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THE ABUJA DECLARATION AND HEALTH EQUITY By Simon Moshy

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Page 1: By Simon Moshy.  Health Sector 2011/12  MoHSW 2012/13  Health Block Grants  Essential Medicines & Medical Supplies  Key Messages 2

THE ABUJA DECLARATION

AND HEALTH EQUITY

By Simon Moshy

Page 2: By Simon Moshy.  Health Sector 2011/12  MoHSW 2012/13  Health Block Grants  Essential Medicines & Medical Supplies  Key Messages 2

2

TALKING POINTS Health Sector 2011/12

MoHSW 2012/13

Health Block Grants

Essential Medicines & Medical Supplies

Key Messages

Page 3: By Simon Moshy.  Health Sector 2011/12  MoHSW 2012/13  Health Block Grants  Essential Medicines & Medical Supplies  Key Messages 2

3

HEALTH SECTOR 2011/12

Abuja target

Page 4: By Simon Moshy.  Health Sector 2011/12  MoHSW 2012/13  Health Block Grants  Essential Medicines & Medical Supplies  Key Messages 2

4

SOCIAL SECTOR IS NO PRIORITY

Source: PWC (2008,2009,2010,2011), Budget Speech Reviews.

2008/09 2009/10 2010/11 2011/120%

5%

10%

15%

20%

25%

Education

Health

Sh

are

of

Tota

l B

ud

get

Page 5: By Simon Moshy.  Health Sector 2011/12  MoHSW 2012/13  Health Block Grants  Essential Medicines & Medical Supplies  Key Messages 2

5

INFRASTRUCTURE IS PRIORITY

Source: PWC (2008,2009,2010,2011), Budget Speech Reviews.

2008/09 2009/10 2010/11 2011/120%

5%

10%

15%

20%

25%

Education

Infra-structure

Health

Sh

are

of

Tota

l B

ud

get

Page 6: By Simon Moshy.  Health Sector 2011/12  MoHSW 2012/13  Health Block Grants  Essential Medicines & Medical Supplies  Key Messages 2

6

ABUJA DECLARATION

Source: PWC (2008,2009,2010,2011), Budget Speech Reviews.

2008/09 2009/10 2010/11 2011/120%

5%

10%

15%

20%

25%

Abuja Target

Health

Sh

are

of

Tota

l B

ud

get

Page 7: By Simon Moshy.  Health Sector 2011/12  MoHSW 2012/13  Health Block Grants  Essential Medicines & Medical Supplies  Key Messages 2

7

DOMESTIC VS FOREIGN FUNDING

20

05

/06

20

06

/07

20

07

/08

20

08

/09

20

09

/10

20

10

/11

20

11

/12

20

12

/13

20

13

/14

0%10%20%30%40%50%60%70%80%90%

100%share of domestic funding to total budget

share of foreign funding to total budget

Healt

h S

ecto

r Fu

nd

ing

S

hare

Projection (linear)Actual

Source: Health Sector PER Updates (2005-2010).

Page 8: By Simon Moshy.  Health Sector 2011/12  MoHSW 2012/13  Health Block Grants  Essential Medicines & Medical Supplies  Key Messages 2

8

MINISTRY OF HEALTH

AND SOCIAL WELFARE

Page 9: By Simon Moshy.  Health Sector 2011/12  MoHSW 2012/13  Health Block Grants  Essential Medicines & Medical Supplies  Key Messages 2

9

MOHSW TOTAL SPENDING

Source: Budget Estimates (2011,2012), Vol. II and IV.

2009/10 2010/11 2011/12 2012/130

100,000,000,000

200,000,000,000

300,000,000,000

400,000,000,000

500,000,000,000

600,000,000,000

700,000,000,000

800,000,000,000

DevelopmentRecurrent

Page 10: By Simon Moshy.  Health Sector 2011/12  MoHSW 2012/13  Health Block Grants  Essential Medicines & Medical Supplies  Key Messages 2

10

UNNECESSARY EXPENDITURES IN THE MOHSW

Budget Item 2010/2011 2011/2012 2012/13

Change 2011/12 to

2012/13Allowances

5,740,981,080

8,503,305,502

10,285,936,066

21.0%

Fuel, Oil, Lubricants

957,716,5261,140,988,00

01,234,716,00

08.2%

Training1,830,172,20

26,593,318,36

06,771,232,00

02.7%

Travel2,097,792,84

04,725,189,00

02,376,312,00

0-49.7%

Hospitality

395,967,340 708,454,0003,890,634,60

0449.2%

Acquisition of Vehicles

0 341,000,000 260,000,000 -23.8%

Total 11,022,629,988

22,012,254,862

24,818,830,666 12.8%

Source: Budget Estimates (2012), Vol. II.

Page 11: By Simon Moshy.  Health Sector 2011/12  MoHSW 2012/13  Health Block Grants  Essential Medicines & Medical Supplies  Key Messages 2

11

MOHSW DEVELOPMENT EXPENDITURES

2009

/10

2010

/11

2011

/12

2012

/13

050,000,000,000

100,000,000,000150,000,000,000200,000,000,000250,000,000,000300,000,000,000350,000,000,000400,000,000,000450,000,000,000500,000,000,000

Foreign Local

Source: Budget Estimates (2011, 2012), Vol. II and IV.

Page 12: By Simon Moshy.  Health Sector 2011/12  MoHSW 2012/13  Health Block Grants  Essential Medicines & Medical Supplies  Key Messages 2

12

MOHSW DEVELOPMENT EXPENDITURES

Source: Budget Estimates (2012), Vol. IV.

Preve

ntiv

e se

rvices

Curat

ive

serv

ices

Policy

and

Plann

ing

Hum

an R

esou

rce

Dev

.

Social

Wel

fare

040,000,000,00080,000,000,000

120,000,000,000160,000,000,000200,000,000,000

2011/12 2012/13

Page 13: By Simon Moshy.  Health Sector 2011/12  MoHSW 2012/13  Health Block Grants  Essential Medicines & Medical Supplies  Key Messages 2

13

HEALTH EQUITY

Health block grant

Page 14: By Simon Moshy.  Health Sector 2011/12  MoHSW 2012/13  Health Block Grants  Essential Medicines & Medical Supplies  Key Messages 2

14

HEALTH BLOCK GRANT ALLOCATION FORMULA Formula has been developed in 2002 by

Georgia State University.

Allocation FactorsPopulation (70%)Under-five mortality (10%)Poverty count (10%)District vehicle route (10%)

Page 15: By Simon Moshy.  Health Sector 2011/12  MoHSW 2012/13  Health Block Grants  Essential Medicines & Medical Supplies  Key Messages 2

15

HEALTH BLOCK GRANT ALLOCATION FORMULA

Page 16: By Simon Moshy.  Health Sector 2011/12  MoHSW 2012/13  Health Block Grants  Essential Medicines & Medical Supplies  Key Messages 2

16

HEALTH BLOCK GRANT ALLOCATION

Source: www.pmoralg.go.tz/

0 500 1000 1500 2000 2500 3000 35000

500

1000

1500

2000

2500

3000

3500

2005-06

2008-09

Allocation by the Formula (TZS)

Actu

al

Re

so

urc

e A

llo

ca

tio

n (

TZ

S)

Line of E

quality

Page 17: By Simon Moshy.  Health Sector 2011/12  MoHSW 2012/13  Health Block Grants  Essential Medicines & Medical Supplies  Key Messages 2

17

ESSENTIAL MEDICINES AND

MEDICAL SUPPLIES

Page 18: By Simon Moshy.  Health Sector 2011/12  MoHSW 2012/13  Health Block Grants  Essential Medicines & Medical Supplies  Key Messages 2

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MEDICINES & MEDICAL SUPPLIES Sikika’s survey from May to August 2011

shows that from 100 inquiries for a specific essential medicine or medical supply, on average, 29 were reported to be out of stock.

Budget for Essential Medicines and Supplies in 2012/13:PSU/MSD est. need: TZS 198 bn (100%)MTEF: TZS 75.5 bn

(38%)

Source: MTEF of MoHSW (2012).

Page 19: By Simon Moshy.  Health Sector 2011/12  MoHSW 2012/13  Health Block Grants  Essential Medicines & Medical Supplies  Key Messages 2

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MEDICINES & MEDICAL SUPPLIES

Source: MTEFs of MoHSW.

2007/08

2008/09

2009/10

2010/11

2011/12

2012/130

10

20

30

40

50

60

70

80

90

ForeignLocal

Billion

TZ

S

Page 20: By Simon Moshy.  Health Sector 2011/12  MoHSW 2012/13  Health Block Grants  Essential Medicines & Medical Supplies  Key Messages 2

20

KEY MESSAGES Health sector is no priority

Long way to Abuja target of 15%

Unnecessary expenditures in the MoHSW are still increasing

Health block grant formula is not applied

Persistent lack of funding for essential medicines & medical supplies

Page 21: By Simon Moshy.  Health Sector 2011/12  MoHSW 2012/13  Health Block Grants  Essential Medicines & Medical Supplies  Key Messages 2

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Please visit our website at

www.sikika.or.tz

Asanteni Sana!