This ODI research report, What can a ministry of finance do to improve health spending? explores how governments—particularly in low- and lower-middle-income countries—can strengthen the efficiency and impact of health expenditure despite severe fiscal constraints. With government health spending averaging just $56 per capita in lower-middle-income countries and less than $10 in low-income countries, expanding budgets is increasingly unrealistic amid slow economic growth, weak revenue mobilisation, and rising debt-service burdens. The report examines how ministries of finance can still play a transformative role in improving value for money in health.
Authored by Danielle Serebro and Tom Hart, the paper outlines 10 practical areas for action across three core themes: better budgeting and prioritisation; stronger budget execution and procurement; and more effective public financial management systems for health. These include aligning health sector plans with budgets, improving cash management, reforming procurement, enabling facility-level autonomy, advancing digital financing tools, and leveraging health taxes.