Final Report:Health sector Public Expenditure Review(PER) update financial year (FY) 06

The Public Expenditure Review update for FY2005/06 (FY06) takes a slightly different form from previous years. A summary briefing paper was provided for discussion at the Annual Joint Heath Sector Review, while this later report has been provided as input to the Cluster PER and the budget process for FY2007/08. The change in timing had some negative consequences in that it overlapped with the final stages of the budgetary process for FY2006/07, making it more difficult than usual to access key individuals and data. Review of the PER findings and recommendations for FY05 found that there had been some progress in the area of lobbying for additional funds for that year’s budget, that it had been agreed to review the allocation formula for drugs and medical supplies, and that a tracking study on all drugs and supplies within the sector had been initiated. However, other recommendations had not been followed up, in part due to human resource constraints within the Department of Policy and Planning. Notable was the failure of the High Level committee on health financing, established during FY2003/04, to meet regularly and take forward the many issues in this area.\u

Public Health Sector Performance Profile 2001

\ud The health sector has been undergoing far-reaching reforms since the mid-1990s and has adopted a Sector-Wide Approach (SWAp). The reforms are being implemented at all levels and involve fundamental changes in many critical areas of the sector. The complexity of the current reforms and the challenges ahead are quite immense. Thus, close monitoring and evaluation of the health sector’s performance overtime is quite imperative. To this effect, 26 indicators, (input, process, output and outcome), encompassing financial, human, utilisation and epidemiological data have been identified and selected. The Public Health Sector Performance Profile has been developed to provide a commentary on the performance of the public health sector utilising the identified indicators. It is expected to be produced on an annual basis and will fulfill two critical roles, i.e., a tool to track the health sector reform progress year-on-year and to provide critical information for the monitoring of the health sector Poverty Reduction Strategy Paper (PRSP) targets. The work on performance monitoring in the health sector comes at quite an opportune time in light of the PRSP and Poverty Monitoring. Efforts have been made to ensure that the work in the health sector is securely anchored to these critical processes. This first profile provides baseline data for most of the identified indicators, although issues over completeness and quality of data, particularly routine and denominator data, still remains an outstanding and critical obstacle in this challenging process. Moreover, as this is a very new an innovative initiative, there may be other groups working on relevant/critical data which has not yet been accessed by the profile. Consequently, it is hoped that this profile will act as a catalyst and encourage such groups to come forward and to contribute to the next profile in 2002. Altogether, there are 26 Health Sector performance indicators, including those indicators which the health sector is expected to report on for the PRSP. There are 7 input indicators covering financial and human resources at the national, regional and district level. Process indicators consist of four in total, including the utilisation of HMIS/NSS data at the district level, proportion of public health facilities in a good state of repair, percentage of public health facilities without any stock outs and availability of drug kits in public health facilities. There are six output indicators encompassing cost sharing, OPD attendance, proportion of births attended by skilled attendants’, immunisation, malaria and consumer satisfaction. Finally, there are nine outcome indicators and these cover a number of aspects, including, maternal death, malnutrition, malaria and HIV/AIDS. Each indicator is presented under the following headings: relevance, sources of data, data quality, baseline data, discussion and future development of the indicator.\u