Budget and resource tracking

Dr. Michael McQuestion Dr. Cliff KamaraMs. Dana Silver

Sustainable Immunization Financing ProgramAnglophone African Peer review workshop

Nairobi, Kenya26 October 2015

Overview

• “To pay for something is to own it”• Most countries are actually paying most of

their immunization program costs but are not properly capturing and reporting those expenditures

• The countries are closer to the country ownership goal than they know

What the world sees now

Government R.I. expenditures per surviving infant (US$)Anglophone African SIF countries

Country 2010 2011 2012 2013 2014

Kenya 4 4 4 3

Liberia 3 2

Nigeria 4 7

Sierra Leone 0 2 6

Uganda 3 10

Africa mean 5 5 3 5 4

Weighted mean 15 12 5 8 10

Sources: WHO/UNICEF Indicator 6730; UN Population Division

Note: mid-year exchange rates used

PEFA standards• 1. Credibility of the budget - The budget is realistic

and is implemented as intended• 2. Comprehensiveness and transparency - The

budget and the fiscal risk oversight are comprehensive, and fiscal and budget information is accessible to the public.

• 3. Policy-based budgeting - The budget is prepared with due regard to government policy.

PEFA standards• 4. Predictability and control in budget execution - The

budget is implemented in an orderly and predictable manner and there are arrangements for the exercise of control and stewardship in the use of public funds.

• 5. Accounting, recording and reporting – Adequate records and information are produced, maintained and disseminated to meet decision-making control, management and reporting purposes.

• 6. External scrutiny and audit - Arrangements for scrutiny of public finances and follow up by executive are operating

Budgets

• As their budgets grow, immunization managers are obliged to:– demonstrate transparency and accountability

(budget efficiency)– link outputs and impacts to investments

(“value for money”)– create new budgets based on actual

expenditures (empirical budgeting)

Resource tracking

• Across the SIF countries, national counterparts are approaching these budget challenges in different ways

• They are innovating, developing new budgeting and resource tracking practices

• SIF Program provides a generic tool- budget flow analysis flowsheet

Partenaires

2010

%

2011

%

2012

%

2013

%

MONTANT MONTANT MONTANT MONTANT MONTANT MONTANT MONTANT MONTANT

PREVU LIBERE PREVU LIBERE PREVU LIBERE PREVU LIBERE

EN $ EN $ EN $ EN $ EN $ EN $ EN $ EN $

GVT 6713193 1604175 24% 7653996 1819612 24% 15 855 306 5 350 949 34% 10 610 555 4 128 764 39%

GAVI 78 397 442 25 701 000 33% 4 758 500 1 281 360 27% 73 010 784 31 625 999 43% 58 986 600 39 089 915 66%

OMS 5 382 466 17 993 274 334% 17 393 274 17 393 274 100% 14 939 380 24 745 892 166% 20 397 479 15 629 248 77%

UNICEF 8 530 647 23 848 264 280% 23 848 264 23 848 264 100% 20 109 850 21 577 095 107% 21 984 143 9 449 735 43%

USAID 3 700 300 3 700 300 100% Nd nd 0% nd 0% nd nd 0%

ROTARY 431 858 223 265 52% 223 265 223 265 100% nd nd 0% 165 750 50 000 30%

CTB 13 031 666 13 031 666 100% Nd 0 0% nd nd 0% nd nd 0%

MSH Nd Nd 0% 438 425 438 425 100% nd nd 0% nd nd 0%

Axxes Nd Nd 0% 1 339 500 1 339 500 100% nd nd 0% nd nd 0%

MCHIP Nd Nd 0% 37 385 37 385 100% 40 000 42 033 105% 45 700 37 837 83%

BM Nd Nd 0% Nd nd 0% 21 179 021 11 215 310 53% 5 446 306 5 446 306 100%

PROSANI nd nd 0% nd nd 0% 1 137 700 2 460 738 216% 2 742 460 2 716 868 99%

Total 115 650 572 86 101 944 74% 55 692 609 46 680 085 83% 146 272 041 97 018 016 66% 120 378 993 76 548 673 64 %

Best practice (DRC): Central level

Best practice (DRC): district level

Nom du Antenne -

Année de Rapport -Trimetre Annuel -

Identification - Responsible -

La Devise -Date de la Production du Rapport -

Trimestre Mois Central(A.)

Provincial(B.)

Auto-finacement

(C.)

Contributions Nationales

(A.-C.)

GAVI(D.)

UNICEF(E.)

OMS(F.)

Autres Partenaires

(G.)

Contributions des Partenaires

(D.-G.)

JanvierFévrier

MarsAvrilMaiJuin

JuilletAout

SeptembreOctobre

NovembreDécembre

$0 $0 $0 $0 $0 $0 $0 $0 $0 $0

0% 0% 0% 0% 0% 0% 0% 0% 0% 0%

REPUBLIQUE DEMOCRATIQUE DU CONGOMINISTERE DE LA SANTE

Rapport Sommaire du Formulaire 6

US$ Dollar10/16/2015

II

III

IV

Total par chaque source

Pour cent de la contribution

Sommaire des données financières

Information Generale de l'Antenne

Programme Elargi de Vaccination (PEV)

Contributions Nationales du Gouvernement Contributions des Partenaires Total par mois des toutes les

sources(A.-G.)

I

Année

sélectionner dumenu déroulant

informations apparaît

automatiquement

Sabin SIF Budget flow analysis tool

Budget Processes

Description Accounting concepts Amount in US$Local Currency

exchange rate to US$ =

1The initial projected immunization program budget (from current cMYP, amount of routine recurrent government projected costs, Spreadsheet 4. Financing)

Projected government R.I. budget

2The adjusted proposed immunization budget after review by the Ministry of Health, Council of Ministers or other budget review institution(s). The amount that was submitted for parliamentary approval.

Immunization budget proposed by MOH

3 The final immunization budget that was approved by parliament. Immunization budget approved by parliamentFramework Indicators

PEFA Indicator KeyFormula Guide

Cash Hoarding

Misclassification

Budget Credibility

Absorptive Capacity

Reporting Accuracy

(Box 7 / Box 6 ) x 100

Phase-V:Reporting 8

Amount of government routine EPI expenditures reported for Indicator 6730 of the WHO/UNICEF Joint Reporting Form (JRF) for the reporting year.

If Box 7 > Box 8, then (Box 8/ Box 7) x 100If Box 7 < Box 8, then (Box 7/ Box 8) x 100

Phase-IV:Expenditure 7 Amount of actual public routine immunization program expenditures.

Includes expenditures against in-year supplementary budgets. Total immunization expenditures as of end fiscal year

[ (Box 5 - Box 6) / Box 5 ] x 100

6 Amount of funds in Box 5 actually allocated by the Ministry of Health to the immunization program.

Amount of disbursed budget actually allocated to immunization program

(Box 7 /(Box 3+ Box 4 ) x 100

Phase-III:Disbursement

5 The amount of funds disbursed by Treasury to the Ministry of Health for immunization.

Amount disbursed against approved immunization budget by Treasury to MOH

Phase-I:Proposed Budget Public Expenditure and Financing

Accountability (PEFA)

Phase-II:Approved

Budget4 Additional in-year funds approved for immunization. Any additional

(supplemental) increases to the budget during the fiscal year.Total in-year immunization budget increase(s) approved

by parliament [ ((Box 3 + Box 4) - Box 5) /(Box 3+ Box 4) ] x 100

End: XXXCountry: Fiscal Year: Start: XXX

Sabin SIF Budget flow analysis tool

02468

10121416

2010 2011 2012 2013 2014

Routine immunization program budget performance: DRC (nominal US$m)

(sources: Sabin SIF budget flow analyses, provisional MoH data, WHO/UNICEF JRF)

approved disbursed spent reported

Sabin SIF Budget flow analysis tool

Indicator 2010 2011 2012 2013 2014cash hoarding1 57% 63% 10% 41% 31%misclassification2 - - 8% 4% 1%absorptive capacity3 100% 100% 78% 77% 85%budget credibility4 54% 19% 77% 44% 59%reporting accuracy5 9% 35% 100% 100% 100%

4 Program expenditures as a percent of approved budget5 Percent of program expenditures reported (JRF Indicator 6730)

Derived Sabin SIF budget flow indicators: DRC (Provisional MoH data)

Notes:1 Percent of approved budget not disbursed by treasury to MOH2 Percent of immunization allotment not allocated by MOH to immunization program3 Percent of allocated funds spent by immunization program

Sabin SIF Budget flow analysis tool

0

20

40

60

80

100

2010 2011 2012 2013 2014

Derived Sabin SIF budget flow indicators: DRC(Sources: Sabin SIF budget flow analyses, provisional MoH data,

WHO/UNICEF JRF)

cash hoarding misclassification absorptive capacity

budget credibility reporting accuracy

Resource tracking examples

• In three SIF countries, immunization managers secured the budget they sought simply by presenting EPI expenditure data over the previous several years as part of their “investment case”– Demonstrated budget credibility, sound

budget management

Resource tracking examples

• In two SIF countries, national immunization teams provided feedback on immunization expenditures to provincial officials, the public– Immediate improvement in provincial

expenditure reporting

Resource tracking examples

• In one SIF country, the immunization team presented the completed SIF budget flow analysis to parliamentarians, who then showed it to the prime minister, who then instructed the minister of finance to fully disburse the immunization budget– “information is power”

Thank you!