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APHA Scientific Session and Event Listing

Recorded presentation

Hailu Nega, Leulseged Ageze, Melinda Ojermark, and Charlotte Leighton. International Health Division, Abt Associates, Inc., P.O.Box 1392, Code 1110, Addis Ababa, Ethiopia, 0112511509904, lageze@healtheth.org.et

Abstract for APHA 2006

The Implications of Decentralized Planning and Budgeting on Health Care Financing in Ethiopia

The learning objective of the paper is to share experiences of fiscal decentralization in Ethiopia and its implications on flow of public resources to the health sector. NHA data revealed that in 1999/2000, the per capita health expenditure was only about US$5.6 per annum, which is less than half of the Sub-Saharan African average of US$13 per annum, and much less than the US$34 per capita level recommended by the Commission on Macroeconomics and Health of WHO.

Since 2003/4, Ethiopia embarked on a full-fledged fiscal decentralization process which gives the full authority and power of budget allocation to the Woredas (districts) by which Woredas receive block grants from the Regional Governments, and earmark allocations to sectors as per their priority.

The purpose of this paper is to assess what in fact the public funding trends for health have been in the past three years under decentralization. The paper will describe briefly the decentralized budgeting process and flow of funds. It will examine primary interview data from regional and local officials and financial information collected from health facilities and finance offices to assess health sector budgeting in the three largest regions which contain over 85% of the country's population. The paper will also identify operational issues that facilitate and hinder allocation of resources to health and identify challenges and issues for the future.

Learning Objectives:

• The learning objective of the paper is to share experiences of fiscal decentralization in Ethiopia and its implications on flow of public resources to the health sector.

Presenting author's disclosure statement:

Any relevant financial relationships? No

Recorded presentation