Government of the Punjab Health Department

Version II

DraDftrfaofrt fDoirscDuisssciuosnsion

MEDIUM TERM BUDGETARY FRAMEWORK (MTBF)

(2010-13)

Volume - II

Medium Term Budgetary Framework (MTBF) ? Health Department

(2010-13)

Government of the Punjab Health Department

i

27th July 2010

Table of Contents

Draft for Discussion

MESSAGE FROM SECRETARY HEALTH DEPARTMENT

1

ACRONYMS

2

SECTION I

4

1.

Introduction and Background to the Department

4

1.1. Particulars of the Department

4

1.2. Vision Statement

4

1.3. Policy Objectives

4

1.4. Overview of Health Sector in Pakistan

5

1.5. Overview of Health Sector in Punjab

6

1.6. Organizational Structure and Functions of the Department

7

1.6.1. About the Department

7

1.6.2. Key Functions of the Department:

8

1.6.3. Planning & Budgeting Process in the Department

9

1.7. Share of Health Budget in Provincial Budget Outlay

11

2.

Priorities in the medium term (2010-13)

12

3.

Medium Term Budget Estimates (2010-13)

13

3.1 Summary of MTBF Estimates (2010-13)

13

3.2 MTBF Allocations by Policy Objectives

16

3.3 MTBF Allocations ? by Object Classification

18

3.4 MTBF Allocations ? by Functional Classification

21

3.5 MTBF Allocations ? by Cross Classification

23

3.6 Key Inputs and Outputs ? Current Budget

29

3.7 Selective Outputs for Large Development Schemes

36

3.8 Recurrent Impact of Development Projects

40

APPENDIX ? B: EXPLANATORY NOTES TO MTBF ESTIMATES (2010-13)

42

APPENDIX ? C: MTBF AT HEALTH DEPARTMENT

46

GLOSSARY OF TERMS

50

SECTION II

53

PART ? A: DETAILS OF CURRENT BUDGET ESTIMATES 2010-13

53

i

PART ? B: DETAILS OF DEVELOPMENT BUDGET ESTIMATES 2010-13

Draft for Discussion

221

ii

Draft for Discussion

MESSAGE FROM SECRETARY HEALTH DEPARTMENT

This was second year of MTBF reforms in the Health Department. As in the first year, the Medium Term Budgetary Framework (MTBF) Statement 2010-13 of the Department was finalized after a meticulous exercise spread over several months. The MTBF statement 2010-13 was an upshot of hard work put together by officials of the Department, spending units and the consultants engaged for this initiative. The format of the statement is as it was in the last year i.e. it has two sections: Section 1 deals with basic information about the Department along with analysis and summaries of MTBF estimates 2010-13 & past trends in budget allocations. It also gives a summary on cost of health policies besides a summary of a set of key `outputs' that the spending units would aim to deliver in 2010-13 along with key resources (Inputs) required. Section 2 of the Statement gives MTBF estimates for non-devolved spending units of the Department separately for current and development budgets for 2010-13.

Health Department delivers more complex and sensitive services than any other Department of the Government. It controls (directly or indirectly) a number of diverse entities that provide specialized services to the people in the Province and manages a large portfolio of development schemes in various sub-sectors. Role of the Department keeps evolving with the passage of time in relation to both delivery of health services and formulation and implementation of health policies. A key policy change happened during FY 2008-09 aimed at the provision of free treatment, strengthening of infrastructure and provision of other support facilities in tertiary care hospitals under Chief Minister's initiative. This policy change resulted in a bigger resource envelope for the Department and its tertiary care hospitals.

The Health Department has decided to begin to coordinate the work of the development wing and the budget and accounts wing into a FMC tasked in FY 2008-09 to drive financial management reforms in Health Department and spending agencies, and for collecting budget and expenditure information from districts. The FMC is responsible for coordinating the budget preparation and execution process and ensuring adherence to the budget preparation principles. The FMC is central to financial reporting in health sector, with the goal of generating management accounting information to facilitate budgetary control and achievement against policy goals. The pilot implementation of MTBF in coordination with the FMC seems to have laid a foundation for costing the health strategies and correlating operational targets of the spending units with their financial requirements. This essentially entails a paradigm shift in its own right and obviously requires a high degree of diligence and commitment. Let me express my unequivocal support for this major initiative and reiterate Department's total support and ownership for this.

Fawad Hasan Fawad

1

Acronyms

ADP AMI

BHU BCC BPS DDO DGHS DHQH FD FMC FSW FY GDP IDU LGO LHW MDG MO MSW MTBF MTDF No. P&DD PACP PHSRP PMU PO RHC SPO SU THQH UOM WMO

Annual Development Plan Autonomous Medical Institutions Basic Health Unit Budget Call Circular Basic Pay Scale Drawing and Disbursing Officer Director General Health Services District Headquarter Hospital Finance Department Financial Management Cell Female Sex Worker Fiscal Year Gross Domestic Product Intravenous Drug User Local Government Ordinance Lady Health Worker Millennium Development Goal Medical Officer Male Sex Worker Medium Term Budgetary Framework Medium Term Development Framework Number Planning & Development Department Punjab Aids Control Program Punjab Health Sector Reforms Program Program Management Unit Planning Officer Rural Health Center Senior Planning Officer Spending Unit Tehsil Headquarter Hospital Unit of Measurement Woman Medical Officer

2

Draft for Discussion

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