[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"doc-detail-108815-en":3,"doc-seo-108815-105":30,"detail-sidebar-cat-0-en-105":91},{"code":4,"msg":5,"data":6},0,"success",{"doc_id":7,"user_id":8,"nickname":9,"user_avatar":10,"doc_module":4,"category_id":11,"category_name":12,"doc_title":13,"doc_description":14,"doc_content":15,"file_id":16,"file_url":17,"file_type":18,"file_size":19,"view_count":20,"is_deleted":4,"is_public":21,"is_downloadable":21,"audit_status":21,"page_count":22,"language":23,"language_code":24,"site_id":25,"html_lang":24,"table_of_contents":26,"faqs":27,"seo_title":13,"seo_description":14,"update_tm":28,"read_time":29},108815,2336464648746,"Skyler","https://ap-avatar.wpscdn.com/davatar_276721f389ce27ea32af1340a28f341c",8,"Research & Report","Tanzania Health Policy Note - Reasons and Consequences of Low Budget Execution","Tanzania’s health sector faces poor, worsening budget credibility reflected in a 15–20% deviation between budgeted and actual spending, driven largely by unrealistic revenue forecasts. Implementation cuts reduce investment and non-wage recurrent funding despite relatively protected personnel allocations, leading to opportunistic budgeting, unreliable local financing, arrears accumulation, supplier cost increases, and operational constraints that reduce efficiency. The note recommends more predictable funding, stronger payment systems and budget controls, arrears clearance, and closer donor alignment to honor commitments, improving service delivery and maintenance of the capital stock.","Public Disclosure Authorized Public Disclosure Authorized  \nTanzania Health Policy Note: Reasons and Consequences of Low Budget Execution  \nMariam Ally  \nMoritz Piatti-Fünfkirchen  \nThis is the second in a series of health policy notes that address critical health finance related questions in Tanzania. They are issued as part of a larger public expenditure review exercise. The audience is government, civil society and the development partner community with the aim to initiate a dialogue around key health finance issues and present recommendations to government. This policy note raises budget execution in health as a problem and discusses reasons behind low rates and the consequences for service delivery.  \nKey Findings and Recommendations  \nMain Finding: Budget credibility in Tanzania is poor and has been deteriorating. There is a 15-20% deviation between budgeted spending and actual spending in part due to poor revenue forecasts. This affects all sectors including health. While budget allocations for personnel has largely been protected, the investment and non-wage recurrent budget have seen significant cuts during implementation. The consequences include an opportunistic budget process that prevents strategic planning, unreliable funding at the local government level that undermines an output orientation for facility budgets, a significant accumulation of arrears and supplier price increases, as well as inefficiencies in the sector that stem from insufficient budget provisions for operational expenditure items to enable health staff to work. Lastly, it has undermined the maintenance budget thereby gradually eroding the capital stock in the sector.  \nRecommendation 1: Advocate for a more predictable resource envelope to the Ministry of Finance. This can be done through communicating the consequences of low budget execution on service delivery.  \nRecommendation 2: Bolster the effect of fluctuations through reducing service providers’dependency on government other charges budget provisions. This could be done by strengthening a unified payment system toward which other sources (such as donor financing and complimentary financing) contribute.  \nRecommendation 3: Strengthen budget controls. As budget releases were not made, spending units accumulated arrears to continue their activities. This leads to arrears and inefficiencies and should be discouraged. Therefore, budgetary and commitment controls should be strengthened at point of budget execution to prevent commitments without available resources. In addition, an effort should be made to clear outstanding arrears.  \nRecommendation 4: Work closer with the donor community to channel a greater share of donor support through the budget and ensure that commitments are honored.  \nBudget credibility in Tanzania is problematic and deteriorating. At the aggregate level expenditure outturn has decreased significantly since 2010. Budgeted and actual expenditureshave increasingly fluctuated in part because of worsening revenue estimates, and an underestimation of resource needs for other priority sectors such as infrastructure. Unreliable revenue and expenditure estimates at the macro level have trickled down to the sectors as is clearly visible in the scores by government function and even economic classification (with scores of a D and C respectively) . A separate PEFA assessment at local government level finds a similar trend, which follows unreliable fiscal transfers from central level.  \nTable 1 An Overview of Government Budget Credibility  \n\n| PEFA Assessment |  | Aggregate | Expenditure | ...by | …by |\n| --- | --- | --- | --- | --- | --- |\n|  |  | expenditure | composition | government | economic |\n|  |  | outturn | outturn | function | type |\n| General\u003Cbr>govt | General government (2010)\u003Cbr>General government (2013)\u003Cbr>General government (2017) | A\u003Cbr>B\u003Cbr>C | D\u003Cbr>DD+ | n/a\u003Cbr>n/a D | n/a\u003Cbr>n/a C |\n| Local government | Linid (2016) Rorya (2016) Mwanza (2016) Longido (2016) Senge","cbCaifrnVqfXq5j6","https://ap.wps.com/l/cbCaifrnVqfXq5j6","pdf",193966,5,1,4,"English","en",105,"# Key Findings and Recommendations\n## Main Finding: Budget Credibility and Sector Impacts\n## Recommendation 1: Predictable Resource Envelope\n## Recommendation 2: Reduce Dependence on Volatile Charges\n## Recommendation 3: Strengthen Budget and Commitment Controls\n## Recommendation 4: Coordinate with Donor Community\n# Evidence and Supporting Indicators\n## PEFA Assessment Overview of Government Budget Credibility\n## Budget Execution Rates by Sector and Expenditure Type","[{\"question\":\"What is the main problem highlighted in Tanzania’s health budget execution?\",\"answer\":\"Budget credibility is poor and deteriorating, with a 15–20% gap between budgeted and actual spending, contributing to low execution in health and other sectors.\"},{\"question\":\"Which health budget components are most affected during implementation?\",\"answer\":\"Personnel budgets are largely protected, but investment and non-wage recurrent budgets experience significant cuts, reducing operational and development capacity.\"},{\"question\":\"What consequences does low budget execution have for service delivery?\",\"answer\":\"It drives opportunistic budgeting, undermines output-oriented local facility funding, increases arrears and supplier prices, creates inefficiencies from insufficient operational provisions, and erodes maintenance funding over 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is the main problem highlighted in Tanzania’s health budget execution?","Question",{"text":75,"@type":76},"Budget credibility is poor and deteriorating, with a 15–20% gap between budgeted and actual spending, contributing to low execution in health and other sectors.","Answer",{"name":78,"@type":73,"acceptedAnswer":79},"Which health budget components are most affected during implementation?",{"text":80,"@type":76},"Personnel budgets are largely protected, but investment and non-wage recurrent budgets experience significant cuts, reducing operational and development capacity.",{"name":82,"@type":73,"acceptedAnswer":83},"What consequences does low budget execution have for service delivery?",{"text":84,"@type":76},"It drives opportunistic budgeting, undermines output-oriented local facility funding, increases arrears and supplier prices, creates inefficiencies from insufficient operational provisions, and erodes maintenance funding over 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