Study on the Traceability of Public Expenditure in the Health, Nutrition, Water, Hygiene, Sanitation and Education Sectors

The Government of Cameroon carried out a study on the traceability of public expenditure in the health and education sectors respectively between 2003 and 2004 and in 2010. In view of the relevance of the results obtained, it was recommended that this study be made permanent by extending it to all priority sectors. MINEPAT, MINFI, MINSANTE, MINEDUB, MINESEC and MINEE have decided, for the year 2018, with the support of UNICEF, to conduct a study on the traceability of public spending in the health, nutrition, water, hygiene, sanitation and education sectors. The Public Expenditure Tracking Survey (PETS) was initiated in several developing countries by the World Bank to better analyse the links between public expenditure and results in the sectors concerned. They were motivated for the most part by the observations made on the low impact of the increase in public spending on the results
in the targeted sectors. This technique makes it possible to monitor the flow of resources step by step at all levels of the administration (central, decentralised and decentralised) in order to quantify the share of budgetary resources that actually reaches the final service providers. By collecting and comparing data at multiple levels (from central government to local government to the most peripheral levels such as health centres and schools), PETS helps determine resources diverted from their original destinations. The PETS 3 study comes at a time when the Ministry of Public Health has just adopted its second Sectoral Health Strategy (2016-2027). The evaluation of the previous strategy 2001-2015 showed, among other things, that the efforts made by the Government and its national and international partners have, in general, improved the health of the population. However, a significant number of weaknesses were noted, particularly in legislation, regulations and policy, budget/expenditure, management (planning, direction, control andmonitoring/evaluation) etc. The diagnosis of the health sector has shown:
– Insufficient high-level political commitment in relation to the percentage of
State funding allocated to the health sector (about 4.76% according to the law of the
2017 finance budget, compared to 15% recommended by the Abuja Declaration);
– The lack of an integrated approach and sufficient coordination in the management of
Financing (existence of multiple health financing schemes) – 28 counted
in 2013); (excerpt Main report)