Cros, Marion JaneEl Kadiri El Yamani, FatimaMuvudi, MichelNana, Aminata TOU2025-07-152025-07-152025-07-15https://hdl.handle.net/10986/43458The Democratic Republic of Congo is committed to achieving Universal Health Care by 2030. Progress toward this goal faces challenges due to limitations in the execution and allocation of the country's health budget. This contributes to health spending being predominantly financed by households and donors rather than the government. The only part of the government health budget that is consistently executed in line with allocations is for health worker payments. Execution rates for other spending categories are volatile and generally low. Many parts of the budget are not executed at all, while some activities are implemented without having been included in the budget. Budget execution within the Ministry of Health is influenced by both internal and external factors. Inconsistencies between strategic planning, budget preparation, and execution processes hinder effective financial management; inaccurate cost estimations; heavy reliance on exceptional procedures for spending and over-execution of specific budget lines to the detriment of otherwise planned activities. External challenges include a systematic over-estimation of national revenue; the highly centralized nature of budget execution processes; the dominance of health worker payments in budget allocations; the non-respect of budget management rules and cumbersome procurement and expenditure execution procedures.en-USCC BY-NC 3.0 IGOGOOD HEALTHBUDGET EXECUTION CHALLENGESHEALTH FINANCING PERSPECTIVEPUBLIC FINANCIAL MANAGEMENTUNIVERSAL HEALTH CAREWorking PaperWorld Bankhttps://doi.org/10.1596/43458