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dc.contributor.authorWitter, Sophie
dc.contributor.authorJones, A.
dc.contributor.authorEnsor, Tim
dc.date.accessioned2018-06-29T22:01:47Z
dc.date.available2018-06-29T22:01:47Z
dc.date.issued2013-06
dc.identifierER3204
dc.identifier.citationWitter, S., Jones, A. & Ensor, T. (2013-06) How to (or not to) . . . measure performance against the Abuja target for public health expenditure, Health policy and planning, pp. 01-Jun.
dc.identifier.issn0268-1080
dc.identifier.urihttp://dx.doi.org/10.1093/heapol/czt031
dc.identifier.urihttps://eresearch.qmu.ac.uk/handle/20.500.12289/3204
dc.description.abstractIn 2001, African heads of state committed 'to set a target of allocating at least 15% of our annual budget to the improvement of the health sector'. This target has since been used as a benchmark to hold governments accountable. However, it was never followed by a set of guidelines as to how it should be measured in practice. This article sets out some of the areas of ambiguity and argues for an interpretation which focuses on actual expenditure, rather than budgets (which are theoretical), and which captures areas of spending that are subject to government discretion. These are largely domestic sources, but include budget support, which is externally derived but subject to Ministry of Finance sectoral allocation. Theoretical and practical arguments in favour of this recommendation are recommended using a case study from Sierra Leone. It is recommended that all discretionary spending by government is included in the numerator and denominator when calculating performance against the target, including spending by all ministries on health, social health insurance payments, debt relief funds and budget support. Conversely, all forms of private payment and earmarked aid should be excluded. The authors argue that the target, while an important vehicle for tracking political commitment to the sector, should be assessed intelligently by governments, which have legitimate wider public finance objectives of maximizing overall social returns, and should be complemented by a wider range of indicators, to avoid distortions.
dc.format.extent01-Jun
dc.publisherOxford University Press
dc.relation.ispartofHealth policy and planning
dc.subjectAbuja target
dc.subjecthealth financing
dc.subjectAfrica
dc.titleHow to (or not to) . . . measure performance against the Abuja target for public health expenditure
dc.typearticle
dcterms.accessRightsrestricted
dc.description.facultysch_iih
dc.description.referencetextActionAid. 2005. Four Years After Abuja: More Action Required on Spending Commitments! Nairobi: ActionAid International Africa. Govenda V, McIntyre D, Loewenson R. 2008. Progress towards the Abuja Target for Government Spending on Health Care in East and Southern Africa. Cape Town, SA: EQUINET. Government of Sierra Leone, Ministry of Health and Sanitation. 2009. The National Health Sector Strategic Plan 2010-2015. http://www. health.gov.sl/home/, accessed 13 September 2012. Government of Sierra Leone, Ministry of Health and Sanitation, the World Bank, the World Health Organization. 2012. Sierra Leone National Health Accounts. Freetown: Ministry of Health and Sanitation. Government of Sierra Leone, Statistics Sierra Leone. 2008. Demographic Health Survey. www.statistics.sl, accessed 14 May 2013. HDI. 2012. Human Development Index Website. http://hdr.undp.org/en/ statistics/, accessed 23 April 2013. HRC. 2006. Financial Factors Affecting Slow Progress in Reaching Agreed Targets on HIV/AIDS, TB and Malaria in Africa. London: DFID Health Resource Centre. Moreno-Serra R, Smith PC. 2012. Does progress towards universal health coverage improve population health? Lancet 380: 917-23. OECD, EUROSTAT, WHO. 2011. A System of Health Accounts. Paris: OECD Publishing. Organisation of African Unity. Abuja Declaration on HIV/AIDS, tuberculosis and other related infections diseases. In: OAU (ed). African Summit on HIV/AIDS, Tuberculosis and Other Related Infectious Diseases, Abuja, Nigeria 24-27 April 2001. WHO. 2011. The Abuja Declaration: 10 Years on. Geneva: World Health Organization. Witter S, Garshong B. 2009. Something old or something new? Social health insurance in Ghana. BMC International Health and Human Rights 9. World Health Organization's Data Repository. http://apps.who.int/ ghodata/, accessed 20 September 12. World Health Organization. 2001. Macroeconomics and Health: Investing in Health for Economic Development. Report of the Commission for Macro- Economics and Health. Geneva: WHO. World Health Organization. 2012. WHO Global Health Expenditure Atlas. Geneva: WHO.
dc.description.ispublishedpub
dc.description.eprintid3204
rioxxterms.typearticle
qmu.authorWitter, Sophie
dc.description.statuspub


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