Public financial management (PFM) systems are a series of interlinked sub-systems that oversee budgeting, executing, and reporting on the use of public resources across the public sector. Effective PFM systems provide an essential foundation for service delivery by the following:
Promoting prudent budget decisions, allowing for stable financing to flow to the health sector
Preparing realistic budgets to guide spending within the health sector
Providing a reliable flow of public funds and in-kind resources to health services during budget execution
Ensuring the responsible and efficient use of resources through reporting and oversight mechanisms.
Providing adequate and reliable financing is central to the international commitment to achieve universal health coverage under the Sustainable Development Goals. Yet, in many countries, public sector funding for health services is inadequate, inefficient, unreliable, and unaccountable. Collectively these will undermine the coverage and quality of essential health services.
This paper sets out a problem-driven approach to diagnosing PFM problems in health services delivery to better inform UNICEF country office operation, and potentially for use by country governments in tackling and solving these problems as well.
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