Impact of the budget process on the performance of public health programs: A balanced scorecard assessment of Thyolo District Health Office in Malawi
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Date
2022-06-06
Authors
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Publisher
Kamuzu University of Health Sciences
Abstract
This is a retrospective descriptive case study.
The problem
Implementation of the Decentralisation Policy in Malawi has delegated a lot of responsibility and
funds for public health programs to the District Health Office (DHO). To produce the performance
the country has envisioned. there is need to develop ways to ensure districts effectively utilise
these resources. There exist several management tools for managing organisational performance.
Of these tools, the budget is the only management tool that can directly link an organisation’s
funding utilisation with its performance. Studying the budgeting practices of organisations and
how they affect performance thus provides valuable insights into how organisations can use this
tool to optimise their performance. Indeed, studies in private for-profit companies have
demonstrated relationships between the three budget processes of negotiation, approval, and
implementation, with organisational performance. However, very few such studies have been done
in the public sector, let alone in the public health sector in developing countries. As such, it is
imperative to study how the budgeting practices affect the performance of public health programs.
Study Objectives
The main objective of the study is to assess the effect of the budget process on the performance of
public health programs at Thyolo District Health Office. in the 2020/2021 financial year.
The specific objectives are the following:
• To assess the effect of budget negotiation on public health program performance at
Thyolo District Health Office. in the 2020/2021 financial year.
• To assess examine the effect of budget approval on public health program
performance at Thyolo District Health Office in the 2020/2021 financial year.
• To assess examine the effect of budget implementation on public health program
performance at Thyolo District Health Office. in the 2020/2021 financial year.
Methodology
This is a retrospective descriptive case study. It will be carried out at Thyolo DHO. The study
population comprises the 20 distinct public health programs that DHOs are currently mandated to
manage in the decentralised era. Convenience sampling has been used to select 16 programs to be
studied. These have been chosen because it is the reports of these programs that are readily
available in the District Health Management Information System (DHIS2). Program performance
data will be collected from the DHIS2 system using forms. Data on budget processes will be
obtained through interviews with the respective District Program Coordinators using a structured
questionnaire.
The data will be analysed with SPSS. To make inferences, regression analysis with Pearson’s
correlation coefficients will be used to determine the significance of the relationship between the
budget processes (independent variables) and the performance of public health programs(dependent variable) at Thyolo DHO. Judgement of significance will be made at 95% level
(p<0.5).
Expected Findings
It is expected that the study will demonstrate the nature of the relationship between budget
processes and the performance of public health programs at Thyolo DHO. This knowledge will
provide insight into what best practices DHOs can employ to use the available funds effectively.
Dissemination
The results will be disseminated to Thyolo DHO, the Ministry of Health, the Ministry of Local
Government, the College of Medicine Research Ethics Committee (COMREC), and the wider
scientific community. Dissemination will be through meetings, sharing of research report and
publication of findings in a journal.
Description
Keywords
Effect of budgeting on public health programs