Table 8 Comparison with the WHO budgeting for health guide [1] and responses from the interviews
Budgeting for healthcare guide recommendations as per WHO | Responses from interviews |
|---|---|
Three cycles in the budgeting process | |
1. Implementation of the current year’s budget | ✓ |
2. Planning the upcoming year’s budget | ✓ |
3. Audit and review of the previous year | ✓ |
Members involved in the budget process | |
1. Ministries of budget/finance | ✓ |
2. Ministries of health | ✓ |
Roles and responsibilities | |
Ministries of budget/finance: leading members for budget development | ✓ |
Ministries of health: analysis of expenditure forecasts, preparation, presentation and negotiation of priority based budget proposals | ✓ |
Fund flows | |
Treasury ⇨ Minister of Health ⇨ Sub recipients (districts and health providers) | ✓ National treasury ⇨ Provincial treasury ⇨ Department of health ⇨ Districts |
Budget cycle referred to as a fiscal year which is 12 months | ✓ 1 April—31 March |
Budget formulation considerations | |
1. Decisions consistent with macroeconomic objectives | ✓ |
2. Aligned to health priorities | ✓ |
3. Historical budgeting unless there are changes in the economic situation or government priorities | ✓ |
4. Economic growth | ✓ |
5. Inflation | ✓ |
6. Demography | ✓ |
7. Revenue | ✓ |
8. Fiscal goals | ✓ |
9. Aligned with the constitution and public financial management | ✓ PFMA |
Promotes performance-based budgeting | X |
Access to quality budget and financial data | X This is what all provinces are aiming towards, but is still a work in progress |
Medium-term expenditure framework—3-year period spending plan | ✓ |