Helping to Define Financial Objectives in Bolivia
Estimation Year
1996, 1997, 1998, 2000
Actual Policy Use
In contracting with municipalities the MOH sets contract objectives as well indicators to monitor contract compliance. NHA provides data on financial objectives such as increasing public expenditure per capita or increasing municipalities’ share of total health expenditures (to 10% of total). Prior to NHA, there was no information on how much municipalities were spending. In Bolivia 3.2% of general taxation funds allocated to municipalities were to be earmarked for health in the form of a contribution to the public insurance program (percentage was increased to 6.4% in 1999 when the insurance for mothers and children (SNMN) was expanded into the Basic Insurance (SBS)). NHA findings showed that in actuality municipalities contributed less than the target amount on health. Based on this, the government instituted a system to collect public insurance contributions at the central level, that is, before general taxation funds were transferred to municipalities. This lead to an increase in health spending by municipalities.
Source
Fernando Lavandnez, Former Head of Health Reform Unit, MoH
