WHO's Health Financing Team organized a Global Learning Event on 28 June 2022 to provide a deeper understanding of programme-based budgeting (PBB) reforms in the health sector.
PBB is a tool to link budget allocations to outputs rather than inputs. A programme-based budget groups expenditures by policy objectives or outputs, usually through a three-tiered structure (goal, sub-programme, activity) and is accompanied by a performance monitoring framework that links expenditure to key achievements.
Over the past two decades, nearly all low- and middle-income countries (LMICs) have initiated reforms to shift from input-based budgets to programme (output-based budgets), and health has often been a pilot sector for the introduction of these reforms. While some LMICs are more advanced in the reform processes and already operate using full-fledged PBB, most have faced design and implementation challenges in making this shift.
Event’s objectives
The Global Learning Event was designed as a technical deep-dive on PBB that aimed to
- Help frame and identify the key questions and considerations that PBB implementers need to reflect on when introducing or refining PBB in the health sector,
- Discuss good practices and explore how the trade-offs that emerge at each stage of the reform process can be addressed, and
- Identify remaining gaps in knowledge and needs for future reform support and cross-learning.
Participation
The online event was attended by 300+ unique participants, mainly from health and finance authorities of LMICs. It included speakers from the World Health Organization, the World Bank Group, the OECD, Public Expenditure and Financial Accountability (PEFA), GAVI, The Global Fund, The Collaborative Africa Budget Reform Initiative (CABRI), P4H and Results for Development (R4D), as well as several country experts involved in the design, implementation and monitoring of PBB.
WHO work
The Global Learning Event on PBB was organized in the frame of the Montreux collaborative agenda on fiscal space, public financial management and health financing. It builds on an extensive programme of work developed by WHO Health Systems Governance and Financing on PBB reforms, which includes in-depth country reviews and the development of How to make budgets work for health: A practical guide to designing, managing and monitoring programme budgets in the health sector (2022).
Recording