IDEAS home Printed from https://ideas.repec.org/a/spr/hecrev/v10y2020i1d10.1186_s13561-020-00286-9.html
   My bibliography  Save this article

Budgeting challenges on the path towards universal health coverage: the case of Benin

Author

Listed:
  • Elisabeth Paul

    (Campus Erasme, Route de Lennik 808
    Quartier Agora, Bat. B3)

  • N’koué Emmanuel Sambiéni

    (University of Parakou)

  • Jean-Pierre Wangbe

    (University of Abomey-Calavi)

  • Fabienne Fecher

    (Quartier Agora, Bat. B3)

  • Marc Bourgeois

    (Quartier Agora, Bat. B3)

Abstract

Background In its pursuance of universal health coverage (UHC), the government of Benin is piloting a project of mandatory social insurance for health entitled “ARCH”. Methods We analysed budget data and ARCH documents, and conducted four observation missions in Benin between March 2018 and January 2020. Results are presented in terms of the three classical objectives of public expenditure management. Results The government of Benin faces important budgeting challenges when it comes to implementing the ARCH social insurance project: (i) the fiscal space is quite limited, there is a limited potential for new taxes and these may not benefit the ARCH funding, hence the need to prioritise fiscal resources without jeopardising other areas; (ii) the purchasing of health services should be more strategic so as to increase allocative efficiency and equity; (iii) the efficiency of the expenditure process needs to be improved, and more autonomy needs to be devoted to the operational level, so as to ensure that health facilities are reimbursed in a timely fashion in order to meet insured people’s health costs, in such a way as to avoid jeopardizing the financial equilibrium of these facilities. Conclusion The important budgeting challenges faced by Benin when it comes to implementing its UHC policy are also faced by many other African countries. It is important to avoid a situation in which the resources dedicated by the government to the social health insurance system are at the expense of a reduction in the financing of preventive and promotional primary healthcare services.

Suggested Citation

  • Elisabeth Paul & N’koué Emmanuel Sambiéni & Jean-Pierre Wangbe & Fabienne Fecher & Marc Bourgeois, 2020. "Budgeting challenges on the path towards universal health coverage: the case of Benin," Health Economics Review, Springer, vol. 10(1), pages 1-8, December.
    • Handle: RePEc:spr:hecrev:v:10:y:2020:i:1:d:10.1186_s13561-020-00286-9
    DOI: 10.1186/s13561-020-00286-9
    as

    Download full text from publisher

    File URL: http://link.springer.com/10.1186/s13561-020-00286-9
    File Function: Abstract
    Download Restriction: no
    File URL: https://libkey.io/10.1186/s13561-020-00286-9?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    References listed on IDEAS

    as
    1. International Monetary Fund, 2018. "Angola: 2018 Article IV Consultation-Press Release; Staff Report; and Statement by the Executive Director for Angola," IMF Staff Country Reports 2018/156, International Monetary Fund.
    2. Yevgeny Goryakin & Paul Revill & Andrew J. Mirelman & Rohan Sweeney & Jessica Ochalek & Marc Suhrcke & Peter Berman, 2020. "Public Financial Management and Health Service Delivery: A Literature Review," World Scientific Book Chapters, in: Paul Revill & Marc Suhrcke & Rodrigo Moreno-Serra & Mark Sculpher (ed.), Global Health Economics Shaping Health Policy in Low- and Middle-Income Countries, chapter 7, pages 191-215, World Scientific Publishing Co. Pte. Ltd..
    3. International Monetary Fund, 2018. "Benin: Third Review Under the Extended Credit Facility Arrangement and Request for Waiver of Nonobservance of Performance Criterion-Press Release; Staff Report; and Statement by the Executive Director," IMF Staff Country Reports 2018/364, International Monetary Fund.
    4. International Monetary Fund, 2018. "Chad: First Review Under the Extended Credit Facility Arrangement, and Request for a Waiver of Nonobservance of Performance Criteria - Press Release; Staff Report; and Statement by the Executive Direc," IMF Staff Country Reports 2018/108, International Monetary Fund.
    5. International Monetary Fund, 2018. "Mongolia: Staff Report for the Third Review Under the Extended Fund Facility-Press Release; Staff Report; and Statement by the Executive Director for Mongolia," IMF Staff Country Reports 2018/098, International Monetary Fund.
    6. International Monetary Fund, 2018. "Niger: Third Review Under the Extended Credit Facility Arrangement, Request for Waiver of Nonobservance of Performance Criterion, and Request for Augmentation of Access-Press Release; Staff Statement;," IMF Staff Country Reports 2018/372, International Monetary Fund.
    7. Mcintyre, Di & Meheus, Filip & Røttingen, John-Arne, 2017. "What level of domestic government health expenditure should we aspire to for universal health coverage?," Health Economics, Policy and Law, Cambridge University Press, vol. 12(2), pages 125-137, April.
    8. Ortiz, Isabel, & Cummins, Matthew. & Karunanethy, Kalaivani., 2015. "Fiscal space for social protection and the SDGs options to expand social investments in 187 countries," ILO Working Papers 994877663402676, International Labour Organization.
    9. International Monetary Fund, 2018. "Iceland: 2018 Article IV Consultation-Press Release; Staff Report; Staff Statement; and Statement by the Executive Director for Iceland," IMF Staff Country Reports 2018/318, International Monetary Fund.
    10. Helene Barroy & Susan Sparkes & Elina Dale & Jacky Mathonnat, 2018. "Can Low- and Middle-Income Countries Increase Domestic Fiscal Space for Health: A Mixed-Methods Approach to Assess Possible Sources of Expansion," Post-Print hal-02137487, HAL.
    11. International Monetary Fund, 2018. "Cameroon: Third Review Under the Extended Credit Facility Arrangement and Requests for a Waiver of Nonobservance of a Performance Criterion and Modification of Performance Criteria-Press Release; Staf," IMF Staff Country Reports 2018/378, International Monetary Fund.
    12. Klasa, Katarzyna & Greer, Scott L. & van Ginneken, Ewout, 2018. "Strategic Purchasing in Practice: Comparing Ten European Countries," Health Policy, Elsevier, vol. 122(5), pages 457-472.
    13. International Monetary Fund, 2018. "Sri Lanka: 2018 Article IV Consultation and the Fourth Review Under the Extended Arrangement Under the Extended Fund Facility-Press Release; Staff Report; and Statement by the Executive Director for S," IMF Staff Country Reports 2018/175, International Monetary Fund.
    14. Huihui Wang & Nathaniel Otoo & Lydia Dsane-Selby, 2017. "Ghana National Health Insurance Scheme," World Bank Publications - Books, The World Bank Group, number 27658.
    Full references (including those not matched with items on IDEAS)

    Citations

    Blog mentions

    As found by EconAcademics.org, the blog aggregator for Economics research:
    1. Chris Sampson’s journal round-up for 26th October 2020
      by Chris Sampson in The Academic Health Economists' Blog on 2020-10-26 12:00:03

    Citations

    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.
    as


    Cited by:

    1. Hubert Amu & Kwamena Sekyi Dickson & Kenneth Setorwu Adde & Kwaku Kissah-Korsah & Eugene Kofuor Maafo Darteh & Akwasi Kumi-Kyereme, 2022. "Prevalence and factors associated with health insurance coverage in urban sub-Saharan Africa: Multilevel analyses of demographic and health survey data," PLOS ONE, Public Library of Science, vol. 17(3), pages 1-14, March.

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Elisabeth Paul & N'koué Emmanuel Sambiéni & Jean-Pierre Wangbe & Fabienne Fecher & Marc Bourgeois, 2020. "Budgeting challenges on the path towards universal health coverage: the case of Benin," ULB Institutional Repository 2013/312499, ULB -- Universite Libre de Bruxelles.
    2. Izzet Alp Gul & Gülgün Kayakutlu & M. Özgür Kayalica, 2020. "Risk Analysis in Renewable Energy System (RES) Investment for a Developing Country: A Case Study in Pakistan," Arthaniti: Journal of Economic Theory and Practice, , vol. 19(2), pages 204-223, December.
    3. Kolesar, Robert John & Pheakdey, Sambo & Jacobs, Bart & Phay, Sokchegn, 2021. "Decision time: Cost estimations and policy implications to advance Universal Health Coverage in Cambodia," Journal of Policy Modeling, Elsevier, vol. 43(1), pages 127-145.
    4. Daniel Chukwuemeka Ogbuabor & Obinna Emmanuel Onwujekwe, 2019. "Aligning public financial management system and free healthcare policies: lessons from a free maternal and child healthcare programme in Nigeria," Health Economics Review, Springer, vol. 9(1), pages 1-10, December.
    5. Koddenbrock, Kai & Sylla, Ndongo Samba, 2019. "Towards a political economy of monetary dependency: The case of the CFA franc in West Africa," MaxPo Discussion Paper Series 19/2, Max Planck Sciences Po Center on Coping with Instability in Market Societies (MaxPo).
    6. Miss Yinqiu Lu & Dmitry Yakovlev, 2018. "Instruments, Investor Base, and Recent Developments in the Malaysian Government Bond Market," IMF Working Papers 2018/095, International Monetary Fund.
    7. Rahman, Md Mizanur & Jung, Jenny & Islam, Md Rashedul & Rahman, Md Mahfuzur & Nakamura, Ryota & Akter, Shamima & Sato, Motohiro, 2022. "Global, regional, and national progress in financial risk protection towards universal health coverage, 2000–2030," Social Science & Medicine, Elsevier, vol. 312(C).
    8. Kwame Adjei-Mantey & Charles Yuji Horioka, 2023. "Determinants of health insurance enrollment and health expenditure in Ghana: an empirical analysis," Review of Economics of the Household, Springer, vol. 21(4), pages 1269-1288, December.
    9. Helena Owusu & Pruthu Thekkur & Jacklyne Ashubwe-Jalemba & George Kwesi Hedidor & Oksana Corquaye & Asiwome Aggor & Allen Steele-Dadzie & Daniel Ankrah, 2022. "Compliance to Guidelines in Prescribing Empirical Antibiotics for Individuals with Uncomplicated Urinary Tract Infection in a Primary Health Facility of Ghana, 2019–2021," IJERPH, MDPI, vol. 19(19), pages 1-14, September.
    10. Cummins, Matthew, 2019. "Fiscal Space for Children and Human Capital in Eastern and Southern Africa: Options and Strategic Entry Points to Address Investment Gaps in 16 Countries," MPRA Paper 96410, University Library of Munich, Germany.
    11. Yingya Yang & Liangliang Zhou & Chongmei Zhang & Xin Luo & Yihan Luo & Wei Wang, 2022. "Public Health Services, Health Human Capital, and Relative Poverty of Rural Families," IJERPH, MDPI, vol. 19(17), pages 1-14, September.
    12. Elisabeth Paul & Garrett Wallace Brown & Valéry Ridde, 2020. "Misunderstandings and ambiguities in strategic purchasing in low‐ and middle‐income countries," ULB Institutional Repository 2013/309855, ULB -- Universite Libre de Bruxelles.
    13. Steven F Koch & Naomi Setshegetso, 2020. "Catastrophic health expenditures arising from out-of-pocket payments: Evidence from South African income and expenditure surveys," PLOS ONE, Public Library of Science, vol. 15(8), pages 1-14, August.
    14. Noort, Bart A.C. & Ahaus, Kees & van der Vaart, Taco & Chambers, Naomi & Sheaff, Rod, 2020. "How healthcare systems shape a purchaser’s strategies and actions when managing chronic care," Health Policy, Elsevier, vol. 124(6), pages 628-638.
    15. Robert John Kolesar & Peter Bogetoft & Vanara Chea & Guido Erreygers & Sambo Pheakdey, 2022. "Advancing universal health coverage in the COVID-19 era: an assessment of public health services technical efficiency and applied cost allocation in Cambodia," Health Economics Review, Springer, vol. 12(1), pages 1-20, December.
    16. Deepak Kumar Behera & Ranjan Kumar Mohanty & Umakant Dash, 2020. "Cyclicality of public health expenditure in India: role of fiscal transfer and domestic revenue mobilization," International Review of Economics, Springer;Happiness Economics and Interpersonal Relations (HEIRS), vol. 67(1), pages 87-110, March.
    17. Barlow, Pepita, 2020. "Global disparities in health-systems financing: A cross-national analysis of the impact of tariff reductions and state capacity on public health expenditure in 65 low- and middle-income countries, 199," LSE Research Online Documents on Economics 104107, London School of Economics and Political Science, LSE Library.
    18. Bhumika Muchhala, 2022. "The Structural Power of the State-Finance Nexus: Systemic Delinking for the Right to Development," Development, Palgrave Macmillan;Society for International Deveopment, vol. 65(2), pages 124-135, December.
    19. Xiaofeng Shi & Jianying Li & Fei Wang & Hasan Dinçer & Serhat Yüksel, 2019. "A Hybrid Decision-Making Approach for the Service and Financial-Based Measurement of Universal Health Coverage for the E7 Economies," IJERPH, MDPI, vol. 16(18), pages 1-20, September.
    20. Carolina Bloch, 2019. "Fiscal space for child-sensitive social protection in the MENA region," One Pager 427, International Policy Centre for Inclusive Growth.

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:spr:hecrev:v:10:y:2020:i:1:d:10.1186_s13561-020-00286-9. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: Sonal Shukla or Springer Nature Abstracting and Indexing (email available below). General contact details of provider: http://www.springer.com/economics/journal/13561 .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.