Publication: Public Spending In Health Sector in Malawi
Loading...
Date
2020-12
ISSN
Published
2020-12
Author(s)
Yoo, Katelyn Jison
Nkhoma, Dominic
Ally, Mariam
Kuguru, Toni Lee
Borrazzo, John
Hettinger, Patrick
Zamawe, Collins Owen Francisco
Schneider, Pia
Editor(s)
Abstract
Malawi’s economic growth has been low and volatile for the past two decades, leading to stagnating high poverty levels. The Coronavirus (COVID-19) pandemic will negatively affected economic growth leading to lower government revenue. Despite low per capita growth, Malawi has made strong progress in many areas of human capital development since 2000. Notwithstanding the above, Malawi still faces considerable gaps in human capital, which will impede its ability to reduce poverty in the medium term. Malawi lags behind in some health and nutrition outcomes, including HIV and malaria prevalence. Strengthening human capital in Malawi will be critical to reduce poverty, increase inclusion in society, and create jobs. The World Bank launched a new Human capital index (HCI) in October 2018 as part of its broader Human capital project. One factor that contributes to low human capital outcomes is Malawi’s adolescent fertility rate, one of the highest rates of in the world, with 132 births per 1,000 women aged 15-19. The main underlying cause for the high adolescent fertility rate is the high rate of child marriage. The government is making efforts to strengthen human capital. To strengthen human capital in the face of limited fiscal space, Malawi needs to improve the efficiency and effectiveness of government and donor spending on human capital. To address this problem, there is need to integrate financial reporting systems at district and central government levels. This will enhance government’s ability to monitor and evaluate expenditure and program implementation across sectors.
Link to Data Set
Citation
“Yoo, Katelyn Jison; Nkhoma, Dominic; Piatti, Moritz; Ally, Mariam; Kuguru, Toni Lee; Borrazzo, John; Hettinger, Patrick; Zamawe, Collins Owen Francisco; Schneider, Pia; Chansa, Collins. 2020. Public Spending In Health Sector in Malawi. © World Bank. http://hdl.handle.net/10986/36131 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 Public Financial Management in the Health Sector(World Bank, Washington, DC, 2020)This study assesses the extent to which public financial management (PFM) in Malawi supports health service provision at the local government level. Using a conceptual framework that links the budget cycle to health service provider management and service delivery goals, the study assesses how the various stages of the budget cycle affect service delivery at health centers and hospitals. Government and faith-based health providers, known as Christian Health Association Malawi (CHAM), are assessed separately. The study provides insights into provider autonomy and flexibility; financial management capacity; payment arrangements; and the performance orientation of budget provisions or purchasing. The results suggest that significant gaps exist, which undermine the service delivery goals of efficiency, quality, equity, and accountability of service provision. A summary of the findings is presented in the report. It provides complimentary guidance as to how PFM systems facilitate provider management and service delivery at district level health centers and hospitals. Findings and recommendations from the study are expected to support decision makers and practitioners with ongoing PFM reforms.Publication Zambia Health Sector Public Expenditure Review(World Bank, Washington, DC, 2018-12)The Zambian government has outlined an ambitious rights-based approach to health care provision as outlined in its national health policy. Specifically, the government is determined to achieve universal health coverage (UHC) by providing all its citizens with access to free quality health care services through the public health system. To examine trends and patterns in health expenditures and to identify opportunities for achieving value for money and equity, the Zambian government, with technical and financial support from the World Bank and the U.K. Department for International Development (DFID), conducted a public expenditure review (PER) of the health sector. This review covers 2006−2016 and builds on the PER that was produced in 2009. This report shares the results of the PER and provides key policy recommendations on how to address the existing challenges.Publication Tanzania Health Sector Public Expenditure Review 2020(World Bank, Washington, DC, 2020-04)This Public Expenditure Review (PER) report provides an update on trends and patterns of health expenditures in the public sector. It assesses the availability of fiscal space, the role of user fees and pooled financing arrangements, and provides an overview of the fund flow and financial management processes. The report also explores equity and allocative efficiency considerations, access to care and technical efficiency.Publication Zambia Health Sector Public Expenditure Tracking and Quantitative Service Delivery Survey(World Bank, Washington, DC, 2019-04)Zambia’s health sector has continued to evolve with the government undertaking several reforms aimed at improving the performance of the sector to achieve the Sustainable Development Goals (SDGs) and their precursor, the Millennium Development Goals (MDGs). Amid the ongoing reforms, the health sector has recorded a number of achievements, but some challenges remain. This Public Expenditure Tracking and Quantitative Service Delivery Survey (PET-QSDS) assesses the financing and delivery of health services, and whether the reform objectives have been made. This was achieved by reviewing the flow of financial and other resources in the public health sector from administrative units to service delivery points at the facility level. The data were collected from administrative units, health workers, and patients to gauge the various dimensions of the health system that include financial flows, management of infrastructure, human resources for health, and patient management. Specifically, the issues which were reviewed are: Availability, adequacy, and timeliness of resources for service delivery; implementation of some key policy reforms such as user fee removal and adherence to policy guidelines; donor resource coordination, ownership, and fragmentation at the district level; assessment of human resources management at the district and facility levels; and comparison of staff satisfaction, absenteeism, and service delivery in districts implementing the Results-based Financing (RBF) model and non-RBF districts.Publication Tanzania Health Policy Note(World Bank, Washington, DC, 2021-01-12)This is the second in a series of health policy notes that address critical health finance related questions in Tanzania. They are issued as part of a larger public expenditure review exercise. The audience is government, civil society and the development partner community with the aim to initiate a dialogue around key health finance issues and present recommendations to government. This policy note raises budget execution in health as a problem and discusses reasons behind low rates and the consequences for service delivery.
Users also downloaded
Showing related downloaded files
Publication Doing Business 2014 : Understanding Regulations for Small and Medium-Size Enterprises(Washington, DC: World Bank Group, 2013-10-28)Eleventh in a series of annual reports comparing business regulation in 185 economies, Doing Business 2014 measures regulations affecting 11 areas of everyday business activity: Starting a business, Dealing with construction permits, Getting electricity, Registering property, Getting credit, Protecting investors, Paying taxes, Trading across borders, Enforcing contracts, Closing a business, Employing workers. The report updates all indicators as of June 1, 2013, ranks economies on their overall “ease of doing business”, and analyzes reforms to business regulation – identifying which economies are strengthening their business environment the most. The Doing Business reports illustrate how reforms in business regulations are being used to analyze economic outcomes for domestic entrepreneurs and for the wider economy. Doing Business is a flagship product by the World Bank and IFC that garners worldwide attention on regulatory barriers to entrepreneurship. More than 60 economies use the Doing Business indicators to shape reform agendas and monitor improvements on the ground. In addition, the Doing Business data has generated over 870 articles in peer-reviewed academic journals since its inception.Publication Classroom Assessment to Support Foundational Literacy(Washington, DC: World Bank, 2025-03-21)This document focuses primarily on how classroom assessment activities can measure students’ literacy skills as they progress along a learning trajectory towards reading fluently and with comprehension by the end of primary school grades. The document addresses considerations regarding the design and implementation of early grade reading classroom assessment, provides examples of assessment activities from a variety of countries and contexts, and discusses the importance of incorporating classroom assessment practices into teacher training and professional development opportunities for teachers. The structure of the document is as follows. The first section presents definitions and addresses basic questions on classroom assessment. Section 2 covers the intersection between assessment and early grade reading by discussing how learning assessment can measure early grade reading skills following the reading learning trajectory. Section 3 compares some of the most common early grade literacy assessment tools with respect to the early grade reading skills and developmental phases. Section 4 of the document addresses teacher training considerations in developing, scoring, and using early grade reading assessment. Additional issues in assessing reading skills in the classroom and using assessment results to improve teaching and learning are reviewed in section 5. Throughout the document, country cases are presented to demonstrate how assessment activities can be implemented in the classroom in different contexts.Publication World Development Report 2006(Washington, DC, 2005)This year’s Word Development Report (WDR), the twenty-eighth, looks at the role of equity in the development process. It defines equity in terms of two basic principles. The first is equal opportunities: that a person’s chances in life should be determined by his or her talents and efforts, rather than by pre-determined circumstances such as race, gender, social or family background. The second principle is the avoidance of extreme deprivation in outcomes, particularly in health, education and consumption levels. This principle thus includes the objective of poverty reduction. The report’s main message is that, in the long run, the pursuit of equity and the pursuit of economic prosperity are complementary. In addition to detailed chapters exploring these and related issues, the Report contains selected data from the World Development Indicators 2005‹an appendix of economic and social data for over 200 countries. This Report offers practical insights for policymakers, executives, scholars, and all those with an interest in economic development.Publication Remarks to the Annual Meetings 2020 Development Committee(World Bank, Washington, DC, 2020-10-16)David Malpass, President of the World Bank Group, announced that the Board approved a fast track approach to emergency health support programs that now covers 111 countries. Most projects are well advanced, with average disbursement upward of 40 percent. The goal is to take broad, fast action early. The operational framework presented back in June has positioned the Bank to help countries address immediate health threats and social and economic impacts and maintain our focus on long-term development. The Bank is making good progress toward the 15-month target of 160 billion dollars in surge financing. Much of it is for the poorest countries and will take the form of grants or low-rate, long-maturity loans. IFC, through the Global Health Platform, will be providing financing to vaccine manufacturers to foster expanded production of COVID-19 vaccines in both part 1 and 2 countries, providing production is reserved for emerging markets. The Development Committee holds a unique place in the international architecture. It is the only global forum in which the Governments of developed countries and the Governments of developing countries, creditor countries and borrower countries, come together to discuss development and the ‘net transfer of resources to developing countries.’ The current International Financial Architecture system is skewed in favor of the rich and creditor countries. It is important that all voices are heard, so Malpass urged the Ministers of developing countries to use their voice and speak their minds today. Malpass urged consideration of how we can build a new approach to debt restructuring that allows for a fair relationship and balance between creditors and debtors. This will be critical in restoring growth in developing countries; and helping reverse the inequality.Publication World Development Report 2011(World Bank, 2011)The 2011 World development report looks across disciplines and experiences drawn from around the world to offer some ideas and practical recommendations on how to move beyond conflict and fragility and secure development. The key messages are important for all countries-low, middle, and high income-as well as for regional and global institutions: first, institutional legitimacy is the key to stability. When state institutions do not adequately protect citizens, guard against corruption, or provide access to justice; when markets do not provide job opportunities; or when communities have lost social cohesion-the likelihood of violent conflict increases. Second, investing in citizen security, justice, and jobs is essential to reducing violence. But there are major structural gaps in our collective capabilities to support these areas. Third, confronting this challenge effectively means that institutions need to change. International agencies and partners from other countries must adapt procedures so they can respond with agility and speed, a longer-term perspective, and greater staying power. Fourth, need to adopt a layered approach. Some problems can be addressed at the country level, but others need to be addressed at a regional level, such as developing markets that integrate insecure areas and pooling resources for building capacity Fifth, in adopting these approaches, need to be aware that the global landscape is changing. Regional institutions and middle income countries are playing a larger role. This means should pay more attention to south-south and south-north exchanges, and to the recent transition experiences of middle income countries.