World Bank2012-06-142012-06-142008-02https://hdl.handle.net/10986/8006This report concerns improving intergovernmental fiscal relations and public health and education expenditure policy in Ukraine. The large amount of resources the budget spends on services such as health and education, through its local government do not obtain good value. This is due to the acute inefficiency of service provision in these sectors, which generates under-spending on quality-enhancing expenditures and investments. The local governments are essential in providing and financing services such as health and education, and in channeling public investments across the country, and thus reforms in these sectors need to go hand-in-hand with intergovernmental fiscal reforms. Despite their large role in allocating spending, the ability of local governments to determine spending structure and to allocate expenditures within sectors is quite limited. The government needs to improve resource allocation by strengthening its intergovernmental fiscal system and by creating sufficient fiscal savings within the current fiscal envelopes of the health and education sectors in order to re-allocate these savings towards quality enhancing expenditures and investments within each sector.CC BY 3.0 IGOACCESS TO MARKETACCOUNTINGACCREDITATIONADDITIONAL CONTRIBUTIONSADDITIONAL FINANCINGADMINISTRATIVE CAPACITYADMINISTRATIVE COSTSADMINISTRATIVE REFORMSAGEDAGGREGATE COSTAGINGAUCTIONSAVERAGE EARNINGSBANK ACCOUNTSBANK EDUCATIONBANKSBEDSBLOCK GRANTBORROWINGSBUDGET PROCESSBUDGET REFORMCADASTRECALCULATIONSCAPITAL ALLOCATIONSCAPITAL BUDGETINGCAPITAL EXPENDITURECAPITAL EXPENDITURESCAPITAL INVESTMENTCAPITAL INVESTMENTSCAPITAL PROJECTSCARDIOVASCULAR DISEASESCHILD MORTALITY RATESCITIESCLINICSCOMPLIANCE COSTSCONTRIBUTIONSCREDIT GUARANTEESCREDIT RATINGCRISIS MANAGEMENTCURRENT EXPENDITURECURRICULUMDEBTDEBT SECURITIESDECENTRALIZATIONDELIVERY COSTSDEMOGRAPHIC PROFILEDOCTORSDONOR FUNDINGDONOR RESOURCESDONOR SUPPORTECONOMIC MANAGEMENTECONOMIES OF SCALEEDUCATION SPENDINGEMERGING ECONOMYEMPLOYERENROLLMENTENROLLMENTSEQUALIZATIONEQUIPMENTEXCESSIVE DEBTEXPENDITURE RESPONSIBILITIESFISCAL BALANCEFISCAL CADASTREFISCAL CAPACITYFISCAL EFFORTFISCAL REFORMSFISCAL RESPONSIBILITYFIXED CAPITALFIXED CAPITAL INVESTMENTSFIXED INVESTMENTSFOREIGN CURRENCYFUTURE GROWTHGENDERGOVERNANCE ISSUESGOVERNMENT BANKRUPTCYGOVERNMENT BORROWINGGOVERNMENT BUDGETGOVERNMENT DEBTGOVERNMENT DEBT MARKETGOVERNMENT EXPENDITUREGOVERNMENT GUARANTEESHARD BUDGET CONSTRAINTSHEALTH CAREHEALTH CARE SPENDINGHEALTH DELIVERYHEALTH EXPENDITUREHEALTH EXPENDITURESHEALTH FACILITIESHEALTH INDICATORSHEALTH INSURANCEHEALTH OUTCOMESHEALTH SECTORHEALTH SERVICESHEALTH SPENDINGHEALTH STATUSHEALTH STATUS INDICATORSHEALTH SYSTEMHOSPITALSHOUSEHOLD EXPENDITURESHOUSEHOLDSWorld Bank10.1596/8006