Health Care in the Central Highlands Project

Investment in civil works and equipment has recurrent budget implications. Monitoring of whether provinces are allocating greater resources to recurrent budgets is difficult as financial tracking is complicated in a devolved financial management system. User fees may help support the ongoing expenditure support for buildings and equipment in the curative sector, but the preventive system has limited capacity to mobilize resources outside of the state budget. Given these constraints, future projects must have investment allocations that reflect the limited capacity for increasing recurrent expenditure, and use appropriate technology that has manageable cost implications.