The document analyzes the medicines budget for the district of Layyah, Punjab from 2010-2015. It finds that over this period, the budget demanded increased but the budget allocated, released, and utilized all decreased. Specifically, the medicines budget allocated for 2014-2015 was Rs. 58.06 million compared to Rs. 74.73 million in 2010-2011. This represents only a 35% allocation against the demand that year. The document also notes per capita health spending is very low in Layyah compared to international standards and recommends increasing budget allocations and ensuring full utilization to improve healthcare.

1. 2015
Medicines Budget Analysis
DISTRICT LAYYAH, PUNJAB
BY: LAILA RUBAB JASKANI

2. DISTRCT LAYYAH
SUMMERY OF MEDICINES BUDGET
FOR THE FY 2010-2015
Rs in Million
Sr.# YEAR
BUDGET
DEMANDED
BUDGET
ALLOCATION
RELEASED UTILIZATION
1 2010-11 102.35 74.73 74.73 64.20
2 2011-12 103.55 72.60 72.60 69.80
3 2012-13 132.30 66.62 66.62 58.25
4 2013-14 162.80 60.21 60.11 59.73
5 2014-15 164.80 58.06 53.26 -
TOTAL 665.80 332.22 327.32 251.98
Data Source: EDO Health office and EDO Finance and Planning District Layyah.
The trend analysis of medicines allocations in District Layyah reflect downward movement in
budget allocations, released and utilization as against upward movement in budget demanded
over the period of analysis. The medicines budget allocated in fiscal years 2014-15 to health
institutions of Layyah was Rs. 58.06 million as against allocations of Rs. 74.73 million.
Figure 1 Trend Analysis of Medicines Budget 2010-15
When compared with budget demands, the district Layyah received only 35% of its demanded
amount of medicines budget in fiscal year 2014-15. This percentage was maximum (73%) in
fiscal year 2010-11 but decreased on yearly basis over the period of analysis.
-
20.00
40.00
60.00
80.00
100.00
120.00
140.00
160.00
180.00
2010-11 2011-12 2012-13 2013-14 2014-15
BUDGET DEMANDED
BUDGET ALLOCATION
RELEASED
UTILIZATION

3. Figure 2: Medicines Budget 2010-15 - Demand vs. Allocations
In fiscal years 2013-14 and 2014-15, the medicines budget was not fully released to health
institutions of the district. In fiscal year 2013-14 the amount released was Rs 53.26 million as
against allocated amount of Rs. 58.06 million. Similarly in fiscal year 2014-15 the released
amount was Rs. 60.11 million as against allocated budget of Rs. 60.21 million.
Figure 3: Medicines Budget 2010-15 - Allocations vs. Released
Over the period of analysis, the district government of Layyah has reduced the medicines
budget while total allocations towards health institutions are increasing in the same period.
This decrease in medicines budget and diversion of funds towards other heads reflect non-
seriousness of the management towards provision of medicines to patients in the district.
-
20.00
40.00
60.00
80.00
100.00
120.00
140.00
160.00
180.00
2010-11 2011-12 2012-13 2013-14 2014-15
102.35 103.55
132.30
162.80 164.80
74.73 72.60 66.62 60.21 58.06
BUDGET DEMANDED
BUDGET ALLOCATION
-
10.00
20.00
30.00
40.00
50.00
60.00
70.00
80.00
2010-11 2011-12 2012-13 2013-14 2014-15
74.73 72.60
66.62
60.21 58.06
74.73
72.60
66.62
60.11
53.26
BUDGET ALLOCATION
RELEASED

4. Figure 4: Trend Analysis - Medicines vs. Total Budget Allocations
Years Total Budget
Medicines Budget
Amount % of Total Budget
2010-11 429.77 74.73 17%
2011-12 453.51 72.60 16%
2012-13 664.78 66.62 10%
2013-14 817.44 60.21 7%
2014-15 711.46 58.06 8%
Per Capita Health Spending in 2013-2014 at the District Layyah
Name of
Health
Facility
Budget
allocation
2013-14
Annual Patients
2013-14
Per unit
Catchment
Population(MS
DS)
Per Patient
Cost
(medicines
budget)
BHUs 19,000,000 383,637 25,000 49.52
RHCs 2,100,000 87,248 100,000 24.06
THQs 14,304,000 432,976 0.5 to 1.0 m 33.03
DHQ 22,500,000 272,277 1 to 3 million 82.63
74.73 72.60 66.62 60.21
58.06
429.77
453.51
664.78
817.44
711.46
-
100.00
200.00
300.00
400.00
500.00
600.00
700.00
800.00
900.00
2010-11 2011-12 2012-13 2013-14 2014-15
Medicines Budget
Total Budget

5. The Punjab health sector strategy states that, Per capita government investment in the health is
low as per international standards, currently estimated to be between $6.5 and $7.5 per person
per year in 2010-11.(Punjab Health Sector Strategy,2012-2020).
Punjab Growth Strategy, 2018 estimates that there is a 50% gap between existing annual
spending on health. This strategy seeks to reduce this to 20% by 2020. It also seeks to increase
per capita expenditure on health from the current USD 10.3 to USD 16 by 2020. The Government
also aims to target that all districts are able to utilize more than 90% of released funds. (Punjab
Growth Strategy, 2018 final version).
In Punjab, government financing of health expenditure stands at approximately 23% of total
health 3.13. Expenditures in the province, (Punjab Social Sector Public Expenditures Review,
2013).While in comparison with Layyah District Health department is 8% for medicines in 2014-
2015. Unfortunately this reveals that the health expenditures on health is poor of the toal GDP
of Punjab.
Rationally according to the PHSS, 2012-2020 the Per capita government funding in US $ is 8.5
US $ in Punjab. According to Operational Plan to Implement Phase I (2012-16) of the Punjab
Health Sector Strategy (2012-20)Per capita government expenditure (in US $) target is $12 by
2020.
Critical Gaps and Recommendations:
Based upon these analysis EVA-BHN call to action to District Government Layyah;
1) There is 9% gap in the health budget allocation for the year of 2013-2014 as compares to
last five years budget for health in Layyah
49.52
24.06
33.03
82.63
0
10
20
30
40
50
60
70
80
90
BHUs RHCs THQs DHQ
PER PATIENT COST (MEDICINES BUDGET)
- FY 2013-14

6. 2) The downward trends of medicines budget reflects decrease in budget allocation instead
of increase according to the increase in catchment population of health facilities
3) Total resources of budget decreasing, allocation of budget does not reflects health as a
priority. It is against the government commitment of health as a right for all and as a
priority of government. Health should be consider as a right and priority for district Layyah
health management
4) When we take into account the inflationary impact the amount allocated for medicines
will even more reduced to rupees
5) Per capita health spending in Layyah in last five years which is very low of current inflation
rate. Per capita income needs to be increase as per international health standards and the
Per capita government funding in US $i and accordingly the increasing catchments
population
6) The budget utilization is low against the total allocated budget for medicines budget item.
The department of health in Layyah district must ensure 100% of budget utilization in the
medicines budget item line.ii
i Rationally according to the PHSS, 2012-2020 the Per capita government funding in US $ is 8.5
US $ in Punjab. According to Operational Plan to Implement Phase I (2012-16) of the Punjab
Health Sector Strategy (2012-20)Per capita government expenditure (in US $) target is $12 by
2020.
ii Utilization rate over the time period is low as compare to medicines budget released. The
underutilization may cause constraint in advocating for budget increase in medicines item line