Zambia Health Sector Public Expenditure Review

Picazo, Oscar F.; Zhang, Feng

doi:10.1596/978-0-8213-7804-5

Cited by 12 publications

(17 citation statements)

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“…By 2000, life expectancy at birth had fallen to 42 years, the second lowest reported for that year in the human development indicators. One, if not the major, concern was the health sector's ‘human resource crisis’, as some 69 per cent of professional posts were unfilled (Leiderer et al ., ; Picazo & Zhao, , p. 15).…”

Section: What Worked and What Did Not In Zambia's Social Sectors?mentioning

confidence: 99%

“…Source: augmented from De Kemp et al . () based on data from Picazo and Zhao (), MoH (Annual Health Statistical Bulletin, various years); Ministry of Finance and National Planning, poverty reduction budget support progress reports (various years); WDI 2012. WDI estimates developed by the UN Inter‐agency Group for Child Mortality Estimation (UN International Children's Emergency Fund, WHO, World Bank, UN Department of Economics and Social Affairs and UN Procurement Division).…”

Section: What Worked and What Did Not In Zambia's Social Sectors?mentioning

confidence: 99%

“…Between 2001 and 2005, the share of donor funding in total health expenditure grew from 15 to 47 per cent, while domestic contribution fell from 41 to 20 per cent. By 2009, the share of external resources in health funding in Zambia exceeded that of any other country in the region (Picazo & Zhao, , p. 22). However, most of this increase was the result of vertical funds operating outside the sector basket mechanism (De Kemp et al ., , p. 142).…”

Section: What Worked and What Did Not In Zambia's Social Sectors?mentioning

confidence: 99%

“…More importantly, however, the coordinating function of the SWAp architecture was undermined by large initiatives and vertical funds such as the Global Fund and PEPFAR, which brought in significant amounts of funding that were not channelled through the common SWAp basket (Picazo & Zhao, , p. 245; Republic of Zambia, , p. 44). Moreover, almost all donors, including those contributing to the basket also continued to provide off‐budget funding (Republic of Zambia, , p. 43).…”

Section: What Worked and What Did Not In Zambia's Social Sectors?mentioning

confidence: 99%

“…These off‐budget funds commonly relied on their own separate planning, budgeting and reporting formats, much like in the traditional mode of project aid, thus increasing transaction costs and workload for the administration (especially at lower level) and leading to duplication of activities. Various studies argue that these parallel aid‐delivery systems created by vertical funds reduced the effectiveness of the SWAp mechanism and complicated donor coordination as well as accountability and alignment (Picazo & Zhao, , p. 247; Sundewall et al ., ; Republic of Zambia, , p. 34; Pereira, , pp. 13–14).…”

Section: What Worked and What Did Not In Zambia's Social Sectors?mentioning

confidence: 99%

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Donor Coordination for Effective Government Policies?

Leiderer

2015

J of Intl Development

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New aid approaches devised under the Paris/Accra agenda for more effective aid are expected to make a particular difference in health and education as, arguably, in these sectors aid fragmentation is particularly prevalent. This article reviews evidence from recent in-depth country work on the extent to which the harmonisation and alignment principles, implemented through new aid modalities, have contributed to health and education outcomes in Zambia. Evidence suggests that even in a 'model' case for adopting Paris-style aid instruments such as Zambia, implementation of good aid principles has been insufficient to overcome the negative side effects of uncoordinated and fragmented aid.

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Section: What Worked and What Did Not In Zambia's Social Sectors?mentioning

confidence: 99%

Section: What Worked and What Did Not In Zambia's Social Sectors?mentioning

confidence: 99%

Section: What Worked and What Did Not In Zambia's Social Sectors?mentioning

confidence: 99%

Section: What Worked and What Did Not In Zambia's Social Sectors?mentioning

confidence: 99%

Section: What Worked and What Did Not In Zambia's Social Sectors?mentioning

confidence: 99%

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Donor Coordination for Effective Government Policies?

Leiderer

2015

J of Intl Development

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Responding to aid volatility: government spending on district health care in Zambia 2006–2017

Jackson

Forsberg

Chansa

et al. 2020

Global Health Action

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Background: A corruption event in 2009 led to changes in how donors supported the Zambian health system. Donor funding was withdrawn from the district basket mechanism, originally designed to pool donor and government financing for primary care. The withdrawal of these funds from the pooled financing mechanism raised questions from Government and donors regarding the impact on primary care financing during this period of aid volatility. Objectives: To examine the budgets and actual expenditure allocated from central Government to the district level, for health, in Zambia from 2006 to 2017 and determine trends in funding for primary care. Methods: Financial data were extracted from Government documents and adjusted for inflation. Budget and expenditure for the district level over the period 2006 to 2017 were disaggregated by programmatic area for analysis. Results: Despite the withdrawal of donor funding from the district basket after 2009, funding for primary care allocated to the district level more than doubled from 2006 to 2017. However, human resources accounted for this increase. The operational grant, on the other hand, declined. Conclusion: The increase in the budget allocated to primary care could be an example of 'reverse fungibility', whereby Government accounted for the gap left by donors. However, the decline in the operational grant demonstrates that this period of aid volatility continued to have an impact on how primary care was planned and financed, with less flexible budget lines most affected during this period. Going forward, Government and donors must consider how funding is allocated to ensure that primary care is resilient to aid volatility; and that the principles of aid effectiveness are prioritised to continue to provide primary health care and progress towards achieving health for all.

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