Investment Rating - The report does not explicitly provide an investment rating for the healthcare sector in the Democratic Republic of the Congo (DRC) Core Insights - The DRC aims to achieve Universal Health Coverage (UHC) by 2030, but faces significant challenges due to limitations in budget execution and allocation, leading to a reliance on household and donor funding rather than government support [5][23] - Government health budget execution rates are low, with an average execution rate of 47.6% from 2016 to 2020, significantly below the overall government spending average of 80% [39][40] - The health budget is heavily skewed towards personnel costs, which account for 60% of total health budget expenditures, limiting the ability to execute other spending categories [53] Summary by Sections 1. Health Financing Background - From 2016 to 2021, household payments and donor contributions accounted for over 80% of total healthcare spending, while government financing ranged from 10% to 16% [23][24] - Total healthcare spending was estimated between $19 and $22 per capita from 2013 to 2019, far below the $86 per capita needed for UHC [24] 2. Health Budget Execution - The average execution rate of the health budget was 47.6% compared to the initial budget allocation, with significant variations across budget categories [39][40] - The execution rate for personnel costs was 103%, while other categories, such as provincial allocations and hospital funding, had execution rates below 20% [40][41] - In 2019, only six out of over fifty departments achieved budget execution for operational costs, highlighting severe inefficiencies [45] 3. Public Financial Management Controls in Health Expenditure - The report identifies a lack of integration between strategic planning and budget preparation, leading to challenges in resource allocation [58] - Budget management rules are often ignored, with some agencies systematically overspending their allocations, which reduces available resources for other departments [55][72] - The procurement process is cumbersome, leading to delays and inefficiencies in budget execution [56][68] 4. Good Practices and Bottlenecks - The establishment of a tripartite health-budget-finance committee aims to monitor budget execution and improve coordination among stakeholders [70] - Key bottlenecks include unrealistic revenue forecasts, a highly centralized budget execution process, and a lack of respect for budget management rules [72][73]
医疗保健预算执行从瓶颈到解决方案
Shi Jie Yin Hang·2025-08-05 07:04