2019 budget allocation for Primary Health Care Division was only 4%

The Budget Credibility Report covering the period 2017-2019 has shown that in 2017, goods and services, transfers and grants and capital expenditure were responsible for the variance of 29 percent. This analysis was undertaken by the Consortium of Non-Governmental Organisations (NGOs). In 2018 and 2019, the variance of 44.8 percent and 46.0 percent was driven by goods and services and capital expenditures. The composition of the budget by economic classification is important to show the movements between different categories of inputs—for example, capital and recurrent expenditures.

The composition of variance for the review period was 29.2%, 44.8% and 46.0%, which shows that the variance in expenditure composition by economic classification ranged between 29.2 percent and 44.8 percent during 2017, 2018 and 2019 respectively, and the country attracted a score for the present dimension as ‘D’.  The dimension which is the aggregate expenditure out-turn compared to original approved budget that scored D, was as a result of the actual expenditure being between 90% and 110% of budget in two of the last three years and would have been scored ‘B’ except that no data was available on total expenditure including donor projects.

“The weak score is a cause for concern as it shows the actual expenditure on goods and services economic classification, which is essential for supporting the activities of Ministries, Departments and Agencies (MDAs),” explained Abu Bakarr Kamara, National Coordinator Budget Advocacy Network (BAN). It is under the goods and services budget that MDAs provide estimates for their programs to be implemented. It analysis showed that in 2019, the Ministry of Health and Sanitation’s Primary Health Care Division received only Le740 million from a budget of Le20.4 billion which accounts for only 4% execution rate.

“This means that health service delivery at the primary level will be reduced, hence citizens will not receive adequate healthcare. Similarly, capital expenditures have been below the approved budget over the review period,” said Kamara. Furthermore, the Ministry of Health only received Le3.2 billion of their capital budget from an approved amount of Le52 billion (6 percent execution rate). Kamara went further to note that in the Ministry of Health and Sanitation, the expectation would be that primary healthcare department should be prioritised for resource allocation as critical department for improving the health status of citizens.

However, though the division had an approved budget of Le20.4 billion in 2019, only Le749 million was disbursed. In contrast, the administrative division had an approved budget of Le10.3 billion, but it went on to receive and spend Le20.3 billion. This was factored under the expenditure composition out-turn by economic type dimension. This dimension measures the difference between the originally approved budget and end-of-year out-turn in expenditure composition by economic classification during the last three years including interest on debt, but excluding contingency items.

Variance in expenditure according to economic type is calculated in accordance with the Public Expenditure and Financial Accountability (PEFA) 2016 Framework. It is based on total expenditure excluding contingency and donor-funded project expenditure, but including interest.

By Zainab Iyamide Joaque