SNG supported local governments shift from traditional / incremental budgeting to evidence based budgeting in primary healthcare. The support included undertaking budget analysis, needs assessments, development of budget proposals and support in budget execution. Later on, the programme also supported development of an MS Excel-based system to support budget preparation, execution, and reporting. The key features of the system are:
- Identification of needs in PHC: The first step in this direction was to ascertain needs of the sector. For this purpose, a simple and short survey questionnaire was developed to collect information on district health priorities and challenges to inform PHC budget. Later on, secondary data was used to undertake needs assessment. The key areas of assessment of needs, included access, quality and coverage of public health services to the citizens, especially women, girls and marginalised groups.
- Pre-budget consultations in districts: SNG supported a simple but structured approach for budget consultations for formulation of the budgets. The focus was on embedding the process by supporting the use of an ‘Evidence-based Budgeting’ by district officials.
- Development of budget proposals: Evidence of citizens’ needs and findings of budget analysis were utilised to lobby district governments on adoption of budget proposals and development of district primary healthcare budgets.
- Budget development: SNG district teams continued to lobby district governments to ensure adoption of the budget proposals in the district budgets for primary healthcare. The work on needs assessment, budget analysis and budget proposals helped rationalise primary healthcare budgets of the district governments. This also resulted in an increase of the budget allocations in almost all key critical areas of service delivery in primary healthcare.
- Training on Budget Execution: SNG prepared a training manual for training of the staff on evidence based budgeting. Training workshops were held to impart training to budget / planning related staff of all pilot district governments / District Health Authorities.
- Improving budget by aligning functional classification: SNG identified issues in the ‘functional and object classification codes’ used for budgeting, leading to low or no utilisation of funds during the budget execution phase. The SNG team led a review to identify such codes and suggested corrective measures across all 36 districts in Punjab. The draft report was shared with district governments, Finance Department and DFID health sector programme, including DFID’s health programme for feedback and agreement.
- System based budget development, execution and reporting in PHC: The SNG Programme supported district governments in developing a system-based process for development, execution and reporting of primary healthcare budgets in the districts.
- More responsive , efficient and result oriented planning and budgeting
- Developed evidence based budgets that are aligned to the needs of people
- Trained staff available for Evidence based budgeting
- Increased budget utilisation in 6 Districts
- Developed an MS Excel based system