Fibromyalgia Support - Ottawa West. Firefly Counselling and Consulting. Five Star Wellbeing Counselling and Consulting. Fondation canadienne des maladies inflammatoires de l'intestin. Fondation canadienne du foie. Fondation des maladies mentales FMM. Food Bank Directory, Government of Saskatchewan. Four Counties Addiction Services Team. Fragile X Research Foundation of Canada. Fraser East Eating Disorder Program.
Fraser South Eating Disorders Program. Frederick Banting Secondary Alternate Program. Fresh Start Cleaning and Maintenance. Friends and Advocates Centre. Gander Military Family Resource Centre. Ganohkwasra Family Assault Support Services. Gay and Lesbian Alliance Against Defamation. Gay Asian Pacific Support Network. Gay, Lesbian Straight Education Network. General Hospital Health Sciences Centre. General Practice Psychotherapy Association. George Hull Centre for Children and Families. Georgian Bay Family Health Team.
Georgian Manor Home for The Aged. Georgian Triangle Mood Disorder Association. Geriatric Psychiatry Community Services of Ottawa. Gestalt Institute of Toronto. Gignul Non-Profit Housing Corporation. Girls Incorporated of Upper Canada. Glen Cairn Community Resource Centre. Good Shepherd - Women's Services. Good Shepherd - Youth Services. Goodwill Industries, Barrie, R.
Grand Society of Ottawa-Carleton. Green Leaf Psychological Services. Griffin Centre Mental Health Services. Groupe d'entraide des troubles de l'humeur d'Ottawa. Groupe de soutien pour les personnes atteintes de dystonie d'Ottawa-Outaouais. Habitude Addiction and Wellness Centres. Haldimand Norfolk Information Centre. Halifax Sexual Health Centre. Halton Alcohol, Drug and Gambling Assessment. Hamilton Mental Health Outreach. Hamilton Regional Indian Centre. Hamilton-Wentworth District School Board.
Hastings Children's Aid Society Belleville. Headwaters Health Care Centre. Health and Community Services - Western Region. Health and Community Services, St. Health and Social Services, Government of Nunavut. Health Connect Counselling Partners. Health Sciences Centre Winnipeg.
WHO/Europe | Child and adolescent health
Hearing Voices Network of Atlantic Canada. Heart to Home Meals Niagara. Hemachromatosis Society of Canada. Hillsborough Hospital and Special Care Centre. Home health care for seniors. Hong Fook Mental Health Association. HopeSpring Cancer Support Centre. Hopewell Eating Disorder Support Centre. Horse Alternative Therapeutic Services. Horses at Heart Therapeutic Equestrian Adventures.
Hospital for Sick Children, Department of Psychiatry. Hotel Dieu Grace Healthcare. House of Compassion of Toronto. Human Services Justice System Program. Humber River Regional Hospital. Humewood House- for young women. Huron Safe Homes for Youth. Huron-Perth Centre for Children and Youth. I M Confident Niagara Canada.
Independent Living Centre Kingston. Independent Living Resource Centre. Infant Development of Renfrew County. Infertility Awareness Association of Canada.
Innovative Community Support Services. International Center for Clubhouse Development. International Society for Interpersonal Psychotherapy. International Society for Mental Health Online. Internet Surfing Safety Interstitial Cystitis Support Group. Intervenant en faveur des enfants de l'Ontario. Jewish Family and Child Services. Jewish Family Service Calgary.
John Howard Society of Durham Region. John Howard Society of Kingston and District. John Howard Society of Niagara. John Howard Society of Simcoe and Muskoka. John Howard Society of Sudbury. John Howard Society of Toronto. John Howard Society, Belleville. Joseph Brant Memorial Hospital. Jubilee Heritage Family Resources. June Callwood Centre for Women and Families.
Kamloops Eating Disorders Program. Kanata Psychology and Counselling Centre. Karen Stenning, Speech-Language Pathologist. Kawartha Family Court Assessment Service. Kelford Youth Services Inc. Kelowna Eating Disorders Program. Kelty Mental Health Resource Centre. Kerry's Place Autism Services. Keystone Child, Youth and Family Services. Kidney Foundation of Canada. KidsAbility Centre for Child Development. Kina Gbezhgomi Child and Family Services. Kinark Child and Family Services. Kitchener Downtown Community Health Centre. Klinic Community Health Centre. Kunuwanimano Child and Family Services.
L'Association canadienne de la maladie coeliaque. L'association Canadienne pour la therapie conjugale et familiale. L'Association des jeunes de la rue. L'Association des travailleurs sociaux du Nouveau-Brunswick. L'Association des travailleuses et travailleurs sociaux de l'Ontario. L'institut national canadien pour les aveugles. La Banque d'Alimentation d'Ottawa. La clinique de counseling sans rendez-vous. La clinique de discours, voix et langue. La clinique de services psychologiques de l'UQO.
La Leche League, section Ottawa. La ligne ontarienne sur le jeu problematique.
Outiller les parents en leur enseignant des techniques pour bien s’occuper des enfants – Norvège
Lacey House Extended Care for Women. Lake of the Woods Child Development Centre. LakeCity Employment Services Association. Lanark Children's Aid Society. Lanark County Community Justice Program. Lanark County Mental Health. Lanark County Support Services. Lanark County Therapeutic Riding Program. Lanark Highlands Food pantry. Lara Sigurdson and Associates. Laurencrest Youth Services Inc. Le Bureau de l'intervenant provincial en faveur des enfants et des jeunes. Le Centre de ressources pour les familles des militaires de Bagotville.
Organisations de la santé mentale
Le centre de ressources pour les familles militaires de North Bay. Le Centre des ressources pour les familles militaires de Kingston. Le conseil Canadien de l'enfance exceptionnelle. Learning Disabilities Association of Alberta. Learning Disabilities Association of Canada. Learning Disabilities Association of Ontario. Learning Disabilities Association of Ottawa-Carleton.
Learning Disabilities Association of Peel Region. Leeds Grenville Mental Health. Legal Aid Ontario, Barrie Office. Legal Aid Ontario, Collingwood Office. Legal Aid Ontario, Midland Location. Legal Aid Ontario, Orillia Office. Les centres de la petite enfance de l'Ontario. Les Services pour enfant Madame Vanier. Les Services psychologiques Fisher Bloom. Les Services Psychologiques Medipsy Medipsy. Let's Talk - Counselling and Therapy. Life Restoration Counselling Group.
Ligne d'aide sur la drogue et l'alcool. Ligne d'information sur les missions LIM. List of Shelters in the Niagara Region. Listing of Shelters in Waterloo Region. Literacy and Essential Skills. London Autistics Standing Together. London Health Science Centre. Looking Glass Foundation for Eating Disorders. Lotus Centre for Special Music Education. Mackenzie Richmond Hill Hospital. MacPhee Centre for Creative Learning. Main Street Community Services. Maison Interlude House Outreach. Maison Interval de Lanark County. Major Progressions Music Therapy. Make Way For Me!
Occupational Therapy For Children. Manitoba Adolescent Treatment Centre. Manitoba Association of Women's Shelters. Manitoba Farm and Rural Stress Line. Manitoba Keewatinow Okimakanak Inc.
Child and adolescent health
Mobile Crisis Team Contact Information. Manitoba League of Persons with Disabilities. Manitoba Speech and Hearing Association. Marigold Whole Life Centre. Maximum Independence - a bphealth Clinic. Meaghan Lambert Counseling Services. Mental Health and Addictions Access Line. Mental Health and Family Services Division. Mental Health and Justice Initiative.
Mental Health Coalition of Nova Scotia. Mental Health Foundation of Nova Scotia. Mental Health Information from Settlement. Mental Health Mobile Crisis Team. Mental Health Rights Coalition. Mental Health Services in Saskatchewan, Overview. Mental Health Services of Oxford County. Merrickville District Community Health Centre. Mikey's Place for Autism Resource Centre. Military Family Resource Centre Meaford. Military Family Resource Centres.
Mills Community Support Corporation. Ministry of Community and Social Services. Misiway Milopemahtesewin Community Health Centre. Mon Ami Children's Services. Montfort Hospital Satellite Office. Montreal Centre for Anxiety and Depression. Mood Disorders Association for Waterloo Region. Mood Disorders Association of British Columbia. Mood Disorders Association of Manitoba. Mood Disorders Association of Ontario.
Mood Disorders Centre of Ottawa. Mothercraft - Early Child Development. Music Therapy Services of Simcoe County. Muslim Family and Child Services of Ontario. Muslim Social Service Kitchener Waterloo. Mutual Support Systems of the Niagara Region. N'Swakamok Native Friendship Centre. Nanaimo Regional General Hospital. Naomi's Family Resource Centre. Narcotics Anonymous, Alliston Group. National Alliance for Research on Schizophrenia and Depression.
National Alliance on Mental Illness. National Association for the Dually Diagnosed. National Association of Social Workers. National Center for Learning Disabilities.
National Coalition for the Homeless. National Council on Alcoholism and Drug Dependence. National Council on Problem Gambling. National Down Syndrome Society. National Eating Disorder Information Centre. National Eating Disorders Association. National Family Caregivers Association. National Institute of Mental Health. National Inuit Youth Council. National Suicide Prevention Lifeline. Native Alcohol and Drug program.
Native Child and Family Services of Toronto. Native Council of Prince Edward Island. Nelson House of Ottawa Carleton. Nepean Seniors Home Support. New Beginnings Support Group. New Heights Youth Centre Inc. New Leaf Psychology Centre. Newfoundland and Labrador Psychology Board.
Niagara Coalition Addressing Youth Violence. Niagara Regional Native Center. Niagara Suicide Prevention Coalition. Nog-da-win-da-min Family and Community Services. Norman Johnston Secondary Alternate Program. North Bay Indian Friendship Centre. North Bay Regional Health Centre. North Halton Mental Health Clinic. North of Superior Programs. North Renfrew Family Services. North Simcoe Therapy Network. North York General Hospital. Northern Initiative for Social Action. Nos enfants notre avenir NENA. Nova Scotia College of Counselling Therapists. Nova Scotia College of Social Workers.
Nova Scotia Health Authority: Mental Health and Addictions. Nova Scotia Public Trustee. Nunavut Department of Health and Social Services. Nunavut Kamatsiaqtut Help Line. Nurses Association of New Brunswick. Oak Park Neighbourhood Centre. Oakdale Child and Family Services Inc. Odawa Native Friendship Centre. Office of the Children's Lawyer for Ontario. Office of the Public Guardian and Trustee. Office of the Public Guardian. Offord Centre for Child Studies. Olde Forge Community Resource Centre. Ombudsman Office of Ontario.
Ontario Art Therapy Association. Ontario Association for Marriage and Family Therapy. Ontario Association of Child and Youth Counsellors. Ontario Association of Children's Aid Societies. Ontario Association of Residences Treating Youth. Ontario Association on Developmental Disabilities. Ontario Early Years Centre: Ontario Federation of Independent Schools. Ontario Fragile X Support Group.
Ontario Network of Victim Service Providers. Ontario Suicide Prevention Network. Ontario Therapeutic Riding Association. Operational Stress Injury Social Support. Ordre des travailleurs sociaux et des techniciens en travail social de l'Ontario. Organization for Bipolar Affective Disorders. Orillia Grief Resource Network. Orillia Soldiers' Memorial Hospital. Ottawa Aboriginal Head Start Program. Ottawa Anaphylaxis Support Group. Ottawa and District Foster Parent Association. Ottawa and District Post Polio Association. Ottawa Area Intergroup of Alcoholics Anonymous.
Ottawa Assertive Community Treatment Team. Ottawa Catholic School Board. Ottawa Centre for Cognitive Therapy. Ottawa Centre for Mediation. Ottawa Chinese Community Service Centre.
- Événement de la santé mentale.
- Österreich intim: Erinenrungen 1892 bis 1942 (German Edition)?
- Deadpool Vol. 7: Space Oddity (Deadpool (2008-2012)).
- Beastly Bestiary;
- Love in Ruins?
- New Deal Ruins: Race, Economic Justice, and Public Housing Policy?
Ottawa Community Immigrant Services Organization. Ottawa Eating Disorder Clinic. Ottawa Hospital Cancer Centre. Ottawa Independent Living Resource Centre. Ottawa Institute of Cognitive Behavioural Therapy. Ottawa Inuit Children's Centre. Ottawa Psychological Health Centre. Ottawa Twins Parents Association. Ottawa Valley Ambassadors Hockey Club. Ottawa West Community Support.
L'Amie de la Jeunesse. Our Place Community of Hope Centre. Family Resource and Early Years Centre. Outreach Support Services of Niagara. Overbrook-Forbes Community Services Association. Oxford-Elgin Child and Youth Centre. Pacific Post Partum Support Society. Pain Management, Pain Control: Parent Finders, National Capital Region. Parent Support Services of BC. Parents for Children's Mental Health. Parents for Community Living. Parents' Lifeline of Eastern Ontario. Parkdale Community Health Centre. Partir d'un bon pas pour un avenir meilleur. Partners for Mental Health. Pathologistes de discours et langue en Ottawa, programme de premiers mots.
Pathways Alcohol and Drug Treatment Services. Pathways Health Centre for Children. Pathways Psychological and Counselling Services. Pathways Serious Mental Illness Society. Patricia Centre for Children and Youth. Pediatric Physio and Occupational Therapy. Peel Addiction Assessment and Referral Centre. Pembroke Alcoholics Anonymous AA. Perinatal Mood Disorder Awareness Ltd. Peterborough Regional Health Centre. Phoenix Centre for Children and Families. Physician Information Line - Nova Scotia.
Physiotherapy Search via Yellowpages. Planned Parenthood Waterloo Region. Playful Strides Therapy Inc. Police provinciale de l'Ontario. Portail canadien de la recherche en protection de l'enfance. Prevention and Early Intervention Program for Psychosis. Prince George Eating Disorders Clinic. Programme d'aide aux victimes et temoins. Programme de sensibilisation aux jeux de hasard chez les jeunes PSJJ. Programme poigne un poisson pas un buzz pour la jeunesse. Programmes d'aide au droit familial. Programmes de counselling communautaire des TNO.
Providence Care Mental Health Services. Pryor Linder and Associates. Psoriasis Society of Canada. Psychiatric Survivors of Ottawa. Psychological Association of Manitoba. Psychological Association of P. Psychologists' Association of Alberta. Psychotherapy Practice Research Network.
Public Guardian and Trustee of British Columbia. Public Health Agency of Canada. Public Trustee of Manitoba. Public Trustee of New Brunswick. Quebec Branch of the Canadian Psychoanalytic Society. Reaching Our Outdoor Friends R. Reconnect Mental Health Services. Reesor Pigeon Psychological Services. Regeneration Housing and Support Services. Regesh Family and Child Services. Regina Mobile Crisis Services. Region of Waterloo - Social Services.
Regional Housing Support Services. Renfrew and District Food Bank. Renfrew County Addiction Treatment System. Renfrew County and District Health Unit. Renfrew County Substance Abuse Coalition. Renfrew County Therapeutic Riding Program. Renfrew Family and Children's Services. Representative for Children and Youth. Reseau Communautaire pour Enfants. Resource Association for Teens. Richard Pfaff Secondary Alternate Program. Richmond Addiction Services Society. Richmond Eating Disorders Program. Rideauwood Addiction and Family Services. Ridgeview Children's Home Inc.
Rivers Edge Counselling Centre. Robbie Dean Family Counselling Centre. Roth Associates in Psychology. Rouge Valley Health System. Rural Ottawa South Support Services. Rygiel Supports for Community Living. Saint Elizabeth Health Care. Salvation Army Men's Shelter. Salvation Army Sutton Youth Shelter. Salvation Army, Booth Centre. Sandy Hill Community Health Centre. Sante Mantale Communautaires pour Adultes. Sante Mentale pour Enfants Ontario. Psych Interim Autonomous Practice.
Saskatchewan Families for Effective Autism Treatment. Saskatchewan Registered Nurses' Association. Schizophrenia and First Episode Psychosis Program. Schizophrenia Society of Alberta. Schizophrenia Society of Canada. Schizophrenia Society of Newfoundland and Labrador. Schizophrenia Society of Nova Scotia. Schizophrenia Society of Ontario. Schizophrenia Society of Ontario, S. Schizophrenia Society of Prince Edward Island. Schizophrenia Society of Saskatchewan. Seasons Centre for Grieving Children. Seaway Valley Community Health Centre. Self-Help Alliance of Waterloo Wellington.
Self-Management and Recovery Training. Sensibilisation au cancer du sein. Sensory Processing Disorder Network. Serenity House Hospice Inc. Serenity Renewal for Families. Service de police d'Ottawa, Sessions d'information. Service de toxicomanie Cochrane Nord Inc. Service de toxicomanie de Prescott-Russell. Service familial catholique Ottawa Sfco.
Services a l'Enfance et a la Famille du Timiskaming. Services aux familles d'Algoma. Services aux victimes de Prescott-Russell. Services d'aide aux survivantes d'agression sexuelle de Stormont, Dundas, Glengarry and Akwesasne. Services de consultation et de counselling Synergia. Services de counseling sans rendez-vous Tangerine. Services de counselling et de soutien de S.
Services de crises du Canada. Services de toxicomanie, Hopital Communautaire de Cornwall. Services Externes Maison interlude house. Services pour les femmes immigrants d'Ottawa. Servies aux immigrants, T. Seven South Street Treatment Centre. Sexual Assault Support Centre of Ottawa. Shalom Counselling Services Leamington. Shilo Military Family Resource Centre. Shkagamik Kwe Health Centre. Shoore Centre for Learning. Simcoe County District School Board.
Simcoe County Eating Disorders Service. Simcoe Trauma Recovery Clinic. Simcoe Women's Wellness Centre. Sister Margaret Smith Centre. Skerrett Psychology Professional Corporation. Skookum Jim Friendship Centre. Smith Falls Community Health Centre. Smiths Falls Community Hospital. Social Network for Youth of Ottawa-Carleton. Social Planning Council of Waterloo Region. Society for Treatment of Autism. Soloway Jewish Community Centre. Somali Centre for Family Services. Somali Women's Support and Information Line. Somerset West Community Health Centre.
South Ottawa Community Legal Services. Southlake Regional Health Centre. Spectrum Foster Care Services. Clair Child and Youth Services. John Ambulance Therapy Dog Program. Joseph's Hospital-Adolescent Outpatient Services. Leonard's Society of Toronto. Matthew Catholic Secondary School.
Nicholas Adult High School. Thomas Elgin General Hospital. Stars for Life Foundation for Autism. Statistique Canada - Enfants et jeunes. Stepping Stones Counselling Services. Steps and Strides - Social Skills Programs. Stormont Dundas and Glengarry County Library. Stormont Dundas and Glengarry Legal Clinic. Street Haven at the Crossroads. Stroke Survivors Association of Ottawa.
Suffield Military Family Resource Centre. Sugar Ridge Retreat Centre. Summer Camp List, Service Coordination. Summit Counselling Group Inc. Summit Housing and Outreach Programs. Sunbeam Residential Development Centre. Sunnybrook Health Sciences Centre. Sunrise Native Addictions Services. Support and Housing, Halton. Support Enhance Access Service Centre. Supported Training and Rehabilitation in Diverse Environments.
Supportive Housing of Waterloo. Supportive Housing Youth Focus Team. Survivors of Suicide Support Programme. Talbot House Extended Care for Men. Taylor Creek Psychological Services. Tayside Community Residential and Support Options. Teach, Empower, Advocate for Community Health. Telecare Cambridge Distress Centre. Telecare Distress Line of Greater Simcoe.
Terrace Youth Wellness Centre. Thames Valley Children's Centre.
The Affordable Therapy Network. The Balanced Mind Foundation. The Bright Side Initiative. The Centre for Mindfulness Studies. The Community Adolescent Network of Hamilton. The Etobicoke Children's Centre. Yet ministries of health in low- and middle-income countries do not always have a good record in obtaining additional resources from key decision-making institutions. This is despite the strong evidence about the affordability and cost—effectiveness of many public health interventions and of the economic returns of investing in health.
This article sets out 10 attributes of effective budget requests that can address the analytical needs and perspectives of ministries of finance and other financial decision-makers. We developed the list based on accepted economic principles, a literature review and a workshop in June involving government officials and other key stakeholders from low- and middle-income countries.
The aim is to support ministries of health to present a more strategic and compelling plan for investments in the health of women, children and adolescents. Most low- and middle-income countries face financing pressures if they are to adequately address global goals for improving the health of women, children and adolescents. Only six of the 75 priority countries achieved the 5. To scale up from current coverage to the targets for requires There is no consensus about the amount or proportion of national income to spend on health; 3 good outcomes for maternal health, for example, can be achieved even in low-income settings.
This is important, because governments are usually the principal provider of public goods — worthwhile interventions that the private sector tend not to supply because they cannot easily charge a price for it, such as disease surveillance, vector control and other public-wide interventions against infectious diseases. Government expenditure is also a potentially key instrument for addressing health-related poverty and inequity and for preventing impoverishment due to out-of-pocket private expenditure. Target agreed to by many low-income governments in Global health observatory data repository.
An analysis of national health accounts for this article showed that the one lower-middle income and nine low-income countries for which data were available allocated on average just Population growth will put additional demands on already under-funded public health systems. Many countries are losing access to external development finance as they move into middle-income status. How well ministries of health can negotiate with ministries of finance to access and then spend additional financing is therefore a key issue. Many factors, especially political economy factors, affect the level and allocation of public resources for health.
However, the interaction between the ministry of health and ministry of finance is critical for priority setting and resource allocation decisions. The ministry of health is key to this because it is the institution primarily responsible for advocating additional public financial resources and then managing public expenditure. The ministry of finance is also key because it is usually the most influential institution helping to decide the allocation of resources among competing needs and sectors.
All too often health ministry officials are unable to convince their finance ministry counterparts that additional public expenditure is justified. This is despite the fact that the health sector has a strong evidence base, including randomized control trials, to demonstrate the affordability and cost—effectiveness of interventions, immunization being just one example.
There can be missed opportunities to successfully negotiate additional financing due to the way in which health ministries approach finance ministries. The ministry of health proposal may have the appearance of an ad hoc shopping list rather than genuine investment plan that demonstrates prioritized use of scarce resources with a clear focus on significant results and value for money. We also explored the issues during a two-day workshop entitled From shopping lists to investment plans held in June in Geneva, Switzerland, involving 48 government officials and other key stakeholders from ministries of health and finance, from low- and middle-income countries, as well as several bilateral and multilateral development partners.
Improving health and saving lives has, of course, intrinsic value. However, the health ministry needs to also specifically demonstrate how, where, when and at what cost investments in health directly contribute to broader priority national objectives and not just to health goals, important as they may be. There are many arguments that the ministry of health can make, depending on the country. For example, investments in health, including family planning, have been shown to contribute directly and indirectly to favourable demographic trends, better learning outcomes, higher worker productivity and greater household savings and investment, and therefore to better longer term economic growth, often at low per capita cost.
Second, the ministry of finance will usually want to see that the proposed expenditure is an investment yielding substantial outputs and outcomes, and not simply a cost, with a focus on inputs and expenses. Proposals that can demonstrate measurable outputs and outcomes in ways that are affordable, feasible, financially and institutionally sustainable, cost—effective or even potentially cost-saving, and yield economic returns on investment in a wide range of settings are more convincing than budget proposals that focus just on inputs.
Sri Lanka has been able to halve maternal deaths relative to the number of live births every 6 to 12 years for many decades since , despite having spent less on health than most countries of similar income level. Third, a ministry of finance will be more confident about allocating additional resources if the ministry of health provides evidence that it is already making good use of its existing resources. A finance ministry may concede that the health ministry requires additional funding, but may be reluctant to allocate additional funds if it knows or perceives, for example, that public health facilities are irregularly staffed or underused; that there has been under-expenditure in the health budget in previous years; or that there are inefficiencies in procurement or cases of waste and corruption.
World health report Fourth, the ministry of health can make a stronger case if it can specifically demonstrate that the requested expenditure is part of a coherent investment plan, with resources allocated strategically to where they will achieve the highest impact and value for money.
It also helps their case if health ministry officials can explain, for example, that while the unit costs of expanding antenatal care or immunization to remote and rural areas may be increasing, the cost—effectiveness of those interventions could also be increasing if the burden of disease or risk factors are higher in such areas. Some investment plans fail to apply the lesson that investing in preventive maintenance, for example of a cold-chain supply for immunizations, often yields a much higher economic return than investing in new capital equipment.
Fifth, ministries of finance are usually interested in saving money and reducing costs. Health ministries can therefore help their case if they demonstrate that expenditure on health is not just cost—effective but can also be cost-saving to government and to households. It is therefore prudent for health ministries to show in their budget submissions that they include cost-saving interventions, when these are warranted on health grounds, and that they are also alert to the need to avoid unproductive and financially unsustainable cost escalation over the longer term.
Sixth, it helps if health ministries can argue when and how market failures in health require public expenditure. Market failures occur when markets do not allocate resources in a way that maximizes overall welfare. In the health sector, this can justify public expenditure, for example on disease surveillance, which the private sector has little commercial incentive to provide, or on communicable diseases, which affect others beyond the immediate patient paying for a service.
Well-targeted public expenditure is justified to correct significant market failures, although this does not necessarily mean public provision that is, government directly providing the service , and this can run the risk of government failures in provision, including waste and inefficiency. Having an up-to-date national health account that maps the sources and uses of health financing from all sectors, including the private sector, enables health ministries to demonstrate to the ministry of finance where, and why, there are gaps in public provision.
Cambodia provides a good example of how national health accounts can strengthen the evidence base to drive policy discussions and prioritization and allocation of resources. Seventh, an effective health funding proposal is one that identifies, and where possible quantifies, where there are mutual gains for both the ministry of finance and the ministry of health. That is because raising the excise duty on tobacco reduces health risks through reducing consumption while at the same time expanding the financial resources for the ministry of finance through increased tax revenue and for the ministry of health through reduced expenditure on tobacco-related disease.
Analysis shows that raising excise duties on tobacco is not regressive that is, disproportionately affecting the poor over the medium to long term: Eighth, presenting a strong plan for the implementation, management and evaluation of health programmes is important. Some ministries of health, and their development partners, place emphasis on the upstream strategic planning but pay less attention to the downstream realities of procurement, health-worker salaries, supply-side readiness and other key aspects of scaling up implementation in practice. A good investment plan is one that anticipates possible second-round effects of an intervention.
For example, increases in the supply of doctors in a country may lead to increased prescribing of diagnostic tests and drugs that then need to be anticipated and provided for in budgets and supply logistics. In other cases, the funding of building and capital costs of hospitals by development partners may result in a large, and long, tail of recurrent costs, such as staffing, electricity and maintenance, which were not fully anticipated or budgeted for by the ministry of health.
Good implementation can be a particular challenge in the aftermath of decentralization of health services, because staff may lack experience in programme and financial management and in managing larger procurement packages. Ninth, strengthening the information and evidence base for policy and programming is important in budget proposals.
Ministries of health already collect input-focused data, such as salaries and the number of professional training workshops. Collecting and analysing output and outcome indicators and the incremental costs of scaling up programmes, can better inform policy and programming decisions with the ministry of finance. The health ministry is also in a good position to advocate for and help build the civil registration and vital statistics data that are essential for health and broader national planning. Finally, ministries of health need to be cautious about advocating earmarked hypothecated taxes: Such taxes do have some justification from a political economy perspective.
For example, consumers may be more willing to accept increased taxes on tobacco and alcohol if they perceive the benefits of publicly-funded smoking cessation and alcohol reduction programmes or, in the case of the Philippines, an expanded health insurance programme. Earmarked taxes may, however, be persuasive to a finance ministry official if the health challenge is of the highest national priority: A key aspect determining this will be the capacity of a health ministry to present coherent investment plans to the ministry of finance.
This article has identified 10 key attributes which ministries of finance will normally be looking for when they are assessing requests for financing and which health officials can consider before they start annual budget preparations and negotiations with ministries of finance. The factors we have identified are sufficiently broad-based that they can be applied in virtually any setting and any country. We recognize, however, that applying these attributes may be difficult in fragile and conflict-affected states, where basic data may be missing and lines of authority and responsibility may be blurred.
While we focus on what ministries of health can do, we also recognize that ministries of finance too have a responsibility to improve prioritization, planning and resource allocation. Having a credible ministry of finance medium-term expenditure framework would assist a health ministry to achieve better longer term planning. Releasing funds on time to line departments and allowing the ministry of health more flexibility to transfer resources within budget lines, would improve public expenditure and planning.
There are other published guides on how to make good use of health resources. National Center for Biotechnology Information , U. Bull World Health Organ.