PETS in the health sector
This page will summarise information about and major findings of the health sector PETS in:
Rwanda about | findings |
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Ghana about | findings |
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Nigeria about | findings |
Rwanda
| About the PETS - Rwanda | |
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Year of data |
1998/1999 |
| Sample | All health centres (351) All district health offices (40) All regional health offices (11) |
| Level of administration studied | Government, region, district, health centre |
| Expenditures tracked | Non-salary expenditures from government level to regional and district health offices |
| Other data collected | Data on budget processes and record keeping. Data at the health centre level on user fees, staff, equipment and procedures governing the use of funds |
| Type of PETS | Diagnostic |
| Reference | Public Expenditure performance in Rwanda: Evidence from a Public Expenditure tracking study in the health and education sectors, World Bank, Africa Region working paper series no. 45, March 2003. |
| Other comments | The study encompassed both the education sector and the health sector |
| PETS major findings - Rwanda | |
| Key characteristics of resource flows | No government disbursements for
non-salary expenditures at facility level, only for the regional
and district health offices. Health workers are paid by central government |
| Financial management systems | Poor bookkeeping, lack of internal
financial controls and auditing requirements. Atmosphere for leakage
and mismanagement of funds. Better financial management at health centre level than at district and regional offices (due to more local involvement) |
| Leakage of funds | Potentially large leakage of funds.
Large discrepancies between amounts transferred by treasury and the amounts received by regional and district health offices, but it is impossible to tell whether this is caused by poor bookkeeping or by leakage of funds. |
| Delays | Delays in transfer of funds, both from central government to regional offices, and in wages paid directly to health workers. |
| Corruption | Not explicitly discussed |
Ghana
| About the PETS - Ghana | |
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Year of data |
2000 |
| Sample | 39 district offices 94 health centres 44 health clinics 34 health posts |
| Level of administration studied | Government, district, health facilities |
| Expenditures tracked | Non-salary expenditures, from government to facility level |
| Other data collected | Data at facility level on equipment, utilization, staff, client satisfaction, etc. |
| Type of PETS | Diagnostic |
| Reference | Efficiency of Public Expenditure Distribution and Beyond: A report on Ghana's 2000 public expenditure tracking survey in the sectors of primary health and education, World Bank, Africa Region working paper series no. 31, May 2002. |
| Other comments | Monetary values of materials are
estimated. Enumerators did not check records. Figures are based on respondents' answers. The study encompasses both the education sector and the health sector. |
| PETS major findings - Ghana | |
| Key characteristics of resource flows | Funds are converted from cash to
materials between line ministry and district health office. Health workers are paid by central government |
| Leakage of funds | Massive leakage of public funds.
80% of non-salary expenditures did not reach local health clinics. Leakage of salary expenditures is not a problem due to direct payment from the government. Leakage in health sector is larger than in education sector, partly due to a higher share of non-salary expenditures in the health sector |
| Corruption | Not explicitly discussed |
Nigeria
| About the PETS - Nigeria | |
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Year of data |
2002 |
| Sample | 30 local governments in two states
(not representative at national level) 252 health facilities 700+ health workers |
| Level of administration studied | Local government and health facility |
| Expenditures tracked | Salary payments from local government to health workers |
| Other data collected | Budget allocations and financial arrangements. Extensive survey on equipment, staff, salaries, service delivery, and performance. |
| Reference | Decentralized delivery of primary health services in Nigeria. Survey evidence form the states of Lagos and Kogi, World Bank, Das Gupta et al. Africa Region Human Development. Working paper 70. June 2004. |
| Other comments | Main focus of the study is on service delivery, not on resource flows. |
| PETS major findings - Nigeria | |
| Key characteristics of resource flows | Health worker salaries are paid by local government, unlike Rwanda and Ghana, where workers are paid by central government |
| Leakage of funds | Evidence of large-scale leakage
of public resources away from original budget allocations. Extensive non-payment of salaries (42% had not been paid salaries for more than six months during last year). |
| Corruption | Not explicitly discussed |
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PETS |
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Definition |
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Examples & findings |
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PETS as AC tool |
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References |
| CONTACT |
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Hannes Hechler
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