In many low- and middle-income countries (LMICs), traditional line-item budgeting has hindered effective primary care financing by reducing transparency, limiting flexibility, and fragmenting expenditures. Programme-based budgeting (PBB) offers a strategic alternative, aligning public spending with health policy goals and improving accountability for results.
This technical document from the World Health Organization provides practical guidance for designing and implementing programme-based budgets tailored to the needs of primary care. Drawing on global insights, it outlines five key dimensions essential for effective PBB in health: national and subnational budget formulation, comprehensive cost coverage, disbursement and provider payment policies, and performance-monitoring frameworks. While PBB has shown potential to enhance resource allocation and service delivery, its impact in the health sector has been limited due to challenges in reform design and execution. This document equips practitioners with actionable recommendations to overcome these barriers and strengthen primary care systems through more strategic and results-oriented budgeting practices.