A Policy expert has urged civil society organisations (CSOs) to develop the interest and capacity to track and monitor the deliverables reported in the budget to ensure resources allocated to health in particular reach people in their communities.

The Coordinator, Policy and Advocacy at the Alliance for Reproductive Health Rights (ARHR), Mr Leonard Shang-Quartey, said health was one of the few areas where all people living in Ghana could enjoy equitable benefits from Ghana's oil resources.

However, he said funds allocated from the Annual Budget Fund Amount (ABFA) for the sector for capital expenditure compared to other sources was very little.

“It appears the ABFA is being relied on in place of government’s funding despite its complementary purpose.

“Internally generated funds (IGF) appear to be playing a very important role in the provision of goods and services to the health sector with consequences for out-of-pocket spending,” he said when he presented a report on “Health Sector Portion of the National Budget and Implications for Primary Health Care”, at a press briefing in Accra on June 29, 2021.

He said expenditure allocation from IGF to goods and services was about seven times of what was allocated to wages and salaries, and to capital expenditure also from IGF.

“There appears to be an unwritten agreement about which source (government of Ghana, ABFA, IGF and development partners) should hold the different components of the budget more to the convenience of the government over the years,” he said.

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ABFA to health

About GH¢2,768,030,000 was utilised for four ABFA priority areas in 2020 as reported in the 2021 budget and distributed as follows: education and health service delivery (25 per cent), roads, rail, and other critical infrastructure (70 per cent), agriculture (three per cent) and industrial development (one per cent).

According to Mr Shang-Quartey, the merger of health and education made it difficult to unravel at a first look how much specifically went to the two sectors separately.

“It is well known that the Free SHS programme of the government utilises a chunk of the funds. The government’s allocations to wages and salaries in 2020 increased by about 22 per cent compared to 2019 allocations, and for 2021 the increment is 27 per cent compared to 2020 figures and 54 per cent compared to 2019 allocations.

“Allocations from ABFA for the three years are seen to be fluctuating with a significant increment of about 20 per cent in 2020 from 2019 and a sharp decrease of 44 per cent in 2021 from 2020,” he explained.

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Recommendations

Mr Shang-Quartey said the government must consider increments in ABFA funding that match allocations from other sources.

He said the government had the responsibility of providing adequate and equitable funding for all three budget items.

“The government must significantly improve on its funding for capital expenditure and goods and services for the sector.

“The government should ensure that all people living in Ghana draw benefits from the ever-increasing wage bill of the health sector by ensuring equitable distribution of health workers in districts and sub-district health facilities,” he added.