General budget support in developing countries: ensuring the health sector's interest

Author(s): Adélio Fernandes Antunes, Guy Carrin and David B. Evans
Publisher: Department of Health Systems Financing, Health Financing Policy, WHO
Publication date: 2008
Number of pages: 11
Language: English


“Budget support refers to aid where:

  • funds are channelled through the national treasury; and
  • the allocation and management of these funds respects national priorities and procedures.

Budget support targets results delivery in a longer-term horizon than projects. Over the past decade, it has been accompanied by a focus on the importance of good governance to create capacities for sustainable development. In contrast to projects, it concentrates on outcomes rather than outputs, and emphasizes the importance of ownership of policies and programmes by recipient countries. Policy-dialogue between donors and recipient countries is supposed to build on and reinforce partnership. Budget support programmes can take various forms and designs, although two main categories can be identified: GBS and Sector Budget Support (SBS).

General budget support GBS is playing an increasing role in today's aid environment. Ministries of health need to understand how it works, and how to influence decisions about the allocation of the resources it brings - as they should do for all aid instruments.

Active, early participation in poverty reduction strategy discussions and subsequent General budget support GBS negotiations will increase their ability to negotiate adequate funding. It will also ensure that any reforms initiated as part of conditions agreed in GBS programmes are realistic and non-damaging for the health sector. To play this role, ministries of health may need to develop their skills in public administration, financial management and policy-dialogue. It will also require that they properly address good governance issues within the health sector.”