Details for Reform Option "District budget analysis, Madhya Pradesh"
Several stakeholders are involved in funding health services in Guna District, Madhya Pradesh, including the European Commission (EC), DANIDA, UNICEF and DFID. Furthermore, there are multiple sources of funds from central and state governments for health and family welfare services.
The development partners, each of whom has its own funding plan (often for similar activities), agreed with the district collector that a single district health plan which reflected all these activities and sources of funds would help to make the planning and delivery of services more effective by avoiding duplication and facilitating pooling of funds where appropriate.
The first step towards developing an integrated plan was to map out available funds using a “sources to uses” matrix created in an Excel spreadsheet.
Initially, all funds were mapped against the budget lines in the state budget documents. The district budgets referred included those from health as well as other health-impacting departments such as women & child development and public health engineering.
Working discussions were also held to produce a larger picture of resources and relate them with the process of formulating a refreshed district health action plan.
After discussions, a structure founded on four domains: development of community structures and processes, strengthening of sub-health centres, strengthening of referral services and IEC & training was adopted.
It was based on the ongoing district action plan under the EC-supported Sector Investment Programme. This organic approach, which ensures the usefulness and relevance of the information generated, is critical to the success of the process.
Information not available.
Initially Guna district, Madhya Pradesh. The process began in May 2003 but has now been extended across the state.
Six -12 months.
Clarity: A clear picture of total resources facilitates inter and intra-sector coordination and can speed up implementation.
Practical: Avoids duplication of activities / funding.
Effective: Can improve quality of investments and service delivery.
Cooperation essential: Possible reluctance to release budget information by some stakeholders.
Monitoring: Obtaining data on incomes from user charges, and how this is spent, may be problematic.
Complicated: Consolidating a variety of budgets into one framework can be problematic. In this exercise, a general, rather than a very detailed, picture was focussed on.
Budget documents covering relevant centrally-sponsored schemes and other transfers from central government as well as relevant state budget documents, all disaggregated by districts.
Disaggregated budget information from development partners.
Data on income from user charges in public facilities.
Interest among district officials.
Who needs to be consulted
District Health Officials; also District Collector who can facilitate obtaining detailed budget information, income from user charges etc; development partners (where relevant).
It requires a person with computer/spreadsheet skills is required to develop/maintain the spreadsheet matrix, to make it sustainable.
Chances of Replication
It has already been fully replicated to all 48 districts in the state.
It is critical not to be too ambitious or rigid in this exercise but to ensure that the district officials see value in the budget analysis.
Hence the step-by-step approach, doing some analysis, then discussing with officials, then doing more analysis, discussing etc. is important to ensure the exercise is not simply an academic one.
Consolidating a variety of budgets into one framework can be problematic. In this exercise, we focus on getting a general picture, rather than a very detailed one.
Dr. Matthew Jowett, Former Programme Advisor (Financial Management & Economics), European Commission Technical Assistance, New Delhi. September 2003.