Dealing with (mis)alignment between public financial management & health finance

misalignment

I’ve worked on health services reforms in more than 20 developing and transition countries. I’ve learned that the soundness of the interface between health finance arrangements and public financial management structures and processes is critical to the effectiveness of service delivery. Yet, health policy practitioners in these countries are rarely very knowledgeable about this topic; and, they tend to focus on finance mechanisms ‘further down’ (e.g. provider payment; or, how funds are managed within facilities). If the expertise gap is identified, more often than not, a general public financial management expert is brought in. This rarely helps though, as sound practices and principles for managing finances in the core of the public sector frequently conflict with managing finances for service delivery. And few public financial management experts are familiar with the institutional arrangements health agencies use to ‘govern’ finance. Both in the field, and in my teaching, I have longed for a high-quality, accessible resource on this topic. And Hurray! A top-notch team (Cheryl Cashin, Danielle Bloom, Susan Sparkes, Helene Barroy, Joe Kutzin, and Sheila O’Dougherty) at the WHO has developed one: “Aligning Public Financial Management and Health Financing: Sustaining Progress Toward Universal Health Coverage”. I heartily recommend it to any and all health policy practitioners and educators.

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