Health Financing Miano Munene


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Presentation by Miano Munene from HERAF about health financing campaign in Kenya

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Health Financing Miano Munene

  1. 1. HEALTH FINANCING <ul><li>Designing and Implementing Pro-poor </li></ul><ul><li>Financing Campaign </li></ul><ul><li>Miano Munene </li></ul><ul><li>HERAF </li></ul>
  2. 2. Importance of Students Involvement <ul><li>In a democracy, citizens have a right </li></ul><ul><li>To know what money is being spent on, </li></ul><ul><li>What decisions their elected representatives make on their behalf. </li></ul><ul><li>It is only with this knowledge that elected officials can be held accountable for their budget planning, allocations and implementation. </li></ul><ul><li>Monitoring government budgets is also conducive to better decision-making within government. </li></ul><ul><li>It provides a forum for purposeful and concrete engagement between the executive, the legislatures and civil society around critical choices and outcomes. </li></ul>
  3. 3. Budget Process and Systems <ul><li>An in-depth knowledge of the budget decision-making process - leads to greater influence & participation </li></ul><ul><li>Stronger focus on openness and transparency in budget process is a prerequisite for independent analysis </li></ul><ul><li>Growth in budget process work also reflects the changing nature of reforms to the budget process e.g “The role of Parliament and the budget” </li></ul>
  4. 4. Budget Trainings <ul><li>Training materials can be developed for entire budget process or certain areas of the budget </li></ul><ul><li>Can be used to build an audience & allies, and developing capacity within the organization </li></ul><ul><li>Training courses introduce participants to an organization and enhance credibility as a future source of information </li></ul>
  5. 5. Participating Budgeting process ... <ul><li>Is an innovative approach to budget decision making that began at municipal level in Brazil in 1989 - generated widespread interest </li></ul><ul><li>Involves general public directly in making policy decisions </li></ul><ul><li>Allows for open forums during budget process - opportunity for public to allocate resources, prioritize broad social policies and monitor public spending </li></ul><ul><li>Breaks the tradition that the budget process should exclusively occur in the executive with inputs from budget technicians and few politicians </li></ul><ul><li>Examples CSOs in Kenya have regular public forums (Pre & Post Budget Hearings) </li></ul><ul><ul><li>Kenya - “Mwananchi’s Budget’’ </li></ul></ul><ul><ul><li>South Africa’s “People’s Budget”. </li></ul></ul>
  6. 6. Understanding Budget Policies <ul><li>Analysis of Executive Budget Proposals </li></ul><ul><ul><li>Thorough and broad assessment of the budget when it is released by the executive </li></ul></ul><ul><li>Sector Analysis </li></ul><ul><ul><li>Focuses on an important area or sector of the economy or the government </li></ul></ul><ul><ul><li>Reviews a sector in relation to other sectors, the entire economy or its historic levels of support </li></ul></ul><ul><ul><li>Might include cross-country, Sectors, Ministries, departments etc comparisons. Also Recurrent vs Development vote </li></ul></ul>
  7. 7. Understanding Budget Policies <ul><li>Budget and Economic and Social Rights </li></ul><ul><ul><li>All economic and social rights can not be achieved immediately and all at once, but they can and should be realized progressively over time </li></ul></ul><ul><ul><li>Examine how to operationalize rights by turning policy rhetoric or legal commitments to certain rights into budget allocations </li></ul></ul><ul><ul><li>Examine if budgets are consistent with rights conventions </li></ul></ul><ul><li>Analysis of Effects on Different Population Groups </li></ul><ul><ul><li>Effects on different income groups: examine the spending devoted to programs and projects that assist the poor </li></ul></ul><ul><ul><li>Effects on a particular group not defined by income: examine the impacts of the budget on a racial or ethnic minority, women, children, the disabled, people living with HIV/AIDS etc. </li></ul></ul>
  8. 8. At Planning & Formulation Stage <ul><li>At the Planning stage, students can; </li></ul><ul><li>Collaborate with policy makers to make budget input </li></ul><ul><li>Contribute in preparation of District Health Plans - DHSF </li></ul><ul><li>Participate in Sector Working Groups – Health, Education etc </li></ul><ul><li>Generate Proposals for Consideration for budget formulation </li></ul><ul><li>Participate in Public Hearings </li></ul>
  9. 9. Implementation Stage: What to do <ul><li>At this Stage, students can; </li></ul><ul><li>Scrutinize the implementation schedule and timeframe </li></ul><ul><li>Disbursement of funds </li></ul><ul><li>Financial Resources management </li></ul><ul><li>Human Resource management </li></ul><ul><li>Documentation and records </li></ul><ul><li>Procurement and use of materials </li></ul><ul><li>Participation </li></ul><ul><li>Impact assessment </li></ul>
  10. 10. Health Care Financing & Budgetary Allocations Trends <ul><li>Issues </li></ul><ul><ul><li>Preventive Vs. Curative Health? </li></ul></ul><ul><ul><li>Development Vs. Recurrent Expenditure </li></ul></ul><ul><ul><li>Referral Vs Lower level facilities </li></ul></ul><ul><ul><li>Disproportionate allocation to HIV/AIDS </li></ul></ul>
  11. 11. Challenges & Priorities in Access to Health Care Services <ul><li>Policies and institutional challenges </li></ul><ul><li>Mismatch between government priorities as outlined in key policy framework and resource allocation </li></ul><ul><li>Lack of Adequate Personnel </li></ul><ul><li>Decentralizing Health Care </li></ul>
  12. 12. Challenges & Priorities Access to Health Care Services <ul><li>Inequalities in access to health care </li></ul><ul><li>Weak linkages between environmental factors and health </li></ul><ul><li>Widening disparities: </li></ul><ul><li>Inequalities in access to health care </li></ul>
  13. 13. Constraints & Challenges <ul><li>Weak & inadequate legal/ institutional involvement </li></ul><ul><li>Secretive nature of the process </li></ul><ul><li>Lack of capacity to effectively engage </li></ul><ul><li>Lack of inclusive & cross sectoral information </li></ul><ul><li>Inherent suspicion between stakeholders </li></ul><ul><li>Inadequate understanding of national policies, procedures, institutional arrangements, f/works, etc </li></ul><ul><li>Lack of co-ordination /synergy for discernable reforms </li></ul><ul><li>Lack of information pool (sharing) </li></ul><ul><li>New Budget format – GFS </li></ul>
  14. 14. Entry Points- Options & Strategies <ul><li>Advocacy & Lobbying </li></ul><ul><li>Networking and Building Alliances </li></ul><ul><li>Use of Information and Communication </li></ul><ul><li>Public Education and Information outreach </li></ul><ul><li>Research capacity building </li></ul><ul><li>Creation of technical support team </li></ul><ul><li>Demand that all disbursements to spending units to be gazetted to enable easy tracking by interest groups. </li></ul>
  15. 15. CSO Strengths <ul><li>CSO have a host of strengths </li></ul><ul><li>Simplifying budgets and deepening the debate around budget policies and decisions </li></ul><ul><li>Collating and disseminating budget information in user-friendly formats </li></ul><ul><li>Providing independent critical analysis </li></ul><ul><li>Bringing new information to the debate </li></ul><ul><li>Providing training in budget analysis and advocacy </li></ul><ul><li>Helping to build a culture of accountability </li></ul><ul><li>Advocating for more access to budget decision-making </li></ul><ul><li>Mobilizing stakeholders, interest groups and citizens </li></ul><ul><li>Providing input into budget decisions through existing channels of access (for instance submissions to parliamentary committees, SWGs) </li></ul>
  16. 16. THANK YOU