Effective public financial management (PFM) systems provide an essential foundation for service delivery by promoting prudent budget decisions, providing a reliable flow of public funds and in-kind resources to health services during budget execution, and ensuring monitoring, reporting and evaluation of spending for transparent and accountable use of resources.
Given the increasing interest in the relationship between management of public funds and the delivery of health service, the Overseas Development Institute (ODI) and UNICEF undertook research to review PFM diagnostics for the health sector. This led to a working paper that to provide donors, government, and other practitioners with a comparative ‘menu of options’ for considering what – if any – PFM and health diagnostic tools might support their particular objectives. In addition, following the result of the working paper, UNICEF and ODI developed an approach for diagnosing PFM problems in health services delivery to better inform UNICEF country office operation and country governments solving their problems.
When seeking to ensure the financial sustainability of a health program, a budget line item in the Ministry of Health (MOH) budget is often seen as an essential first step. A line item increases visibility of government support in budget prioritization, allocation and execution. A separate budget line may make it more likely that budget decision-makers explicitly allocate resources for immunization. UNICEF conducted a cross-country study in Sub-Saharan Africa to compare how immunization is reflected in MOH budgets. The study compared the number and types of budget line items for immunization services, analyzed the budget realization, and compared it with annual immunization expenditures reported to WHO and UNICEF. Further work is underway to explore different country approaches of budgeting for immunization.
UNICEF has also collaborated with the International Budget Partnership (IBP) to look at underspending in the government immunization budgets. Further analysis is underway on this important issue to examine how much is being spent on immunization, and identify challenges in timely and complete execution of existing immunization budgets.