Joint Annual Performance Review 2007 - Ministry of Health

Constraints:
• The national budget allocated to provincial level based on the passed experience and
was not based on the annual operational plan.
• Delayed in setting up the system to financing to poor through the national budget and
the accounting staff at the hospitals have no capacity in spending budget to support
the poor patients.
• New financial reform, program based budgeting and new government account codes
with unclear guideline or norm.
• No more priority action program.
• Delayed in implementation of inter ministerial Prakas on government subsidy to the
poor.
• Lack HEF operator with the capacity and skill to implement in other non contracting
districts
• Delay implementation of health equity fund schemes in contracting district
• No development partnership harmonization in planning budgeting on HEF was
limited
• Lack of promotion on EF to the poor area.
• Poor management on Health Financing Schemes at HCs and RHs level
• Delay in development of legislation on CBHI.
Strategy 16: Ensure transparent, efficient and health expenditures through strengthening
resource allocation, coordination of different source of funds and monitoring:
The report of public Expenditure Tracking Survey (PETs) have been finished and
disseminated.
Constraints:
• No financial report system officially for national programs, HCs and RHs.
• The budget allocation to provincial (RHs and HCs) in 2007 was not based on the
annual operational plan.
• The department of internal audit has been established but has no functioned yet.
Priorities 2007-2008:
1. Budgeting based on the program.
2. Increase public expenditure per capita in health.
3. Improve disbursements and cash released, especially in the first semester for better
planning and implementation.
4. Closer coordination between MoEF and MoH regarding new process of requests,
Program Based Budgeting.
5. Set up the financial reporting system for program based budgeting.
6. Building the capacity of accounting staff in the new process of program based
budgeting, and new code account.
7. Negotiate with MoEF to find the solution of allocating budget to Provincial level.
8. Continue to allocate the national budget for saving the poor by using the government
budget.
9. Train the account staff at the hospital to know how to use the government budget to
support the poor patients.
10. Improve donors coordination to reduce the overlap spending
11. Expend subsidy schemes to 12 ODs in 2007, and 8 ODs or more in 2008
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