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From Stumbling Block to Enabler: The Role of Public Financial Management in Health Service Delivery in Tanzania and Zambia

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dc.contributor.authorPiatti-Funfkirchen, Moritz
dc.contributor.authorSchneider, Pia
dc.date.accessioned2019-01-11T20:35:44Z
dc.date.available2019-01-11T20:35:44Z
dc.date.issued2018-11-06
dc.description.abstractThe way governments manage resources through the budget cycle has important implications for health policy and whether governments achieve societal objectives such as efficiency, equity, quality, and accountability. Studies found a positive association between health service delivery outcomes and good governance of public finance; however, the mechanisms through which public financial management affects service delivery remain underexplored. This article maps the three stages of the budget cycle to common performance criteria used in health service delivery. It applies this approach to experiences in Tanzania and Zambia. The findings point to a number of stumbling blocks, including the lack of flexibility to provide additional resources for unexpected demand for care, misalignment between budgeting and planning, fragmented funding sources, rigid internal controls, insufficient budget provision leading to arrears, and a budget evaluation system that is excessively compliance driven and gives inadequate attention to issues of equity, quality, and efficiency in service delivery.en
dc.identifier.citationHealth Systems & Reform
dc.identifier.doi10.1596/31149
dc.identifier.issn2328-8604
dc.identifier.urihttps://hdl.handle.net/10986/31149
dc.publisherTaylor and Francis
dc.rightsCC BY 4.0
dc.rights.holderWorld Bank
dc.rights.urihttp://creativecommons.org/licenses/by/4.0
dc.subjectBUDGET EXECUTION
dc.subjectFACILITY MANAGEMENT
dc.subjectHEALTH SYSTEM REFORM
dc.subjectPUBLIC FINANCIAL MANAGEMENT
dc.subjectHEALTH SERVICE DELIVERY
dc.subjectPUBLIC EXPENDITURE
dc.titleFrom Stumbling Block to Enableren
dc.title.subtitleThe Role of Public Financial Management in Health Service Delivery in Tanzania and Zambiaen
dc.typeJournal Articleen
dc.typeArticle de journalfr
dc.typeArtículo de revistaes
dspace.entity.typePublication
okr.associatedcontenthttps://www.tandfonline.com/doi/full/10.1080/23288604.2018.1513266 Journal website (version of record)en
okr.crossref.titleFrom Stumbling Block to Enabler: The Role of Public Financial Management in Health Service Delivery in Tanzania and Zambia
okr.date.disclosure2019-01-11
okr.doctypePublications & Research::Journal Article
okr.doctypePublications & Research
okr.externalcontentExternal Content
okr.guid340091550219884932
okr.identifier.doi10.1080/23288604.2018.1513266
okr.identifier.doi10.1596/31149
okr.identifier.report134675
okr.journal.nbpages336-45
okr.language.supporteden
okr.peerreviewAcademic Peer Review
okr.region.administrativeAfrica
okr.region.countryTanzania
okr.region.countryZambia
okr.topicHealth, Nutrition and Population::Health Economics & Finance
okr.topicHealth, Nutrition and Population::Health Service Management and Delivery
okr.topicHealth, Nutrition and Population::Health Systems Development & Reform
okr.topicPublic Sector Development::Public Financial Management
okr.unitHealth, Nutrition and Population Global Practice
okr.volume4(4)
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