This paper revisits the issue of fiscalspace requirements for achieving health millenniumdevelopment goals (MDGs) in Rwanda. The paper updates andextends work on financing for the health MDGs prepared bythe Ministry of Health (MoH) in 2006. It draws on papersprepared by World Bank staff for a comprehensive healthsector review and information collected during a field visitto Kigali in March 2008. The context is one of large recentincreases of financing from development partners (donors)combined with far reaching reforms of health sectormanagement. The paper aims to provide a concise summary ofthe key issues for policymakers in Rwanda, developmentpartners, and to inform a broader international audience ofthe prospects for scaling up financing for health in orderto substantially raise the health status of low incomecountry populations. The plan of the paper is as follows:section one describes the demographic and health context,the strategic objectives through to 2015, and recent andprospective progress towards achieving these objectives;section two briefly explains the distinctive features ofhealth financing with an emphasis on primary and secondaryservices needed to achieve strategic objectives; sectionthree considers financial flows in the health sector;section four elaborates a forward-looking fiscal space forhealth scenario; section five compares projections of fiscalspace and alignment of health spending with a costingscenario developed using the marginal budgeting forbottlenecks (MBB) tool; section six concludes with adiscussion of the uses and potential ofgovernment-development partner compact for health sectorfinancing in support of a long term health strategy.
PDF
download
878987797
028-85220240
