Fiscal decentralization Family Planning and Decentralization: Two Country Examples.
0000008662 00000 n In Kenya, devolution of budgetary authority to county governments, coupled with financial management and other types of capacity development for county governments, has resulted in increased health sector allocations. Revenues, Please address any questions about this title to publications@imf.org.
0000010224 00000 n The views expressed in IMF Working Papers are those of the author(s) and do not necessarily represent the views of the IMF, its Executive Board, or IMF management. For example, national-level earmarked taxes for health and use of a needs-based formula to allocate resources to local governments may have encouraged local governments to allocate more funding to health in Chile and Colombia. Moussé Sow
Health Policy Plus, 1331 Pennsylvania Ave NW, Suite 600, Washington, DC 20004, financial management and other types of capacity development, Health Laws and Universal Health Coverage:Decentralization, The Effects of Decentralization on Family Planning. Implementing national policies that regulate minimum service packages or funding levels, placing national government staff at decentralized levels to provide guidance, and retaining certain vertical programs and procurement functions – including family planning commodity procurement – at the central level may limit the ability of local governments to reduce funding for family planning. Rwanda: Modern contraceptive use in Rwanda increased from 3 percent in 2000 to 45 percent in 2010, partly due to a carefully planned, phased approach to fiscal decentralization, coupled with community-based health insurance and performance-based financing. Although family planning stakeholders are often excluded from discussions of decentralization, fiscal decentralization has important implications for family planning. An overview of fiscal decentralisation 7 1.1 Introducing fiscal decentralisation 7 1.2 Decentralisation in context 7 1.3 Functional assignment 9 1.4 Financing local governments 10 1.5 The functions of central government in a decentralised system 15 This report presents a framework for how decentralization impacts family planning programs in developing countries. 0000012630 00000 n Countries that have already established strong accountablity and budget management capacity at the local level can benefit from fiscal decentralization. Econometric models 0000005049 00000 n
© 2020 International Monetary Fund. For example, investment in education and skills affects the performance of students and the accumulation of human capital, which are essential drivers of growth and ... Fiscal decentralisation and public expenditure efficiency ..... 239 Table 9.A3.2. Within decentralized systems, national stewardship and financing approaches are still important. Finally, the pace of expenditure and revenue decentralization should be aligned. trailer <<3E985336F7694F9CB45F3090A388752F>]/Prev 183055>> startxref 0 %%EOF 244 0 obj <>stream Fiscal balance Rwanda: Modern contraceptive use in Rwanda increased from 3 percent in 2000 to 45 percent in 2010, partly due to a carefully planned, phased approach to fiscal decentralization, coupled with community-based health insurance and performance-based financing.. Mexico: Federal government decentralization of commodity …
The findings suggest that a larger share of decentralized expenditure is associated with a stronger fiscal balance; however, fiscal decentralization can lead to more pro-cyclical fiscal policy. 0000009206 00000 n 0000003092 00000 n The IMF Press Center is a password-protected site for working journalists. This paper explores the impact of fiscal decentralization on fiscal policy performance in a large sample of advanced and developing economies. 0000008747 00000 n Disclaimer: IMF Working Papers describe research in progress by the author(s) and are published to elicit comments and to encourage debate. This document provides an example of how Kenya devolved functions to county governments.
This presents an opportunity for local government to raise and allocate more funds for health. IMF Members' Quotas and Voting Power, and Board of Governors, IMF Regional Office for Asia and the Pacific, IMF Capacity Development Office in Thailand (CDOT), IMF Regional Office in Central America, Panama, and the Dominican Republic, Financial Sector Assessment Program (FSAP), Currency Composition of Official Foreign Exchange Reserves. Fiscal policy As part of this process, local governments may gain more responsibility for overseeing health service delivery and managing financial resources for health. Sign up to receive free e-mail notices when new series and/or country items are posted on the IMF website. 0000023223 00000 n 0000004956 00000 n 0000006534 00000 n 0000009756 00000 n 0000011918 00000 n Williamson, Duvall, Goldsmith, Hardee, and Mbuya-Brown, 2014. Use the free Adobe Acrobat Reader to view this PDF file. This paper explores the impact of fiscal decentralization on fiscal policy performance in a large sample of advanced and developing economies. Family Planning and Decentralization: Two Country Examples. 0000008548 00000 n 0000004414 00000 n 0000002290 00000 n However, there is mixed evidence on the impact of decentralized financial and decision-making responsibilities for health systems on issues such as health service quality, efficiency, and equity, and on overall health outcomes such as reduced mortality and morbidity. 0000025140 00000 n Government expenditures 0000003795 00000 n In contrast, in economies prone to large volatility from internal and external shocks, the central government may need to retain a sufficient share of expenditure and revenue to conduct counter-cyclical policies. 0000033606 00000 n Many low- and middle-income countries have decentralized financial and decision making responsibilities to lower levels of government as part of larger governance reforms. Thus, the design and pace of fiscal decentralization need to be tailored to the specificities of the economy. ; 0000029714 00000 n Ivohasina F Razafimahefa, Free Download. 0000011463 00000 n 0000005936 00000 n Mexico: Federal government decentralization of commodity procurement to states, including for contraceptives, resulted in states reallocating funds away from family planning and purchasers not benefiting from economies of scale. 0000010633 00000 n 0000011547 00000 n
Further, national governments must make strong commitments to family planning and take proactive measures to protect priority services such as family planning. 0000003698 00000 n 0000005161 00000 n 0000002263 00000 n In some countries, like Rwanda, fiscal decentralization has contributed to improvements in availability of family planning services (Box 1). Box 1. 0000002427 00000 n 0000011039 00000 n 0000001869 00000 n %PDF-1.4 %���� Box 1. These mixed results are mainly due to differences in the types of health functions that are decentralized, how decentralization is implemented, the capacity of local governments to take on the new roles, and the degree to which systems are in place for transparency and accountability within local government.
All rights reserved. learning/specific-topics/fiscal-decentralization. Decentralization of health functions (e.g., planning, budgeting, procurement, resource management, and service delivery for health) aims to improve efficiency and quality of health services and promote accountability. 0000000996 00000 n 0000001688 00000 n This webpage discusses the different types of decentralization, including fiscal decentralization, and how it affects the health sector. However, fiscal decentralization can pose a risk to family planning financing if local governments do not prioritize family planning and reallocate resources to other areas. 0000012273 00000 n Under a fiscally decentralized system, local government may have revenue-raising capabilities and some autonomy over priority setting and resource allocation. The findings suggest that a larger share of decentralized expenditure is associated with a stronger fiscal balance; however, fiscal decentralization can lead to more pro-cyclical fiscal policy. 0000015821 00000 n