Sierra Leone Budget Tracking and Advocacy Workshop on Enhancing Capacity for Budget Analysis and Advocacy for Women's and Children's Health 27-30 August 2013 Nairobi, Kenya
Background/Context Sierra Leone s Government is spending less than half of what is required to deliver basic health services Fluctuating budget allocation, untimely disbursement and effective utilization of funds to the health and sanitation sector
Large funding gap in relation to the Abuja target (2013)? 15% = Le 278 billion Le 84 billion 10.5% = Le 195 billion
Background/Context Out of pocket spending by individuals is extremely high government spending or insurance coverage accounts for only 25% of total health spending in 2011 Sierra Leone is far behind in achieving the WHO recommended per capita spend ( eg in 2013 $10 is allocated per person)
Advocacy Objectives To have comprehensive, nation-wide information on the flow of Government funds within all levels of the health sector. To advocate for increased and efficient use of resources within the health sector.
Advocacy Objectives To identify budgetary issues and campaign asks upon which to engage the MoHS, and other relevant health sector stakeholders. To help ordinary citizens better understand current resource allocation and the budget process.
Strategy Coalition (Save the Children & BAN) Pilot study in 2011 Coalition expansion and resource mobilization among members (CSOs, INGOs, Collaborated with GOSL, Local Councils, DHMT, PHUs, Signed MOUs with coalition partners Engagement with the media Data collection, Draft report and finalized with MDAs Advocacy activities (media, council, DHMT, Chief of staff, minister) Election year manifesto of political parties to prioritize health, used district electoral forums, score cards, signed petitions, pledge card/audio/ video recording of political commitments
Budget tracking scorecards
Some facts 5600 Citizens Health budget Scorecards distributed nationwide and at electoral forums Many candidates pledged to lobby for more funds for MNH Petitions were signed by citizens for improved health spending
Scorecards: A scorecard displaying for each district money allocated and actually disbursed: - For health In the districts - For the DHMT and to PHUs - Ranking of the districts according to health spending
Petitions Petitions were provided for the moderators to collect signatures / marks from citizens to lobby their candidates to promise for increased health allocation and better recording and reporting of health finances.
The petition
Outcomes of Advocacy Strategy Increase in allocation from 7.4% in 2012 to 10.5% in 2013 16% 14% 15% % of total government budget 12% 10% 8% 6% 4% 2% 0% 11% 10.5% 7.9% 7.4% 7.4% 2009 2010 2011 2012 2013 Abuja target % total budget allocated to health
More funds for Health Now Secured
Outcomes of Advocacy Strategy Commitment for supplementary budget secured in 2012
Advocacy Outcome Councils received Q1 & Q2 monies and MDAs received 6 months allocation by mid year in 2013
Advocacy Outcome Political Parties, Chairman, Mayor, Councilors and MPs signed the health pledge
Advocacy Outcome The Abuja15% commitment is a major factor in the govt poverty reduction strategy (Agenda for Prosperity)
Advocacy Outcome Public awareness raised on health spending
Advocacy Outcome More space provided for CSOs at local and central government in the budget processes
Advocacy Outcome Citizens budget now shared by the ministry of finance Local council now making budget documents to the public
Challenges to the implementation of advocacy strategy Lack of fulfilling commitment by government Lack of capacity in financial management within ministries and councils access to timely information from partners (councils, INGOs, MOHs, MOFED, DHMT, Donors etc) Limited financial support (budget tracking can be expensive) Results can be politicized
Media Engagement
Facilitating factors to the achievement of budget advocacy outcome Strong coalition building Political will Information sharing Credibility of budget tracking implementing partners Civil society space to influence change Technical expertise within the coalition Common interest among coalition, ministries, CSOs,