Diagnostic Study of Public Financial Management : To Strengthen Health Financing and Service Delivery in Bangladesh
Robust public financial management (PFM) systems are crucial to ensure the efficacy and integrity of public health spending, thereby contributing to improved service coverage and financial protection, as required for achieving universal health cove...
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| Language: | English |
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World Bank, Washington, DC
2019
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| Online Access: | http://documents.worldbank.org/curated/en/856271558671301506/Diagnostic-Study-of-Public-Financial-Management-To-Strengthen-Health-Financing-and-Service-Delivery-in-Bangladesh http://hdl.handle.net/10986/31768 |
| Summary: | Robust public financial management (PFM)
systems are crucial to ensure the efficacy and integrity of
public health spending, thereby contributing to improved
service coverage and financial protection, as required for
achieving universal health coverage. A weak PFM system has
impeded implementation of the Bangladesh health care
financing strategy 2012-2032. This paper aims to identify
and document major PFM challenges in relation to the
interventions outlined in this strategy document, on the
grounds that relaxing these constraints will strengthen
implementation. Further, the study examines PFM barriers in
service delivery, such as delays in fund availability and
procurement and the lack of operational funds at the
facility level. The paper points to a number of obstacles,
including the absence of a legal framework for implementing
a social health protection scheme, no laws to retain user
fees at health facilities or to change financial rules to
introduce flexible cash at facilities, district health
managers without delegated financial power, noncompliance
with audit observations, and need for PFM capacity
strengthening. Short-, medium- and long-term actions are
presented to address these PFM issues. Removing these
barriers will not require significant additional resources,
but will offer the potential to significantly enhance value
for money for Bangladesh’s government health budget. |
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