Harvard’s Follow-Up Support in Uganda Leads Increases Fiscal Space for Health

Following participation in the Harvard Ministerial Leadership Forums by Uganda’s Ministers of Finance and Health, a Follow-up team of senior health and finance ministry officials began work with the Ministerial Program and its partners. A key focus of this work was the need to reallocate existing budget to priority health areas such as primary health care and capture fiscal space to increase available health funding. By June 2016, the inter-ministerial team had created fiscal space in the health budget to the value of over $22 million for a range of actions designed to strengthen health worker productivity, procurement and supply chain management with the goal of improving the standard of care in frontline health facilities.

According to team members, fiscal space was achieved by applying four of the health financing strategies recommended by the Program:
1. Creation of a health budget framework
2. Streamlined block grants to local government.
3. Transferred funds directly to health sub-districts for use in health centers.
4. Reallocated funds in line with priority goals.

Not long after attending the 2014 Harvard Forum, the Health Minister was appointed Prime Minister. He championed the Ministerial Program’s delivery approach methodology, setting up the Prime Minister’s Delivery Unit housed in the Prime Minister’s Office. What resonated with the Prime Minister is the Ministerial Program’s focus on prioritization of “issues that matter to the population, that have impact” and the promotion of, “collaboration between finance and sectoral ministries”. This view was also shared by the team who took this to heart and have collaborated to release funds for health priorities that have an impact. Since the Program launched, the Prime Minister has seen, “significant improvement especially between the health sector and finance, better political and technical collaboration and increased flow of resources to the health sector… this has impacted positively on service delivery in Uganda”.