Ghana and Bangladesh Share Promising Practices for Health Budget Accountability

A child receives care at a health screening in Bangladesh. (Photo: Maggie Moore/USAID)

Defining Accountability

  1. At the time of priority setting and budget formulation, expectations and goals are clearly defined for both financial management (e.g., amount and proportion of funds spent by each program) and program management (e.g., service delivery targets and health outcomes).
  2. Processes exist to integrate relevant and diverse stakeholders (e.g., Ministry of Health, Ministry of Finance, Ministry of Planning) into priority-setting and budget formulation discussions.
  3. IT infrastructure sufficiently tracks adherence to expectations set across health and PFM domains. This analysis ideally enables monitoring of health spending against both health priorities and PFM objectives.
  4. Consequences for not following defined expectations are well communicated and understood (e.g., reprioritization of misused or unspent funding).
Figure 1. Accountability for “Good” Health Budget Execution

Accountability Approaches in Ghana and Bangladesh

Key Lessons for Improving Budget Accountability

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USAID’s Local Health System Sustainability Project helps countries achieve sustainable, self-financed health systems that offer quality health care for all.

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LHSS Project

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USAID’s Local Health System Sustainability Project helps countries achieve sustainable, self-financed health systems that offer quality health care for all.

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