Health Budgeting at Woreda level and Effect on Access and Quality of Health Services in Somali Region of Ethiopia

Abstract

Ethiopia has made a great effort in recent years to improve maternal, newborn, child health outcomes, however, the uptake of services in Somali Region of the country is still very low. The study was a cross-sectional descriptive survey using qualitative methods, and the participants were key individuals involved in the management of health systems and knowledgeable about on health service delivery in the study sites. The study aimed to explore the budgeting process at the woreda (district) level and its effect on the utilization of equitable quality health services in the region. The woreda health officers determined what is included in the budget of the health facilities without active participation of stakeholders such as health care providers or the community members. Their knowledge and understanding of the planning and budgeting processes varied and little or no support available to them. This suboptimal budgeting process impacts negatively on the quality of health care services being provided, with shortages of essential drugs identified as a major barrier affecting utilization. The need for better budgeting process at the woreda level which could perhaps involve a range of regional level, woreda level and citizen level measures and active participation. This include the implementation of clearer guidelines from regional level, maybe the introduction of standard formulae that ensures that each health centre receives certain percent of overall health budget and specific percentage to be allocated for drugs and supplies and other essential services instead of each woreda official deciding on how much is to allocated arbitrarily.