The International Journal of Health Planning and Management

The government budget is not allocated to the health sector by priority health interventions mainly because of input-based budgeting and could be improved substantially if output-based budgeting is adopted. Fiscal decentralisation as a part of devolution has not worked because of inadequate coordination among federal and provincial governments. The coordination should be improved. The size of the fiscal envelope for health is not measurable because of fragmented revenue streams. Cultural misalignments between the finance ministry and health departments exist.