the World Bank, 2018-08)Mobile money is a recent innovation that provides financial transaction services via mobile phone, including to the unbanked global poor. The technology has spread rapidly in the developing world, “leapfrogging” the provision of formal banking services by solving the problems of weak institutional infrastructure and the cost structure of conventional banking. This article examines the evolution of mobile money and its important role in widening financial inclusion. It explores the channels of economic influence of mobile money from a micro perspective, and critically reviews the empirical literature on the economic impact of mobile money. The evidence convincingly suggests that mobile money fosters risk-sharing, but direct evidence of the promotion of welfare and saving is still mostly rather less robust.Publication World Development Report 2004(World Bank, 2003)Too often, services fail poor people in access, in quality, and in affordability. But the fact that there are striking examples where basic services such as water, sanitation, health, education, and electricity do work for poor people means that governments and citizens can do a better job of providing them. Learning from success and understanding the sources of failure, this year’s World Development Report, argues that services can be improved by putting poor people at the center of service provision. How? By enabling the poor to monitor and discipline service providers, by amplifying their voice in policymaking, and by strengthening the incentives for providers to serve the poor. Freedom from illness and freedom from illiteracy are two of the most important ways poor people can escape from poverty. To achieve these goals, economic growth and financial resources are of course necessary, but they are not enough. The World Development Report provides a practical framework for making the services that contribute to human development work for poor people. With this framework, citizens, governments, and donors can take action and accelerate progress toward the common objective of poverty reduction, as specified in the Millennium Development Goals.Publication Impact Evaluation in Practice, Second Edition(Washington, DC: Inter-American Development Bank and World Bank, 2016-09-13)The second edition of the Impact Evaluation in Practice handbook is a comprehensive and accessible introduction to impact evaluation for policy makers and development practitioners. First published in 2011, it has been used widely across the development and academic communities. The book incorporates real-world examples to present practical guidelines for designing and implementing impact evaluations. Readers will gain an understanding of impact evaluations and the best ways to use them to design evidence-based policies and programs. The updated version covers the newest techniques for evaluating programs and includes state-of-the-art implementation advice, as well as an expanded set of examples and case studies that draw on recent development challenges. It also includes new material on research ethics and partnerships to conduct impact evaluation. The handbook is divided into four sections: Part One discusses what to evaluate and why; Part Two presents the main impact evaluation methods; Part Three addresses how to manage impact evaluations; Part Four reviews impact evaluation sampling and data collection. Case studies illustrate different applications of impact evaluations. The book links to complementary instructional material available online, including an applied case as well as questions and answers. The updated second edition will be a valuable resource for the international development community, universities, and policy makers looking to build better evidence around what works in development.