Transparency and accountability essential for better health outcomes

Monday, 16 May 2016
The Africa Health Budget Network calls on African governments to #ValueOurHealth at the Women Deliver conference in Copenhagen.

The Africa Health Budget Network – a group of African civil society organisations working on health budget advocacy – is at Women Deliver, calling on African governments to #ValueOurHealth by increasing access to budget information and providing more opportunity for public engagement in the budgeting process.

Urgent action is needed to strengthen accountability for how public money is spent, as the publication of the Panama Papers has shown. Transparency and participation are key drivers of accountability and improved decision-making, which will help deliver the investment required for women and children to reach their full potential. African civil society organisations want to know how much is spent on women and children’s health, and participate in health spending decisions, as part of the #ValueOurHealth campaign.

Aminu Magashi Garba from the Africa Health Budget Network said: “It has been shown that public participation and open budgets can improve the health of its citizens because those budgets will be more influenced by the priorities of the people who use health services every day. We see from the 'Panama Papers' that transparency matters because it's our money. Imagine what $50bn could provide for Africa if it were not going elsewhere through illicit financial flows. African voices are calling for better health spending for women and children.”

According to the 2015 Open Budget Survey, published by the International Budget Partnership, 13 countries in sub-Saharan Africa provide minimal or no budget information. Only three countries – Malawi, Uganda and South Africa – provide substantial budget information so that their citizens can see what has been spent and the results of these investments.

Publishing key documents – many of which are produced, but not made available to the public – helps to keep governments accountable for the way they spend public money.

District Councillor Beauty Banda from Nkhatabay District in Malawi, said: “We are only at the beginning of the process of making Nkhatabay’s budgets more transparent, but already I can see the power of opening up our budgets. But transparency isn’t the end goal. It’s that it leads to more efficient spending on what people really need.”

Kenneth Simbaya, Chair of the Union of Tanzanian Press Clubs said: “This is our money and our health. We have a right to see this information and it is a journalist’s responsibility to properly examine expenditure to see if it is fair, sensible and reflects the priorities of the people.”

The voice of the people, through effective participatory processes, must be heard during the formulation and implementation of health budgets. For example, the use of open legislative hearings where the public can testify and social audits have been shown to engage the public in how their money is spent.

Kenneth Mugabe, Director of Budgets in the Ugandan Ministry of Finance, said: “Open budgets are critical for improving the delivery of public services such as health.  In Uganda, we have made transparency part and parcel of our budgetary system.  By forming strong partnerships with civil society, we have been able to ensure that information goes out to the broader public and that that the views of the public are fed back into the system.  In this way, we work with the public to hold line ministries to account.

  • Africa Health Budget Network

The Africa Health Budget Network is a group of African and global organisations and individuals already using or wishing to use budget advocacy as a tool to improve health service delivery in Africa.

African Union High Level Panel on Illicit Financial Flows

Illicit financial flows out of Africa is a matter of major concern because of the scale and negative impact on Africa’s development and governance agenda. The 2015 report from the African Union High Level Panel on Illicit Financial Flows estimates that illicit flows from Africa could be as much as US$50bn a year. This is about double the official development assistance that Africa receives.

Health budget transparency scorecards in Malawi

Three districts in Malawi are rolling out health budget transparency scorecards in order to track and improve the publication of key documents and public engagement in the budget process. This blog outlines how the health budget scorecard was received in Nkhatabay. 

Evidence from Africa

According to the 2015 Open Budget Survey, which included 27 countries in sub-Saharan Africa:

  • Only three African countries provide substantial budget information with scores over 60: Malawi, South Africa and Uganda
  • 13 African countries provide minimal, scant or no budget information
  • Seven African countries could increase budget transparency at almost no cost by publishing documents that the government already produces
  • Eight Francophone African countries have seen a marked increase in transparency since 2012, largely as a result of regional directives on Public Financial Management and a civil society push for more budget information

This article was originally published on

Subscribe to our newsletter


phone+44 (0)20 7430 1900 emailEmail UK Office