Mozambique –
Funding the Health Sector
Celeste Kinsey
Health SWAp Mozambique
Financing for Health in
Mozambique
Managed by
Government
 National budget $150M
 Sector budget support
$75M
 Vertical funds $75–90M
 Projects $20M
Estimates
Managed by
Partners
 Projects $330M



USA $250M
Other $80M
Private $10M
Financing for Health
On Budget
Projects - On
Budget
6%
Vertical Funds
23%
State Budget
48%
State Budget
Prosaude
Vertical Funds
Prosaude
23%
Projects - On Budget
Financing for Health
Total
State Budget
Prosaude
Projects - USA
38%
Private
2%
Projects - Off
Budget Other
12%
State Budget
23%
Prosaude
11%
Vertical Funds
11%
Projects - On
Budget
3%
Vertical Funds
Projects - On Budget
Projects - Off Budget
Other
Projects - USA
Private
National Budget

Decreasing expenditure on health



Between 2008 and 2010 allocations
dropped from approx 11% to 8%
Well below Abuja target of 15%
Competing priorities

Huge volume of external funds
Sector Budget Support
Prosaúde


Since 2004, with change in 2008
2 types of support





Internal Funds
External Funds
Fully aligned with national systems
One plan, One budget, One performance
framework for the sector
No in-year triggers for disbursement
Projects, Vertical and Private
Funds


Current estimate is 185 projects = 65% of
funding for sector
Many partners and implementing agencies




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Difficult to achieve coherence and ensure
coordination
Information is often difficult to obtain
Poor predictability
Complex management separate from normal
business
Takes special efforts to coordinate with
government and also between partners
Characteristics of health sector
financing in Mozambique




Heavy dependence on external funds
Highly fragmented
Complex management requirements
Majority of financing is outside of
national budget or plans
Health Sector Wide Approach
SWAp Saúde





2003 - present
Code of Conduct
Memorandum of Understanding
Health Partners Group
Working groups – coordination and
technical
SWAp Saude

Coordination



Communication

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All partners at the table, no matter how they fund
Representation by a Troika
Joint dialogue: CCS, CCC, HPG, Working Groups
Monitoring

Follows implementation of the PESS and PES,
annually, is based upon SWAp dialogue, annual
review, plans and reports
Lessons Learned



Need a Health Financing Strategy
Donor coordination, dedicated time,
willingness to work together and good
communication are essential
We work better when we work together