Financing the health sector in Ghana: A review of the budgetary process

In the last couple of years, the quest for aid alignment and harmonisation is increasingly putting pressure on development partners to change funding modalities from sectoral pool funding and programme or project support to some form of budget support modality. In Ghana, where donor funds constituted about 13.8% and 14.33% of the health sector budget in 2006 and 2008 respectively (Ministry of Health, 2006, 2008), such changes could result in difficulties with respect to funds flow to the sector. The aim of this paper is to review the budget planning, execution and disbursement processes of the Ministry of Health in Ghana to draw some conclusions on whether a move from pool funding to a form of budget support modality will affect the flow of funds, especially to service providers. The findings of this study exhibit improved national and sectoral level procedures as well as some weaknesses in the budgeting process of the Ministry of Health and the Ministry of Finance and Economic Planning, and cashflow difficulties which can be traced to both ministries. The study also identifies opportunities to improve the levels of dialogue between the Ministry of Health and the Ministry of Finance and Economic Planning. It is believed that the current state of the budget planning, execution and disbursement process in the health sector is unlikely to have an adverse effect on the flow of funds to service providers irrespective of the funding modality used.