Governments are being overwhelmed by the rapid growth of Africa’s cities. Strategic planning has been insufficient and the provision of basic services is worsening. Since the 1990s, widespread devolution has substantially shifted responsibility for coping with urbanisation to local authorities, yet municipal governments across Africa receive a paltry share of national income with which to discharge their responsibilities. Responsible city authorities are examining how to improve revenue generation and diversify their sources of finance. Following the creation of a sustainable development goal for cities (SDG 11), and ahead of the Habitat III summit in October 2016, this Africa Research Institute event examined some of the financing options and the urgent need for a proactive approach on the part of national and municipal governments. The speakers in the podcast include, Professor Susan Parnell Department of Environmental and Geographical Sciences, Jeremy Gorelick, Lead technical adviser, Dakar Municipal Finance Program and Dr Beacon Mbiba, Senior Lecturer, Urban Policy and International Development.
Resource allocation and health financing
The Accra high-level meeting on aid effectiveness comes at a critical juncture for the international community, with the global economy beset by the food and energy crises, and the financial market slowdown that threaten to set back hard-won gains in poverty alleviation. The 2005 Paris Declaration on Aid Effectiveness is a first step in establishing a framework for development cooperation, but its implementation is far behind expectations. Only a few genuine partnerships between donor and recipient countries have been created. With attention paid to national ownership and preservation of national policy space, multi- and bilateral donors should prioritise implementing national International Labour Organisation-supported decent-work strategies as part of development cooperation, and should maintain adequate and predictable budget levels for this purpose. Consulting trade unions and other actors in donor and recipient countries is also important in governing aid effectiveness.
Debates about the best way to fund South Africa's health system have run for over a decade. Plans for social health insurance have not received enough support to become law. In contrast reform of private health insurance regulations have been passed. Why has the pace of reform between the private and public sectors differed? The University of Cape Town, together with the London School of Hygiene and Tropical Medicine, compared reforms to private and social health insurance see why their success has varied.
Debates about the best way to fund South Africa's health system have run for over a decade. Plans for social health insurance have not received enough support to become law. In contrast reform of private health insurance regulations have been passed. Why has the pace of reform between the private and public sectors differed? The University of Cape Town, together with the London School of Hygiene and Tropical Medicine, compared reforms to private and social health insurance to see why their success has varied.
In June 2016, South African Minister of Health Dr Aaron Motsoaledi addressed the media to respond to criticism over the high cost associated with rolling out universal health care in South Africa. “The National Health Insurance (NHI) scheme is the only way to ensure that everyone is not excluded to quality health because of their socio-economic status, ” said Motsoaledi. The NHI White Paper was released last year and plans to reform both public and private health sectors by combining all South Africans into one purchasing pool. The cost of NHI has been estimated to be R256-billion by 2025, which is higher than the current national budget allocation toward healthcare. But according to Motsoaledi, the figure is a projection and could change with the process. Arguing the benefit of pooling resources, he stated that in 2002, the department of health combined all South Africans into one purchasing pool and were able to lower the costs of antiretroviral treatment.
Mandated jointly by the Government of the Republic of Zambia (GRZ) and the Cooperating Partners (CPs) committed to Poverty Reduction Budget Support (PRBS), the learning assessment (LA), integrated into the Joint Annual Review (JAR) 2007 process, pursued the overall objective of developing practical recommendations on strengthening the effectiveness and efficiency of PRBS-supported programme implementation. The recommendations are based on PRBS experience in general and the 2007 JAR process in particular. The quality of dialogue, performance and accountability was to be specifically assessed. Methodologically, the LA made use of good practices developed elsewhere, observations of JAR sessions, interviews, and written feedback.
This paper looks at the role of public expenditure programmes in the health and education sectors and their impact on poverty. It argues for a closer donor involvement at the sector level. The evidence reviewed shows that progress towards the Millennium Development Goals has slowed in some low income countries, notably in Sub-Saharan Africa. Public expenditure has a much less powerful impact on outcomes than demand-side factors. Policies and practices for making public programmes more effective that have been recognised for some time remain unimplemented.
The purpose of this report is to consider the legitimacy of the assumption that communities or societies with more unequal income distributions have poorer health outcomes. The report presents a critical review of the existing international literature on the relationship between income, income inequality and health, in terms of conceptual approaches, research methods and the policy implications drawn from it. The report also offers some guidance for judging between policy priorities based on the relative importance of income inequality versus other potential causal factors in determining population levels of health. An overview of the potential relationship between income, income inequality and health is set out, followed by a discussion of the methodological and technical issues required to explore these links.
Leon DA, Walt G, eds. New York, NY: Oxford University Press, 2001.
The editors identify four themes: health consequences of social and economic change; conceptual issues associated with health and wealth, including the role of health services; emerging and neglected priorities, e.g., the significance of mental illness and injuries; and evidence for policy and interventions. The role of the health care system is considered to be a central issue. The editors argue that access to health care is typically viewed as being more likely to affect health differences in developing than in developed nations, where, relatively speaking, access is more readily available. In contrast, in the developed world, health disparities, they argue, are more likely to be viewed as being due to differences in lifestyle and environmental exposures. Later, they acknowledge that health disparities, in fact, are due to the independent and joint effects of access to health care, as well as to other factors, including lifestyle and the effects of the physical environment.
This paper explores the links between aid and budgets in two ways. First, it documents similarities among 14 aid-recipient country budgets, comparing them with the Creditor Reporting System of the Development Assistance Committee (DAC/CRS) and the UN Classification of the Functions of Government (COFOG) system. It assesses the fit of the latter for practical use by donor agencies. The main aim is to contribute to the development of more comprehensive sub-sector classifications, which may also be movable among top-level sectors, so as to fit around decisions made at country level on sector definitions. Second, the paper constructs a generic functional classification, designed specifically for the purpose of examining budget administrative classifications. This set of functions is grouped at sector level for ease of analysis and use, but is anchored on the lowest level of the classification. The aim was to review the commonalities between budget administrative classifications and develop a draft set of generic functional definitions that best align with the administrative structures of the countries in the sample. Those definitions may then be tested at donor headquarters level. The paper also makes recommendations on how to facilitate the transfer of aid information, particularly aid that is not spent through recipient country budget systems.