Global Health seminar - Public Financial Management and Health System Performance: A Scoping Review

Event details

Abstract:

This scoping review examines how public financial management (PFM) quality impacts health system performance in low- and middle-income countries (LMICs). A total of 34 studies—8 quantitative and 26 qualitative—were analysed. Quantitative evidence consistently shows that higher PFM quality, measured by PEFA scores and budget execution rates, is associated with better health outcomes, including lower under-five and maternal mortality. Qualitative findings highlight recurring challenges across the budget cycle—such as misaligned budgeting, disbursement delays, and weak financial oversight—that hinder service delivery, efficiency, and accountability. Overall, the review underscores PFM as a key determinant of health system performance and identifies the need for more empirical research at sub-national levels and on service delivery indicators.

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