budgeting

Staying Afloat: South Africa Keeps a Focus on Health Priorities During a Financial Storm, 2009-2017

Author
Leon Schreiber
Country of Reform
Abstract

In 2009, South Africa's health-funding system teetered on the verge of collapse. Despite the adoption of a transparent and credible budget framework in 1994, large parts of the public health system suffered from chronic overspending and poor financial control. As wage hikes and supply costs ate into the health budget and as government revenues plummeted in the wake of the 2008 global financial crisis, the national health department had to find ways to preserve priorities, linking them more effectively to the budget. The department won agreement on a list of non-negotiable expenditure items to protect in provincial budgets, used earmarked conditional grants to channel funds to key programs, cut medicine costs by improving central procurement, rolled out a new information technology system, and improved its monitoring of provincial finances. Although the country's nine provincial health departments had important roles to play, most of them struggled. However, the Western Cape was able to set a model by controlling personnel costs, improving monitoring, and creating incentives for health facilities to collect fees. Nationally, total per-capita government revenues dropped by 5% in the immediate aftermath of the financial crisis and grew only slowly thereafter, but the health sector's strategy helped ensure progress on its key priorities even as resources fluctuated.

Leon Schreiber drafted this case study based on interviews conducted in Pretoria and Cape Town, South Africa, in August 2018. Case published October 2018.

To view a short version of the case, please click here

 

Building a Healthier Rwanda: Linking Social Priorities to the National Budget, 2011–2016

Author
Simon Engler
Country of Reform
Abstract

Rwanda’s public health system was among the many casualties of the country’s 1994 genocide. In the aftermath of the violence, health workers were in short supply, maternal and child mortality rates spiked, and infectious diseases such as HIV/AIDs and tuberculosis often went untreated. By 2011, Rwanda had made enormous progress in remedying the situation, but much more remained to be done. From 2011 to 2016, officials in the finance ministry and health ministry worked together to develop five-year plans for public health, translate their new priorities into annual budgets, and monitor spending so as to ensure progress toward national goals. They revised the budget calendar to improve the planning process, helped local authorities build medium-term public-health strategies, and refined the tools used for tracking spending in the health sector. They met or surpassed more than half of the top targets they set for 2015, cementing the gains Rwanda had made since 1994.

Simon Engler drafted this case study with the assistance of Louise Umutoni Bower, based on interviews conducted in Kigali, Rwanda in March, April and August 2018. Case published September 2018.

To view a short version of the case, please click here

Saah Charles N'Tow

Ref Batch
B
Ref Batch Number
31
Country of Reform
Interviewers
Blair Cameron and Pallavi Nuka
Name
Saah Charles N'Tow
Interviewee's Position
Former Director of PYPP and Scott Fellows
Language
English
Town/City
Monrovia
Country
Date of Interview
Reform Profile
No
Abstract

In this interview, Saah Charles N’Tow describes his roles as program director for the President’s Young Professional Program (PYPP) and John Snow Inc.’s (JSI) Scott Family Liberia Fellows Program. He talks about the process of designing a two-year fellowship program to bring young Liberians into key government ministries and agencies. He explains the creation of a selection criteria for fellows and the procedures that ensured the applicant-screening process remained transparent and fair. He discusses how the program held support sessions for applicants focused on resume writing and interview preparation. He addresses the program’s coordination practices with donors on budget support. He notes instances of resistance against the program from ministries and agencies and describes how the program responded to problems arising from the placement of fellows. He highlights the program’s administrative components that included mentoring, training, performance management, and program immersion. Finally, he describes the importance of sustainable funding procedures and talks about the likelihood of continued support for the program through future administrations

Profile

At the time of this interview, Saah Charles N’Tow was Liberia’s minister of youth and sports. He previously served as the program director of the President’s Young Professional Program (PYPP) and John Snow Inc.’s (JSI) Scott Family Liberia Fellows Program. He formerly served as a conflict sensitivity and training officer for the United Nations (UN) Liberia Peacebuilding Office. He obtained his bachelor’s degree in mathematics from the University of Liberia and his master’s degree in humanitarian assistance from Tufts University. 

Full Audio File Size
99 MB
Full Audio Title
Saah Charles N'Tow Interview

Stanley Murage

Ref Batch
ZP
Focus Area(s)
Ref Batch Number
3
Country of Reform
Interviewers
Rushda Majeed
Name
Stanley Murage
Interviewee's Position
Former Special Advisor to the President
Language
English
Town/City
Nairobi
Country
Date of Interview
Reform Profile
No
Abstract

In this interview, Stanley Murage discusses results based management in the Kenyan government, particularly the implementation of Rapid Results Initiatives (RRI). He begins by recounting the early stages of reforming, from when he first started looking at results based management five years before its execution. The process began in 2003 with different economic sectors creating service charters with measurable goals and timelines. Departments set these goals in conjunction with citizens through stakeholder forums that discussed what aims to establish and how to achieve the desired results. This citizen participation is one demonstration of how citizen-centered the reforms were. In addition to soliciting public input, the Rapid Results reforms also improved communication to the public regarding what services to expect and how the reforms benefited citizens. As part of the new emphasis on results and evaluation, the reform teams also implemented results-based budgeting. Murage identified the political steering from the top as a key factor enabling the success of the RRIs. Having skilled people in government was another critical element. Overall, Murage explains that RRIs require accompanying reform structures such as a policy setting body, political will and a good communication strategy. He outlines the set up and process for each of these elements in Kenya’s implementation of Rapid Results. 

Profile

At the time of this interview, Stanley Murage was an engineering consultant. Prior to that he had served as Special Adviser to President Mwai Kibaki for strategic policy analysis. He had previously held other government posts, including Permanent Secretary of Labor, Transport and Communications, and Public Works. Early in his career he served in the public service as a surveyor. In 2005, he was awarded the Chief of the Order of the Burning Spear (CBS) for his government service. 

Harold Jonathan Monger

Ref Batch
ZF
Focus Area(s)
Ref Batch Number
2
Country of Reform
Interviewers
Yoni Friedman
Name
Harold Jonathan Monger
Interviewee's Organization
Liberian Institute of Public Administration
Language
English
Town/City
Monrovia
Country
Date of Interview
Reform Profile
No
Abstract

In this interview, based on his experiences at the Liberia Institute of Public Administration (LIPA), Harold Jonathan Monger explains the challenges involved in institutionalizing capacity building. LIPA is an internal consulting and civil service trainer entity. Monger discusses the budgeting problems in equipping the institute to be able to provide better training and to improve the marketing of its services to government agencies. He also details LIPA’s changing relationships with other internal and external capacity-building consultants such as the Governance and Economic Management Assistance Program and IBI International, both of which have also played significant roles in the designs of certification trainings and civil service workshops. Finally, Monger draws from his extensive experience to comment on what he says are the main obstacles to improving governance in Liberia. He recommends establishing formal, uniform systems and procedures and improving communication and collaboration between agencies to avoid duplication.

Profile

At the time of this interview, Harold Jonathan Monger was director general of the Liberia Institute of Public Administration (LIPA). He has a bachelor of science from Liberia’s Cuttington University and a Master of Public Administration from the University of Southern California. And he has extensive public- and private-sector experience in civil-service capacity building, having been with both the United Nations Development Programme and the United Nations Children’s Fund as well as a Ghanaian consulting company. He has been at LIPA since 2004.

Emil Salim

Ref Batch
C
Ref Batch Number
5
Country of Reform
Interviewers
Matthew Devlin
Name
Emil Salim
Interviewee's Position
Faculty
Interviewee's Organization
University of Indonesia
Language
English
Nationality of Interviewee
Indonesian
Town/City
Jakarta
Country
Date of Interview
Reform Profile
No
Abstract

Emil Salim describes lessons learned from his long career in Indonesia’s government. He describes his efforts to institute procedures to set priorities for budgeting and implementation, to build capacity, to educate leaders (particularly from the military) about economics, to reform civil service, and to facilitate interministerial communications. He defines major challenges he faced in creating communications and systems of local governance for a nation of over 17,000 islands. He gives his views on the transition from a centrally planned economy dominated by the military to an increasingly market-driven, more democratic country and reports on his efforts to enhance civil society. He offers suggestions about how to combat loyalty to agency rather than loyalty to government and the nation.

Case Study:  Against the Odds: Attempting Reform in Suharto's Indonesia, 1967-1998

Profile

At the time of this interview, Emil Salim was on the faculty of the University of Indonesia in Jakarta. He graduated from the university's Faculty of Economics in 1959. He received his Ph.D. in economics from the University of California at Berkeley in 1964. In 1966, he was a member of a team of economic advisers to President Suharto. In 1967 and 1968, he was an adviser to the Ministry of Manpower. From 1967 to 1969, he was chairman of the technical team for the Council for Economic Stability and was a member of Parliament. He was vice chairman of the National Development Planning Agency in 1969. In 1971 was minister of state for the improvement of the state apparatus. During the 1970s, he was minister of communications, of development supervision and of environment.

Full Audio File Size
91MB
Full Audio Title
Emil Salim - Full Interview

Senator Sumo Kupee

Ref Batch
E
Focus Area(s)
Ref Batch Number
4
Country of Reform
Interviewers
Graeme Blair
Name
Senator Sumo Kupee
Interviewee's Position
Senator
Interviewee's Organization
National Legislature of Liberia
Language
English
Nationality of Interviewee
Liberian
Town/City
Monrovia
Country
Date of Interview
Reform Profile
No
Abstract

Senator Sumo Kupee provides insight based on his experiences as Chairman of the Senate Ways, Means, Finance and Budget Committee. He describes the committee’s endeavors to ensure that the oversight responsibility of the legislature with respect to the executive is filled, specifically by scrupulous monitoring of the approval and implementation of the national budget.  He further outlines the committee’s work in drafting a public financial management law, and improving the existing investment incentive code, looking to bring about economic revitalization to facilitate poverty reduction. Kupee stresses the importance of the decentralization of the budget, and details the committee’s efforts to ensure that the budget is county-sensitive and efficiently allocated. He also discusses the creation and plans of the Legislative Modernization Committee, going into depth about problems with appointed personnel and the need for qualified/trained staff. In this respect, Kupee describes his experience with his own staff and the training strategies he employed. Acknowledging the competing factional interests that often need to be overcome when conducting negotiations within governance, he outlines the fragmented conception of loyalties within Liberia and discusses how these play out in Liberian politics. Kupee also stresses the need for reconstruction and infrastructure building within Liberia, considering this a major national task. He concludes by providing information about the avenues he explores when looking to draft new legislation. 

 

Profile

Sumo G. Kupee served as a senator in the National Legislature of Liberia, being elected to the position in 2005. Kupee was also the chair of the Senate Ways, Means, Finance and Budget Committee. In the past, Kupee has served in various capacities at the Ministry of Finance, starting as Commissioner, Bureau of Income Tax, progressing to Special Assistant and Policy Adviser to the Minister of Finance, and later becoming Commissioner of Customs and Excise, the latter being a position he held immediately prior to elections. With an MSc in Development Economics from the People’s Friendship University of Russia (PFUR), Kupee taught at the University of Liberia from 1986-1997, and served as Chairman of the Department of Economics for six years.

 

Full Audio File Size
58 MB
Full Audio Title
Sumo Kupee - Full Interview

Rose N. Kafeero

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F
Focus Area(s)
Ref Batch Number
2
Country of Reform
Interviewers
Andrew Schalkwyk
Name
Rose N. Kafeero
Interviewee's Position
Deputy Secretary of the Public Service Commission
Interviewee's Organization
Uganda
Language
English
Nationality of Interviewee
Ugandan
Town/City
Kampala
Country
Date of Interview
Reform Profile
No
Abstract

Rose Kafeero describes the challenges she faced to implement “results-oriented management” reforms in the Ugandan government. While she believes that the mindset changed over the years and that budgets were prepared on the basis of outcomes, she says the impetus for outcome-based performance weakened when some of the managers leading these reforms left agencies. She also did not have full backing from top officials. She believes that other civil service reforms such as downsizing and divestiture of functions have been more successful. She outlines the merit-based selection process at both the national and district levels. She says that universities do not produce skill levels that match government requirements in some categories. She describes the difficulties of recruiting or retaining civil servants in some categories because of low pay and a failure to provide core benefits such as housing.

Profile

At the time of this interview, Rose N. Kafeero was deputy secretary of the Public Service Commission in Uganda. Upon graduation from university, she was appointed as a personnel officer and subsequently was promoted to higher positions. In 1992, she was elevated to head of department in the Ministry of Public Service and subsequently to her position at the time of the interview.  In that position, she also headed the Department of Monitoring and Guidance, which served as the secretariat to the Public Service Commission.

Full Audio File Size
78 MB
Full Audio Title
Rose N. Kafeero - Full Interview

Kestutis Rekerta

Ref Batch
D
Focus Area(s)
Ref Batch Number
5
Critical Tasks
Country of Reform
Interviewers
Yoni Friedman and Gordon Evans
Name
Kestutis Rekerta
Interviewee's Position
Head of the Lithuanian Strategic Planning Commission
Language
English
Town/City
Vilnius
Country
Date of Interview
Reform Profile
No
Abstract
Kestutis Rekerta talks about his position as head of the Lithuanian Strategic Planning Commission. He discusses the development of strategic planning in Lithuania from 2000 to 2006. He talks about challenges the Commission faced in establishing a good process; he touches on the problems that arose in the prioritization of strategic plans, budget appropriation, and the Commission’s relationship with various ministries as well as with Lithuania’s changing government. Rekerta discusses the influence the Canadian International Development Agency had on the establishment of the Commission, and how they were able to accommodate external models to Lithuanian customs. He also talks about the influence Lithuania’s preparation for EU membership had on various aspects of government.
 
Profile

Kestutis Rekerta was a policy officer for the European Commission. He joined the European Commission in 2007 after much work in the Lithuanian government. Rekerta began working as assistant to the advisor for the EU (European Union) PHARE (Pologne et Hongrie – Aide á Restructruation Economique) project on local authorities in 1993. He then moved on to work as Chief Expert for Public Service Reform, and then later as Head of the Central Management Unit in Lithuania’s Ministry of Public Administration Reforms and Local Authorities. After this position, he was appointed head of the Strategic Planning Commission, and later moved on to be director of the Strategic Planning and Public Administration Department. It was following this work in Lithuania that Rekerta joined the European Commission.

Full Audio File Size
62 MB
Full Audio Title
Kestutis Rekerta - Full Interview

Gregory Ellis

Ref Batch
N
Focus Area(s)
Ref Batch Number
1
Country of Reform
Interviewers
David Hausman
Name
Gregory Ellis
Interviewee's Position
Senior Operations Officer, Fragile and Conflict-Affected Countries Group
Interviewee's Organization
World Bank
Language
English
Nationality of Interviewee
Australian
Place (Building/Street)
World Bank
Town/City
Washington, D.C.
Country
Date of Interview
Reform Profile
No
Abstract
Gregory Ellis, drawing on his experience in reform programs in various countries, discusses general themes in civil reform service across various contexts, especially from the point of view of donor organizations. He emphasizes the need for understanding the political economy of countries undergoing reform, and the need for understanding indigenous customs. He places immense import on the citizen-state relationship in fragile states, and discusses how a state should be involved in service delivery. Ellis especially emphasizes deference to the host nation’s priorities in creating a reform agenda. In discussing capacity building in the Solomon Islands, Ellis reflects upon the dichotomy between service delivery by donors and the sometimes deleterious effect of technical assistance on long-term capacity building. He goes on to discuss restructuring organizations and combating patronage through professional associations, decentralized recruitment and autonomous decision making. Ellis emphasizes especially the role of local consultation, continuity in visionary leadership and long-term commitment in achieving success in fragile states.
Profile

At the time of this interview, Gregory Ellis had been a senior operations officer at the Fragile and Conflict-Affected Countries Group at the World Bank for about a year. His parent organization was the Australian Agency for International Development. He was posted by AusAID in the Solomon Islands between 2005 and 2007, as deputy program manager for the Machinery of Government Program, part of the Regional Assistance Mission to Solomon Islands. Prior to that, between 2000 and 2002 he held a posting in Timor-Leste after the withdrawal of Indonesian forces. 

Full Audio File Size
71MB
Full Audio Title
Gregory Ellis Interview