Masaki, EmikoSamavong, ChanhsyBeveridge, GrantBounthideth, Soulaxay2025-07-152025-07-152025-07-15https://hdl.handle.net/10986/43457The Lao People's Democratic Republic has a high execution rate for its overall health budget, ranging from 89 to 104 percent from 2015 to 2019. Aggregated execution rates are generally high across the main categories of spending - wage, non-wage recurrent and capital with only a couple of outliers during the period of analysis. Some of the public financial management practices employed that enable these high execution rates may, nonetheless, risk lowering the quality of spending. There is also greater variation in execution rates when considering more disaggregated levels of budget spending, including between the central and provincial level of government. Good practices that have helped budget execution include the ringfencing of spending on health and flexibility in budget laws enabling high execution of capital budgets. Key bottlenecks holding back budget execution performance include the lack of a mechanism linking spending to the delivery of outputs; weaknesses in how budget allocations are set for health worker payments; delays in payments reaching health facilities; a lack of transparency in disaggregated spending data, no publication of audits and no reporting on the stock of arrears; inefficiencies in the availability of resources for health facilities; and the widespread use of manual reporting which delays reporting processes and is prone to errors and inconsistencies.en-USCC BY-NC 3.0 IGOGOOD HEALTHBUDGET EXECUTION CHALLENGESHEALTH FINANCING PERSPECTIVEPUBLIC FINANCIAL MANAGEMENTWorking PaperWorld Bankhttps://doi.org/10.1596/43457