Allocative Equity of Health Budget Across Regions in Ghana, 1997-2001

Abstract

The purpose of this study is to describe the trend of resources (budget) flow into the health sector, and evaluate allocative equity of health budget across regions in Ghana form 1997 to 2001. Equity is defined as allocating health care budget according to need. It implies a commitment to ensure high standard of real access and quality in health services for all. Population was adjested on the main allocation measures (U5MR, access - poverty and distance) to determine a region's health needs. Expected regional budget were calculated from the weighted population and were used to compare with the actual budget allocated to a region at a particular fiscal year to evaluate equity. Health budget increased in the first three years of the programme and declined in the last two years. More budget were allocated to regions than other MoH agencies. The results of the analysis also revealed evidence of inequalities in allocation of health budget across regons form 1997 to 2001. Affluent regions got more budget than their expected need. Poverty based allocation gave the best Gini coefficients but, higher than the equity gold standard of zero coefficient. Poverty seems to have been used by health authorities to achieve equity. Comparatively U5MR seems to have had little consideration in budget allocation. Distance produced the worse Gini coefficients implying that it was less considered in budget allocation. The progamme's initial allocation method of equal emphasis among U5MR, distance and poverty was not adhered to inbudget allocation, and therefore did not lead to equity as planned.