Table 1 Misalignment of PFM and health financing functions in FMCHP in Enugu State
PFM system | Health financing functions | Themes | Sub-themes |
|---|---|---|---|
Budget formulation | Revenue raising | Level of funding | Weak budgeting with promised funding remaining static since inception |
Weak enforcement of revised contribution rule | |||
Budget execution | Pooling and fund management | Level of pooling | Only Local Government sustained contribution to FMCHP fund |
Level of administrative efficiency | Weak Steering Committee | ||
No spending cap in the FMCHP guidelines | |||
High unauthorised expenditure from FMCHP fund | |||
Budget monitoring | Purchasing | Payment of providers | Delayed payment of providers |
Fraction of claims paid to some providers | |||
Level of administrative efficiency | Non-remittance of administrative costs to LHAs | ||
Over-reporting of attendance by providers (gaming) | |||
Transparency | Unclear reimbursement process | ||
Lack of financial information disclosure | |||
No regular auditing of FMCHP account | |||
Resistance to financial monitoring committee from SIC officials |