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Public financial management and health services delivery
Necessary, but not sufficient?

Bryn Welham, Tom Hart, Shakira Mustapha and Sierd Hadley

Publisher: ODI


The issues of public financial management (PFM) and healthcare have long been of interest to the development policy community. Both issues are relatively well discussed and studied in their own right, but the relationship between them is comparatively under-theorised and under researched. More recently, the debates in both policy fields have started to place more of a premium on understanding the links between the two issues. To support this closer alignment, this research report looks in more detail at the theoretical and empirical links between these two concepts, predominantly from a PFM perspective.

The report concludes that there is evidence that at least some of the identified problems in health service delivery are clearly associated with weaknesses in core PFM systems. Most obviously, problems related to
the level and flow of resources were typically identified as stemming from weaknesses in the overall budget process, in terms of both the original budgetary allocations and the subsequent use of cash-budgeting practices during execution.

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