Rapid Assessment of the Effect of the Economic Crisis on Health Spending in Mongolia
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World Bank, Washington, DC
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This rapid assessment examines the
effect of Mongolia's economic crisis on government
health budgets and health expenditure, household
out-of-pocket spending and donor health commitments. This
study was part of a larger assessment conducted in four
countries on the effects of the economic crisis on health
spending. A standardized approach was developed for all
country case studies and consisted of a desk review of
internationally-available literature and databases,
extensive in-country review of data and documents available
in government and donor offices, and semi-structured
interviews with government staff, health providers and
development partners. This assessment in Mongolia reveals a
substantial reduction in the government health budget: the
2009 national health budget was significantly lower than the
previous year's, and then was further reduced by 10
percent in a subsequent budget amendment. At national level,
budget cuts were concentrated in investment line items.
Among recurrent line items, the pharmaceutical budget was
hardhit, but salaries were largely preserved, and there were
no retrenchments. Similar patterns were observed at
sub-national level for hospital budgets, which depend on the
central allocations, but not for primary care facilities,
which are funded on a capitation basis. Compared to other
sectors, the health sector was relatively protected during
the economic crisis and the share of health in the total
government budget was higher after the budget amendment than
before. To protect households from the effects of the
economic crisis on health spending, the government undertook
specific policy measures to expand health insurance coverage
to vulnerable groups. Donor commitments to the health sector
during the crisis largely tracked previously planned commitments.
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