Publication: Republic of Congo : Enhancing Efficiency in Education and Health Public Spending for Improved Quality Service Delivery for All
Loading...
Published
2014-06
ISSN
Date
2014-08-14
Author(s)
Editor(s)
Abstract
The development of a wealthier, literate, and healthy society is a fundamental goal of Congo's national development plan (NDP) 2012-16 and poverty reduction strategy paper (PRSP) 2012-16. Appropriate funding allocations and efficient use of funds in education and health are fundamental for the development of the sectors. This public expenditure review (PER) of the Congolese education and health sectors aims at providing inputs to improve efficiency and equity in spending in these sectors. It takes into account the following findings of the macro PER: (i) spending on the social sectors is still low although it has increased over time; (ii) the fiscal space generated by the increased oil revenues has largely boosted investment expenditure; and (iii) budget execution is low which contributes to lower the real level of public spending. The PER is divided in two main parts. Part I, constitutes an overview of the two sector reports. Thus, it presents a brief analysis of the context of the country, a summary of findings of the education and health PER, a discussion on cross-cutting themes on spending in the two sectors, and a summary of recommendations. Part II includes the education and health PER.
Link to Data Set
Citation
“World Bank. 2014. Republic of Congo : Enhancing Efficiency in Education and Health Public Spending for Improved Quality Service Delivery for All. © http://hdl.handle.net/10986/19299 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 Maternal and Child Survival : Findings from Five Countries Experience in Addressing Maternal and Child Health Challenges(World Bank, Washington, DC, 2014-05)Considerable progress has been made towards the achievement of the Millennium Development Goals (MDGs) since 1990. Although advances in improving MDG 4 and MDG 5a (reducing child and maternal mortality, respectively) have been made, progress is some countries have been insufficient. While some countries have made substantial gains, others have not. This paper is part of a larger study that aims to address this gap in knowledge. The paper discusses the findings from qualitative case studies of five countries that are either on track to meet MDGs 4 and 5a by 2015 or have made significant progress to this end (Bolivia, China, Egypt, Malawi and Nepal). Although they have different socio-economic characteristics, all have made significant advancements due to a strong commitment to improving maternal and child health. To do this, strong political commitment, through policies backed by financial and programmatic support, was critical. In addition, focusing on the most vulnerable populations helped increase access to and use of services. Empowering women and families through education, employment, and poverty reduction programs have led to better health outcomes. These countries still face challenges, however, in terms of the evolving health system, and changes at the economic, social and political levels. Future qualitative and quantitative analyses on the returns of health investments, the political context and institutional arrangements at the country level could help deepen the understanding of the ways in which various countries, with their unique conditions, can improve MCH.Publication Equity, Access to Health Care Services and Expenditures on Health in Nicaragua(World Bank, Washington, DC, 2008-06)Nicaragua has embarked on an ambitious health sector program, which has contributed to significant progress in the health sector over the past decade. Health indicators show gradual but steady improvements: access to basic services such as clean water and sanitation facilities has improved, as have other related performance indicators such as life expectancy, infant/child mortality, immunization rates, and child nutrition among others. Despite these achievements, there are still large inequities in access and quality of health services across socioeconomic groups and regions. Poor individuals living in rural areas (especially in the Central and Atlantic regions), the indigenous population, and individuals living in households engaged in agriculture have average access to health care services and preventive care. The lack of risk mitigation mechanisms such as insurance and social security is causing users in Nicaragua to spend, out-of-pocket, a significant share of their income on health care, especially to buy medications and other non-consultation items such as medical tests. Long distances, lack of medicines, and high costs and other demand-side factors (such as self-prescription) constitute the main constraints causing poor and sick individuals to seek informal care or not to seek care at all.Publication Nigeria—Improving Primary Health Care Delivery : Evidence from Four States(Washington, DC, 2008-06)The delivery of quality primary health care (PHC) services can have a large impact on the health of Nigerians. This study aims mainly at understanding the performance of primary health care providers and the variables driving this performance. The study is primarily based on quantitative surveys at the level of primary health care facilities, health care personnel, and households in their vicinity. These surveys were implemented in four states: Bauchi, Cross River, Kaduna, and Lagos. The purpose of this study is three fold: (i) to contribute to the evidence base of the Federal Government's health system reform efforts; (ii) to inform the Bank's and Canadian International Development Agency (CIDA) sector policy dialogue with the Government; and (iii) to inform the current and eventual health support programs of both donors at state level. This study represents the second phase of the Nigeria Health, Nutrition, and Population Country Status Report (CSR). The first phase aimed at analyzing the health situation of the poor and how the health system was performing in terms of meeting their needs. This first phase identified primary health care as the weakest chain in the entire health sector and the level of care the poor use the most. This second phase of the CSR is therefore focused on the analysis of the delivery of PHC services. In contrast to the first phase, this study is mainly based on primary data, data collected through facility, health personnel, and household surveys. This study is focused in the collection of information not previously available, such as detailed roles and responsibilities of the Local Government Area (LGA) and states and community perceptions of PHC services. This study is also to support on-going or eventual health support programs of CIDA and the World Bank at the state level.Publication Capacity Assessment of the Ministry of Health of the Republic of Angola(World Bank, Washington, DC, 2006-06)The World Bank commissioned a capacity assessment study of the Ministry of Health (MOH) that was undertaken in March 2006. The terms of reference covered the following areas: Identify the existing analytical work being done by other donors in the health field and summarize their terms of reference and main conclusions; assess the MOH capacity to implement health policies and strategies adopted by the government; assess the MOH capacity to implement projects financed by the Bank, the Global fund, EU and others focusing the analysis on the MOH capacity for policy formulation, mobilization of funds, and program implementation; assess the capacity at central, provincial and municipal level in (i) program management, (ii) service delivery, including the number and distribution of staff; analyze the decision making process and the incentives for decision making including how much the system is centralized or decentralized; analyze the existing stock of health professionals including the MOH and military, identifying key constraints and gaps in capacity, government plans to increase capacity; existing training institutions and their capacity to produce new professionals and follow-up training; propose options for short term and long-term interventions including training managers, training of doctors and nurses, recruitment, on-job-training, review of curricula and other; make cost estimates of short term capacity building interventions that could be financed by the Bank and other donors; and identify future work that may be needed to undertake deeper or follow-up analysis.Publication Peru’s Comprehensive Health Insurance and New Challenges for Universal Coverage(World Bank, Washington DC, 2013-01)This case study analyzes the progress of Peru's Comprehensive Health Insurance (SIS) and evaluates the challenges that remain to achieving universal health care coverage. Peru is an upper-middle-income country with a gross domestic product (GDP) per capita of just over US$10,000 (purchasing power parity). The country has grown rapidly in the last decade; the average growth rate was 6.5 percent. However, 28 percent of the population lives in poverty (2011), which is estimated with regionally differentiated poverty lines between US$1 and US$2 per capita per day. In addition, only one in four individuals has employment with social security coverage. The SIS aims to reduce economic barriers through the elimination of user fees for a package of services. Although its budget has been low, the SIS has played an important role in the reduction of maternal and child mortality. However, the improvements expected to the overall health system have not materialized. Meanwhile, when the decentralization process transferred funds and authority to the regions, it did so in a context of weak management capabilities, and it failed to clearly define the relationship between the national and regional governments. A major effort to strengthen the technical capacity of the Ministry of Health (MOH) should accompany the strategies outlined above. This effort should emphasize a review of health priorities, the design of effective interventions within a fiscally sustainable benefits package, and the introduction of incentives and new payment mechanisms at hospitals and other health facilities.
Users also downloaded
Showing related downloaded files
Publication Legal Aspects of HIV/AIDS : A Guide for Policy and Law Reform(Washington, DC: World Bank, 2007)This guide to the legal aspects of the pandemic will help enhance the World Bank institution's contribution in support for the global response to HIV in several areas, including strengthening national strategies, accelerating implementation, and generating and sharing knowledge. The guide covers 65 wide-ranging topics in a concise, accessible format, explaining how laws and regulations can either underpin or undermine public health programs and responsible personal behavior. For each topic, the guide summarizes the key legal or policy issues, provides relevant practice examples (citing actual laws and regulations), and offers a selective list of references that may be consulted for more information. This guide creates a supportive legal framework for responding to HIV/AIDS, it is important that governments effectively address gaps and other problematic aspects in their legislation and regulatory systems.Publication Global Economic Prospects, June 2024(Washington, DC: World Bank, 2024-06-11)After several years of negative shocks, global growth is expected to hold steady in 2024 and then edge up in the next couple of years, in part aided by cautious monetary policy easing as inflation gradually declines. However, economic prospects are envisaged to remain tepid, especially in the most vulnerable countries. Risks to the outlook, while more balanced, are still tilted to the downside, including the possibility of escalating geopolitical tensions, further trade fragmentation, and higher-for-longer interest rates. Natural disasters related to climate change could also hinder activity. Subdued growth prospects across many emerging market and developing economies and continued risks underscore the need for decisive policy action at the global and national levels. Global Economic Prospects is a World Bank Group Flagship Report that examines global economic developments and prospects, with a special focus on emerging market and developing economies, on a semiannual basis (in January and June). Each edition includes analytical pieces on topical policy challenges faced by these economies.Publication Digital Africa(Washington, DC: World Bank, 2023-03-13)All African countries need better and more jobs for their growing populations. "Digital Africa: Technological Transformation for Jobs" shows that broader use of productivity-enhancing, digital technologies by enterprises and households is imperative to generate such jobs, including for lower-skilled people. At the same time, it can support not only countries’ short-term objective of postpandemic economic recovery but also their vision of economic transformation with more inclusive growth. These outcomes are not automatic, however. Mobile internet availability has increased throughout the continent in recent years, but Africa’s uptake gap is the highest in the world. Areas with at least 3G mobile internet service now cover 84 percent of Africa’s population, but only 22 percent uses such services. And the average African business lags in the use of smartphones and computers as well as more sophisticated digital technologies that catalyze further productivity gains. Two issues explain the usage gap: affordability of these new technologies and willingness to use them. For the 40 percent of Africans below the extreme poverty line, mobile data plans alone would cost one-third of their incomes—in addition to the price of access devices, apps, and electricity. Data plans for small- and medium-size businesses are also more expensive than in other regions. Moreover, shortcomings in the quality of internet services—and in the supply of attractive, skills-appropriate apps that promote entrepreneurship and raise earnings—dampen people’s willingness to use them. For those countries already using these technologies, the development payoffs are significant. New empirical studies for this report add to the rapidly growing evidence that mobile internet availability directly raises enterprise productivity, increases jobs, and reduces poverty throughout Africa. To realize these and other benefits more widely, Africa’s countries must implement complementary and mutually reinforcing policies to strengthen both consumers’ ability to pay and willingness to use digital technologies. These interventions must prioritize productive use to generate large numbers of inclusive jobs in a region poised to benefit from a massive, youthful workforce—one projected to become the world’s largest by the end of this century.Publication When is a Current Account Deficit Bad?(World Bank, Washington, DC, 2018-10)A current account deficit is sustainable when its underlying drivers support a smooth correction in the future. It is unsustainable when symptomatic of macroeconomic imbalances that would eventually trigger disruptive adjustments. Although a current account deficit in itself is neither good nor bad, it is likely to be unsustainable and lead to harmful consequences when it is persistently large, fuels consumption rather than investment, occurs alongside excessive domestic credit growth, follows an overvalued exchange rate, or accompanies unrestrained fiscal deficits. Even though a current account deficit is often paralleled by deteriorating net foreign assets, it may not be as informative about immediate-term financial vulnerabilities as the size, maturity, and currency composition of gross financial stocks.Publication Developing China’s Ports(Washington, DC: World Bank, 2022-05-17)Many countries in Africa and Asia have coastlines that present opportunities for them to become gateways for trade between the hinterlands and global trading routes. However, policy makers struggle to translate this potential into engines of economic development and social transformation. In the past 40 years, China has taken advantage of its strategic geographical location and its status as one of the world’s top manufacturing regions. From a very low position on almost all metrics, today China has become home to more than half of the world’s top 50 ports. The rapid development of China’s ports was critical for the country’s remarkable economic growth. What China achieved can be informative; how and why China revived and modernized its port sector is especially relevant and provides valuable lessons for other countries. This book explores the transformation of China’s port sector through four topics and four periods, beginning with China’s major economic reforms that started in 1978. The first topic addresses the links between China’s macroeconomic and regional development strategies and development of the port sector. During this period—through about 1991—China began decentralizing port management to facilitate development of special economic zones. The second topic—during the period 1992 through about 2001—is more specific about the ports and analyzes changes in port governance, including the way in which essential investments were determined and financed. The third topic examines the relationship of ports to the cities where they are located and to the hinterlands on which they depend—coinciding with the period 2002–11. Domestic and international investment resulted in many new export-oriented processing factories during this period. The accompanying boost in trade required further expansion of port capacity. The fourth topic addresses how—from 2011 onward—human resource and innovation policies in the port sector have responded to changing demands as the country looks to become a less resource-dependent and more regionally balanced economy.