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Table 1 Misalignment of PFM and health financing functions in FMCHP in Enugu State

From: Aligning public financial management system and free healthcare policies: lessons from a free maternal and child healthcare programme in Nigeria

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