GOVERNANCEBRIEF                                                    APRIL 2018
                                                                  MOZAMBIQUE




MOZAMBIQUE IMPROVES EDUCATION
AND HEALTH BY EMPHASIZING RESULTS

“Strong PFM and accountability systems are critical for greater development results.
Improvements in the supply chain of medicine and in school management will result
in better service delivery to the people, especially to the poor who tend to be greatly
affected by inefficiencies in those systems.”
— Mark R. Lundell, Country Director for Mozambique, World Bank




                                                                                      Maputo train station; Photograph by Rosino




Challenge
Weak implementation of Mozambique’s public financial management (PFM) systems and procedures adversely
affected its health and education sectors, particularly the medical supply chain and school performance.
Medications were unavailable, damaged, or expired, and patients couldn’t be adequately treated. In education,
insufficient school governance led to limited community participation, ineffective supervision, high absenteeism, and
school funding that was delayed or diverted. These outcomes contributed to low student retention and completion
rates as well as substandard learning outcomes.
 GOVERNANCEBRIEF                                                    APRIL 2018
                                                                   MOZAMBIQUE




Approach
The Mozambique Public Financial Management Program for Results in Health and Education shifted the attention
from inputs to results, such as the availability of medicine at health centers and the timing of education grants,
to improve the management of drug supply chains and schools. Government officials focused their attention on
identifying bottlenecks in their sectors and bringing people together to craft solutions across disciplines.

Results
Key achievements are more availability of medicine and greater accountability on providing and using school
resources. The program also contributed to the government’s commitment to strengthening institutional
frameworks and governance systems as well as an expanded results-based financing culture with the adoption of
disbursement-linked indicators in new operations.




           93%                                     85%                                      80%
Before 2014, schools didn’t receive     The availability of essential           Shortages of antiretroviral drugs to
education grants on time. By 2016,      maternal health medicine increased      treat HIV decreased from 27 percent
93 percent of all primary schools       from 78.6 percent in 2013 to 85         in 2013 to 5 percent in 2015.
received them on time, and              percent in 2015.
expenditures in most districts were
reclassified appropriately.

The program provided a unique support structure to create a network of reinforcing incentives. A flexible capacity
building approach ensured that sectors collaborated with PFM agencies and had resources to implement
practices. Allocating funding based on performance allowed the sectors to create their own incentives to
drive behavior at the subnational level. Coaches and facilitators were assigned to each sector ministry and in
each province to support the coordination, behavior change, and implementation discipline needed to reach
performance targets.


                                                          “This operation’s focus on results provides
                                                          a platform to engage and align the Ministry
                                                          of Finance and sector ministries through
                                                          joint identification of disbursement-linked
                                                          indicators that emphasize the link between
                                                          improved PFM and service delivery outputs.”
                                                          — Furqan Ahmad Saleem,
                                                          Task Team Leader for the project, World Bank