BudgIT Liberia, a leading civil society institution working towards the promotion of accountability and transparency in the public space, has released its Phase 2 of its Country Specific Health Sector Accountability Report under its COVID 19 Transparency and Accountability in Africa Project(CTAP) in collaboration with its partners, with the finding that the government’s financing of the health sector falls below expectations despite its commitment made along with other African governments in 2001 when African leaders converged in Abuja, Nigeria and agreed to allocate a minimum of 15% of GDP towards health sector strengthening and made several recommendations to revamp the sector as well as to ensure transparency and accountability in the sector.
Addressing the media yesterday, Tuesday, August 9, 2022 to release the report, the Country Lead, Abraham Varney said that BudgIT saw it necessary to conduct a survey about how funding and materials coming to Liberia to fight the COVID-19 pandemic was used, adding that amidst low funding by the national government to the health sector, reports of corruption in the health sector persist.
“Much more recently, the Office of the Inspector General of the Global Fund found procurement fraud, concealed payments, and wasted or misused resources as fraudulent practices within the National Aids Control Program overseen by the Ministry of Health of Liberia. Other forms of corruption that have been found in the Liberian health system include absenteeism due to nurses and doctors working two or more jobs; diversion of patients from one public health centre to another public health center where public health practitioners have pecuniary interest in the public health centre, bribery to access healthcare services , theft and diversion of drugs from public health centers to private health centers and placement of ghost workers on the Ministry’s payroll”, part of the report said.
The report bemoaning the lack of proper oversight function on the part of the national legislature said that observers of the critical role of the lawmakers in the country have it that they have failed to demand regular statutory reports on the health sector from the ministry of Finance and have also failed to enforce the implementation of the outcome-based and gender-responsive budgets.
“What needs to be enforced is strong political will from the executive in terms of funding to the health sector to at least meet the Abuja Declaration’s benchmark of 15% of total fiscal budget expenditure each year and strong legislative oversight that focuses on the outcome and project-based budgeting with a gender responsive focus”, the report said.
The report further said that donor funding and private sector goodwill also need to be harnessed to yield good results for the citizenry that provide increased access to community and county healthcare systems, take into account the needs of people with disabilities and provide good training for staff in combination with robust monitoring and evaluation mechanisms to ensure that service delivery reaches those it is intended for.
Providing information on the public expenditure on the health sector, the report said it was put at 8.5% of GDP in 2019 and that its current share of the national budget stayed consistently below 20%. It said that in 2019, it was reported at 16.1% of total current health expenditure while in 2022, the total appropriate for health is $78,368.300.00 of which $61,367,357.00 is allocated to salaries and goods and services, representing 78% of the total budget.
Varney ended his prepared text at the press conference with a list of recommendation among which are that the government through the Ministry of Health should collaborate with CSOs and other development partners to put strong institutional measures in place to ensure there is proper Transparency and Accountability in the Health Sector as the pro poor Agenda for Prosperity and Development(PADP), revamping the health sector investment plan with specific focus on addressing issues in the Liberian Demographic and Health Survey with health authorities and CSOs admitting that the office of financial management needs to be more inclusive when developing annual budget proposals to target priority needs and improve health service delivery in the Country by providing all necessary resources to properly operate which the legislature must appropriate adequate relevant budgets and demand periodic reports on budgetary implementation. The legislature also needs to work closely with audit agencies to ensure that their findings are taken seriously by the Ministry of Justice for Prosecution.
Other recommendations include that the private sector should contribute its support to healthcare in the country through the mobilization of private resources to invest in the health sector. Given the infancy nature of Liberia’s healthcare system, investing in modern medicine and delivery yields high profits for the private sector and leads to more money staying in the country that would otherwise have been used outside the country in pursuit of medical care and that government needs to support the Ministry of Justice to prosecute those accused of corrupt practices in the health. It said the executive needs to muster the political will to clamp down hard on health sector corruption to ensure that already scarce resources are effectively utilized.
BudgIT is a civic nonprofit organization registered in 2020 and seeks to enhance citizens’ understanding of the budget and matters of public spending using technological tools to simplify the budget to raise the standard of transparency and accountability in government. Along with its partners, the organization has activated a Pan-African tracking system for all COVID funds received and donated to virtually all African countries and relies on the conviction that every community in the continent has skilled, sensitized and largely self-organizing citizens to engage in budget tracking while presenting feedback and results to the government and development partners in a constructive manner.
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