Resource Type: Brief
Authors: Elizabeth Ohadi, Marianne El-Khoury, Taylor Williamson, and Derick Brinkerhoff
Published: 4/1/2012

Resource Description:

Financial data and management are critical to effective health governance. Access to, and use of, timely and accurate health budgeting and expenditure data are key to public health officials’ capacity to make future investment decisions, understand the effectiveness of current allocations for health, and act as effective stewards of the health system.

A Public Expenditure Management Review (PEMR) combines elements of both surveys and examines the overall governance environment of public expenditure management by studying both how health resources are used and the process by which those resources were allocated. In 2010 and 2011, Health Systems 20/20 conducted a PEMR of the health sector in three Nigerian states based on the methodology developed and used by the World Bank.

This brief discusses the assessment, and summarizes the governance challenges identified in the three state reports that relate to public financial management systems: unavailability of financial data, dysfunctional political influence over the budgeting process, weak budget execution, and weak civil society involvement in budget decisions and execution. Not surprisingly, these health governance problems closely mirror Nigeria’s governance challenges more broadly. The brief draws upon findings from the reports on these three states, as well as information from the stakeholder engagement meetings that were held to discuss those findings.