Sierra Leone Budget Tracking and Advocacy - WHO · Sierra Leone Budget Tracking and Advocacy ....
Transcript of Sierra Leone Budget Tracking and Advocacy - WHO · Sierra Leone Budget Tracking and Advocacy ....
Workshop on Enhancing Capacity for Budget Analysis and Advocacy for Women's and Children's Health
27-30 August 2013 Nairobi, Kenya
Sierra Leone Budget Tracking and Advocacy
Background/Context
• Sierra Leone’s Government is spending less than half of what is required to deliver basic health services
• Fluctuating budget allocation, untimely disbursement and effective utilization of funds to the health and sanitation sector
Large funding gap in relation to the Abuja target (2013)?
15% = Le 278 billion
10.5% = Le 195 billion
Le 84 billion
Background/Context
• Out of pocket spending by individuals is extremely high – government spending or insurance coverage accounts for only 25% of total health spending in 2011
• Sierra Leone is far behind in achieving the WHO recommended per capita spend ( eg in 2013 $10 is allocated per person)
Advocacy Objectives
• To have comprehensive, nation-wide information on the flow of Government funds within all levels of the health sector.
• To advocate for increased and efficient use of resources within the health sector.
Advocacy Objectives
• To identify budgetary issues and campaign asks upon which to engage the MoHS, and other relevant health sector stakeholders.
• To help ordinary citizens better understand current resource allocation and the budget process.
Strategy • Coalition (Save the Children & BAN) • Pilot study in 2011 • Coalition expansion and resource mobilization among members
(CSOs, INGOs, • Collaborated with GOSL, Local Councils, DHMT, PHUs, • Signed MOUs with coalition partners • Engagement with the media • Data collection, Draft report and finalized with MDAs • Advocacy activities (media, council, DHMT, Chief of staff, minister) • Election year – manifesto of political parties to prioritize health,
used district electoral forums, score cards, signed petitions, pledge card/audio/ video recording of political commitments
Budget tracking scorecards
• 5600 Citizens Health budget Scorecards distributed nationwide and at electoral forums
• Many candidates pledged to lobby for more funds for MNH
• Petitions were signed by citizens for improved health spending
Some facts
A scorecard displaying for each district money allocated and actually disbursed:
• - For health In the districts
- For the DHMT and to PHUs
- Ranking of the districts according to health
spending
Scorecards:
Petitions Petitions were provided for the moderators
•to collect signatures / marks from citizens •to lobby their candidates •to promise for increased health allocation and better recording and reporting of health finances.
• The petition
Outcomes of Advocacy Strategy
7.9% 7.4%
11%
7.4%
10.5%
0%
2%
4%
6%
8%
10%
12%
14%
16%
2009 2010 2011 2012 2013% o
f tot
al g
over
nmen
t bud
get
Abuja target
% total budgetallocated tohealth
15%
•Increase in allocation from 7.4% in 2012 to 10.5% in 2013
• More funds for Health Now Secured
Outcomes of Advocacy Strategy • Commitment for supplementary budget secured in 2012
Advocacy Outcome
Councils received Q1 & Q2 monies and MDAs received 6 months allocation by mid year in 2013
Political Parties, Chairman, Mayor, Councilors and MPs signed the health pledge
Advocacy Outcome
Advocacy Outcome
• The Abuja15% commitment is a major factor in the govt poverty reduction strategy (Agenda for Prosperity)
Advocacy Outcome
• Public awareness raised on health spending
Advocacy Outcome
• More space provided for CSOs at local and central government in the budget processes
Advocacy Outcome
• Citizens budget now shared by the ministry of finance
• Local council now making budget documents to the public
Challenges to the implementation of advocacy strategy
– Lack of fulfilling commitment by government – Lack of capacity in financial management within
ministries and councils – access to timely information from partners
(councils, INGOs, MOHs, MOFED, DHMT, Donors etc)
– Limited financial support (budget tracking can be expensive)
– Results can be politicized
Media Engagement
Facilitating factors to the achievement of budget advocacy outcome
• Strong coalition building • Political will • Information sharing • Credibility of budget tracking implementing
partners • Civil society space to influence change • Technical expertise within the coalition • Common interest among coalition, ministries,
CSOs,