Thursday, August 29, 2013

In South Asia Governments Need to Put More Budget Information Out and Bring More People In

On 14 February 2013 civil society organizations, government representatives, and media from South Asia released the regional results of the Open Budget Survey 2012 at an event in Delhi, India. Every two years the International Budget Partnership conducts the Survey (the first round was in 2006) to measure the openness and accountability of government budget systems and practices around the world. Drawing from the Survey, the IBP calculates the Open Budget Index (OBI), the most comprehensive cross-country measure of public access to information on the receipt and expenditure of public funds available.
South Asia was a solid performer in the OBI 2012 with an average regional score of 55, compared to the global average of 43. As a region, South Asia ranked second only to Western Europe and the United States; however, the difference between the average scores for the two regions was 20 points, indicating that South Asian countries have significant ground to cover to catch up. Still, progress within the region over time has been positive, with impressive growth in some countries like Afghanistan and Pakistan, whose OBI 2012 scores jumped by 38 and 20 points since 2010, respectively. Bangladesh also witnessed noteworthy improvements, whereas India’s and Nepal’s performance, though stable, indicates a need for these governments to step up their efforts to improve. All South Asian countries improved their scores across the four rounds of the Survey except Sri Lanka, which dropped drastically from 67 in 2010 to 46 in 2012.
Among the more troubling findings for the South Asia region were those showing that Pre-Budget Statements were published by only Afghanistan and Pakistan; Afghanistan and India were the only countries to publish Citizens Budgets; and the Executive’s Budget Proposals and other published documents in all South Asian countries lacked important details.
The two-day launch event focused on the oversight role of legislatures and supreme audit institutions (SAI), Citizens Budgets, and public engagement. Overall in South Asia, the oversight provided by SAIs is quite robust, but that of legislatures is weak. Even more disappointing was the poor showing by most of the governments in the region on engaging the public in budget processes, with only two producing Citizens Budgets and few making more than minimal efforts to provide citizens opportunities and mechanisms through which to participate. An example of one government that is bringing its people into budgeting is Nepal, where the SAI is proactively engaging civil society in monitoring various public programs like health and education and collaborating on social audits.
The participants identified what South Asian countries need to do to substantially improve their performance, including:
  • take concrete action to embed the principles of oversight and engagement in the budget process – especially legislative and public engagement;
  • institutionalize public engagement, which is currently done in an ad hoc fashion;
  • produce and publish Pre-Budget Statements and Citizens Budgets in each country; and
  • increase the level of detail presented in the eight key budget documents. 
The participants unanimously called for strengthening public engagement and participation in all stages of the budget process, and the Survey researchers and government representatives indicated that a lot was already happening in terms of transparency and accountability. However, researchers cautioned that the next step would be a big one, requiring not simply publishing more documents but rather strengthening the depth and quality of information in all of the key budget documents.
Finally, given the growing civil society interest and engagement with subnational budget processes in the region and the many state-level Indian budget groups present, a special session on subnational budget transparency and accountability was organized. For instance, in Bangladesh and India a fair amount of participation in budget planning and formulation happens under decentralized governance structures, but this is not reflected in the Open Budget Survey because it focuses on national budgets. Issues for common action emerged, and the People’s Budget Initiative, a civil society coalition in India, called for improving access to budget information on frontline service delivery so that civil society could monitor them more effectively.
Ravi Duggal - International Budget Partnership

A Comment on Maharashtra’s Public Health Expenditures

Maharashtra is one of the most developed states in India with an income of over 1540000 crores (per capita 130,000) but despite this it is projected to spend only Rs. 7400 crores on public health services (including medical education and capital expenditure) in 2013-14 or a mere 0.48% of the total income of the state. This is in sharp contrast to the peak that Maharashtra had reached of 1% of SDP and 6% of government expenditure for public health expenditure in 1985-86. Since then the trend has been downwards declining rapidly through the nineties and the new millennium, which was contradictorily the period of high economic growth. (see Table below for trends in public health spending).

Maharashtra Public Health Expenditure Trends and  Key Ratios

1985-86
1995-96
2001-02
2006-07
2008-09
2010-11
2011-12
2013-14 BE
Public Health Expd  Rs.bill
2.77
9.06
15.82
23.24
32.05
46.5
54.1
73.9
Per capita Rs.
63.73
105.95
163.89
220.28
294.31
413.70
474.15
629.47
% to Govt exp
5.97
5.18
4.22
2.96
3.21
3.74
3.83
4.11
% to SDP
1.0
0.70
0.74
0.40
0.42
0.45
0.45
0.48
Source: Maharashtra Civil Budget Estimates, various years; Maharashtra Economic Survey, various years

While we do see a small upturn presumably due to NRHM in the last few years it is certainly not commensurate both with Maharashtra’s high income growth as well as with what is happening in a number of other states who are catching up with Maharashtra in their health outcomes. Infact Maharashtra’s rank in key health outcomes has declined in recent years. For instance Maharashtra’s rank among all states with respect to IMR is 12 but its neighbor Goa with an IMR of 10 in contrast to Maharashtra’s 28 has the lowest IMR in the country.  Goa’s extraordinary performance is due to its much better endowed public health system as well as a high level of public health spending of Rs. 2213 per capita in 2010-11 which was over five times of what Maharashtra spent in the same year. Within Maharashtra if we look at the Mumbai Municipal Corporation we see that it has budgeted to spend as much as Rs. 2509 crores or about Rs.1800 per capita (this excludes what the state government spends in Mumbai) in 2013-14 nearly three times of what the state government spends on average in the state.


So what is very clear when we look at Maharashtra’s health  budget is that too little is being allocated and this then gets reflected in the pathetic situation of public health and public health facilities – huge vacancies in Rural Hospitals and other hospitals as well as PHCs, especially of doctors, specialists and nurses, gross inadequacy of drug supplies in public facilities, poor maintenance of public health facilities and key equipment etc.. The CBM (Community Based Monitoring) process is Maharashtra which is exerting demand side pressure is a good opportunity to pressurize the state government to raise substantially public health budgets. To begin with if Maharashtra is able to reach the national average of 1% of SDP immediately it will be a great step and then it can gradually move towards the UPA goal of 3% of GDP.

Ravi Duggal