Public Financial Management in the Health Sector in Malawi
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World Bank, Washington, DC
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Health outcomes in Malawi have improved
significantly, largely due to improvements in access and
quality. Despite adverse macro-fiscal conditions, fiduciary
concerns, and donors shifting funding toward off-budget
financing modalities, there has been a huge improvement in
service delivery over the past two decades. Improving the
way government funds are spent in Malawi is paramount.
Evidence shows that the quality of public financial
management (PFM) significantly affects service provision and
health outcomes. To assess the extent to which the PFM
system in Malawi supports health service delivery, a study
was undertaken in six districts focusing on health centers
and hospitals. A total of 95 interviews were undertaken with
officials from all six district councils and district health
offices; 10 hospitals; and seven health centers. This policy
brief draws on this study identifying PFM gaps and
constraints at the local level, as well as critical areas
for action. These findings and recommendations are expected
to support decision makers and practitioners with ongoing
public financial management reforms.
Palabras clave
PUBLIC FINANCIAL MANAGEMENT, HEALTH FINANCING, HEALTH SERVICE DELIVERY, HEALTH EXPENDITURE, UNIVERSAL HEALTH COVERAGE, BUDGET EXECUTION
