Public Expenditure Tracking Survey in Health 2000
Ghana, 2000
Identification
GHA_2000_PETSH_v01_M
Public Expenditure Tracking Survey in Health 2000
| Name | Country code |
|---|---|
| Ghana | GHA |
Public Expenditure Tracking Survey
A Public Expenditure Tracking Survey (PETS) is a diagnostic tool used to study the flow of public funds from the center to service providers. It has successfully been applied in many countries around the world where public accounting systems function poorly or provide unreliable information. The PETS has proven to be a useful tool to identify and quantify the leakage of funds. The PETS has also served as an analytical tool for understanding the causes underlying problems, so that informed policies can be developed. Finally, PETS results have successfully been used to improve transparency and accountability by supporting "power of information" campaigns.
PETS are often combined with Quantitative Service Delivery Surveys (QSDS) in order to obtain a more complete picture of the efficiency and equity of a public allocation system, activities at the provider level, as well as various agents involved in the process of service delivery.
While most of PETS and QSDS have been conducted in the health and education sectors, a few have also covered other sectors, such as justice, Early Childhood Programs, water, agriculture, and rural roads.
In the past decade, about 40 PETS and QSDS have been implemented in about 30 countries. While a large majority of these surveys have been conducted in Africa, which currently accounts for 66 percent of the total number of studies, PETS/QSDS have been implemented in all six regions of the World Bank (East Asia and Pacific, Europe and Central Asia, Latin America and Caribbean, Middle East and North Africa, South Asia and Sub-Saharan Africa).
In supporting Ghana government's effort in streamlining public spending and improving related outcome in social sectors, the focus of this Public Expenditure Tracking Survey (PETS) is to measure the leakage between different points of resource distribution. Ideally, a track of records should be available on the flow of government expenditures from the line ministries to district offices, from the district offices to the facilities, and finally on how resources are used by the facilities. However, in Ghana such records are not available. Based on the experiences of a tracking study conducted in Uganda in 1996 this tracking survey aimed to identify the bottlenecks in resource flows in Ghana, and to explore ways of ensuring that monies meant for service delivery reach their targeted points. This research is a pilot project.
The Ghana PETS was designed to track down to what extent public resources flow between three points, central government agencies, district offices and service delivery facilities. First, researchers obtained budget sheets from Ministry of Finance for health sector spending, which provided the actual expenditures by different level of service provisions and by budget items. Second, investigators conducted the tracking survey, which was based on a sample of primary health care facilities, as well as district offices in charge of the health sector.
This research focused on tracking non-salary expenditures, tracking salary spending would require a whole set of different survey instruments, which were beyond the scope of this study.
The fieldwork took place in May 2000. 172 primary health clinics in 40 districts were surveyed.
Public Expenditure Tracking Survey studying expenditure flow in Ghana education sector was carried out at the same time with this research.
Sample survey data [ssd]
Scope
| Topic | Vocabulary |
|---|---|
| Health Systems & Financing | World Bank |
Coverage
National
Producers and sponsors
| Name |
|---|
| Government of Ghana |
| Name |
|---|
| Ghana Country Department |
| Dutch Trust Fund |
Sampling
The study was conducted using multistage sampling. First, four districts were chosen from each of ten regions in Ghana. Based on the natural resource endowment of the districts, and factors such as the level of infrastructure development, the income and welfare levels of the population, two depressed, one average and one better off districts were selected in each region.
The second stage involved the selection of service delivery facilities. From the district list of schools provided, five health facilities (three health posts, one clinic and one health center) per district were selected. It should be mentioned that before starting with the fieldwork, a health center was generally considered as a higher level facility than a clinic, however, the survey showed that the use of the notions "center" and "clinic" is not strictly related to the level of health facilities. In some cases, a "clinic" was actually a higher-level facility than a "health center."
To facilitate the link with the Ghana Living Standards Survey Round 4 (GLSS 4), conducted in 1998, Enumeration Areas (EAs) falling within the selected districts were chosen first. Service facilities located in the selected EAs automatically became part of the sample. Facilities not located in the selected EAs but reportedly used by GLSS 4 households were added as well.
The GLSS 4 sample was selected from a sampling frame of 13,000 EAs developed from the 1984 Population Census. Each EA indicated its locality status (rural, semi-urban or urban), population and household information. The frame was first stratified by ecological zones (coastal, forest and Savannah). Within each zone the EAs were subsequently stratified by rural, semi-urban and urban. The GLSS 4 is based on a stratified nationally representative sample of households. At the first stage, 300 EAs were selected with a probability proportional to size (PPS). At the second stage, 20 households were selected from EA. The PETS was designed with the aim of matching data from this survey with the GLSS 4 dataset.
The PETS covered 143 EAs of the 300 GLSS 4 EAs.
The response rate from health facilities was 87 percent.
In general, there were fewer problems in collecting data from the district offices. With regard to facilities, the non-financial data were quite accurate and consistent with the data from the ministry. However, there were more problems in collecting financial data. Some frequently cited reasons for this problem included the lack of systematic filing procedures, data filed in different places, etc. All data, including those in district offices, are recorded on paper (not in computers) and get discarded promptly. Heads of health facilities changed frequently. However, when a supervisor left, s/he typically did not transfer information to the next head.
Data collection
| Start | End |
|---|---|
| 2000-05 | 2000-05 |
At the district offices and schools, researchers conducted PETS on actual annual public non-salary expenditures received for the last two years. In-kind public resources were asked to be converted to monetary values by the respondents. The respondents provided figures based on their records, but enumerators did not demand to check the records in order to avoid giving an impression of a public auditing.
A team of two enumerators was assigned to each region. The team moved from one district to another. The first points of call were District Education Offices and District Health Offices. Thereafter, the team split, with one enumerator administering questionnaires to selected health facilities, and the other covering education facilities. The fieldwork was preceded by a two-day training and hands-on experience at Kasoa (in the Central Region), Labadi, James Town, Oyarifa and Kaneshie in the Greater Accra Region.
Data Access
Public Use File
Use of the survey data must be acknowledged using a citation which would include:
- the identification of the Primary Investigator (including country name)
- the full title of the survey and its acronym (when available), and the year(s) of implementation
- the survey reference number.
Disclaimer and copyrights
The user of the data acknowledges that the original collector of the data, the authorized distributor of the data, and the relevant funding agency bear no responsibility for use of the data or for interpretations or inferences based upon such uses.
Contacts
| Name | Affiliation | |
|---|---|---|
| Hooman Dabidian | World Bank | hdabidian@worldbank.org |
| Cindy Audiguier | World Bank | caudiguier@worldbank.org |
Metadata production
DDI_GHA_2000_PETSH_v01_M
| Name | Affiliation | Role |
|---|---|---|
| Antonina Redko | DECDG, World Bank | DDI documentation |
2011-09-21
Metadata version
v01 (September 2011)