The causes and effects of unspent health funding in Solomon Islands
We are staff working in the health sector in the Solomon Islands. We have agreed that the inability to spend funds allocated for annual operational plans and budgets is the most immediate constraint to health service provision. It is at the centre of declining staff commitment and the erosion of community confidence in health services, compromising the authority of service directors and creating pressures on higher level services.
The creation of operational plans and budgets requires a considerable amount of work on forecasting activities, particularly in identifying the cost of implementation and the sources of funds. Annual planning starts with an assessment of what might be achieved in the forthcoming year. These plans are often not prioritised and are unrealistic, and budgets are sometimes overestimated. Staff who make funding submissions are trained as clinicians or public health staff, not versed in financial processes and untrained in the applications of financial instructions.
The inclusion of external funds in annual plans and budgets depends on funding ceilings agreed with MHMS centrally. Criteria for funding releases and acquittals are not clearly understood at the provincial level. The perception that funding will be released at agreed levels and within timelines may be unrealistic given that funding processes are not well understood and that the human resource capacity to implement plans is often overestimated.
Despite significant improvement to the availability of health information, there is little use of such information in preparing annual plans, resulting in the inclusion of activities that may produce limited health gains or divert staff from higher priority concerns. Proposed budgets may be based on an idealistic approach to achieving gains that are beyond the capacity of staff to achieve, or on the assumption that development partner funds are unlimited.
Variable timing of funding releases results in implementation of activities in periods inconsistent with the …read more