Implementing Programme Based Budgeting In Ghanas Health Sector PDF Download

This dissertation examines reform ownership as a specific pointer to the reform implementation trajectory in two Sub-Sahara African (SSA) countries. Since the 2005 Paris Conference during which ownership was laid down as a principle entrusted on aid-recipient countries' governments, in order to improve the effectiveness of official development assistance (ODA), only few studies have actually explored this phenomenon. Besides, research on public sector reforms (PSR) in SSA show that the implementation phase is the most challenging. Indeed, among the hurdles to efficient and effective implementation is the issue of reform ownership-an issue that is repeatedly brought up in the field of International Development. However, this study suggests a specific Public Administration perspective, which indirectly implies many levels of policy learning processes, trials and errors, as well as routine or daily operations. Furthermore, although authors agree in recognizing the importance of ownership in successful PSR, they do not agree either on the methods of evaluation or on the most suitable way of constructing, or rather enhancing, ownership. Still, many SSA countries heavily depend on external funding and aid subsidies but are called to develop their own homegrown policies as well as their reform strategies, in order to build a "best fit" model. So how do these countries reconcile financial dependence with endogenous reform approaches? I argue in this study that reform strategy, unlike the technical package of the reform policy, is a deliberate choice of each SSA government. Consequently, through the reform approach, there is room for enhancing reform ownership. This study therefore compares the experiences of performance-based program budgeting (PB2) in Ghana and Cameroon, to demonstrate an upward and inside perspective of reform ownership, derived from the analysis of its implementation process, as opposed to the donor-driven perception. For instance, Public Financial Management (PFM) models proliferate but mostly focus on institutional arrangements and results rather than how these reforms are executed and conducted and, consequently, how reform ownership happens. As a result, analysis of the implementation process-in other words, the concrete policy execution, organizational settings, and actors' behaviors-remain largely overlooked, as African public managers, who are generally at the frontline of the management and execution of these reforms, are often absent from theoretical conversations. Therefore, the main research question stands as follow: How does reform ownership impact the nature, extent and outcome of PB2 reforms in Ghana and Cameroon? This thesis assesses the issue of reform ownership through two dimensions: (1) the steering phase of the reform policy (implementation design) and (2) the execution of the reform, throughout the budget cycle and within three line ministries (health, education, and agriculture). From this twofold perspective and primary data, this study presents a more holistic analysis grounded in critical realism and inspired by both actor-centered institutionalism and implementation theories. It also proposes another approach to PB2 termed here the ownership trajectory approach (OTA), which provides both theoretical and empirical contributions to the analysis and execution of public sector reforms in sub-Saharan Africa. Finally, this dissertation suggests that the traditional notion of "implementation gaps" should be supplemented with the concept of "ownership gaps," as reforms inspired by the New Public Management ideology have taken a methodological turn in developing countries.