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Title page 1

Contents 5

ABSTRACT 3

ACKNOWLEDGMENTS 7

1.0. HEALTH FINANCING CONTEXT 8

2.0. BUDGET EXECUTION IN HEALTH 16

3.0. PUBLIC FINANCIAL MANAGEMENT CONTROLS FOR HEALTH SPENDING 25

4.0. GOOD PRACTICES AND BOTTLENECKS 35

REFERENCES 38

Tables 6

Table 1. Lao PDR Budget by Type of Health Facility 11

Table 2. Lao PDR Budget Execution Rates for Ministry of Health at Central and Provincial Level, 2015/16-22 18

Table 3. Lao PDR Budget Execution for Salaries and Wages, 2015/16-22 21

Table 4. Lao PDR Central and Provincial Ministry of Health Capital Spending Execution, 2015/16-22 23

Table 5. Lao PDR Ministry of Health Information Systems 27

Table 6. Lao PDR Publicly Available Health Spending Reports 29

Table 7. Lao PDR Cash Balances at Health Facilities, 2019 32

Table 8. Summary of Budget Execution Good Practices and Bottlenecks in Lao PDR 36

Figures 5

Figure 1. Lao PDR Domestic Health Funding and Reporting Flows 9

Figure 2. Lao PDR Health Facility Classification and Available Services 10

Figure 3. Lao PDR Domestic Health Sector Financing by Source 14

Figure 4. Lao PDR Donor Financing for Health, 2011-21 15

Figure 5. Lao PDR Domestic Health Execution Rate, 2015/16-22 17

Figure 6. Lao PDR Central Ministry of Health Planned, Actual, and Revised Execution Rates, 2015/16-22 19

Figure 7. Lao PDR Budget Execution for Salaries, Allowances, and Compensation, 2015/16-22 20

Figure 8. Lao PDR Domestic Capital Spending, 2015/16-22 22

Figure 9. Lao PDR Budget Execution for Medical Equipment 24

Figure 10. Lao PDR Budget Execution for Medical Drugs 24

Figure 11. Lao PDR Non-Wage Recurrent Budget Execution, 2015/16-22 24

Figure 12. Lao PDR Ministry of Own Health Revenue (% Total Revenue), 2015/16-22 30

Figure 13. Lao PDR Cash Transfers from National Health Insurance Bureau to Health Centers 31

Figure 14. Lao PDR State Authority for Social Security Utilization Rate and Provincial Hospital Cash Balances, 2020 33