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Table 1 Health financing framework and definitions

From: Aid alignment: a longer term lens on trends in development assistance for health in Uganda

Source of funds Modality for planning, pooling, and disbursing funds Program area or support system
Governments General budget support (GBS): GBS is provided centrally to the GOU and pooled with domestic resources. Funds are not earmarked for specific sectors. Instead they are allocated to health and other sectors based upon the GOU’s general budgeting process and approved by Parliament. Funds are disbursed and managed through the public financial management system. HIV/AIDS and sexually transmitted diseases (STDS)
Sector budget support to PAF (SBS-PAF): The Poverty Action Fund (PAF) pools resources from donors, the government, and debt relief savings into a single basket for priority development activities in support of the PEAP. Donors can contribute to the PAF through budget support specifically earmarked for the health sector or through general contributions to the PAF budget, of which a proportion is allocated towards priority health programs. All funds are managed through the public financial management system.
Multilateral Institutions Essential clinical care, management of childhood illness and mental health
• World Bank
• Africa Development Bank
• United Nations
On-budget project support: On-budget project support is planned in consultation with the GOU and other donors through the MTEF. Funds are designated for specific projects in the public sector, which may be implemented by the GOU, donor government agencies, or multilateral organizations. The process aims to better align external funds with government priorities and avoid duplication. However, unlike budget support, the decision on what type of projects will be funded and how funds will be managed is ultimately the decision of the donor who finances the project.
Sexual and reproductive health
Public health interventions
• Environmental health
• Disease eradication
Official Agencies
• Immunization
• Global Fund for AIDS, Tuberculosis and Malaria (GFATM)
Off-budget project support: Off-budget project support is not planned within the MTEF. It includes projects within the private sector, as well as some projects implemented by donors and multilateral organizations but not planned through the MTEF. With this approach, donors determine the type of projects that will be funded and the timetable for implementation of activities. This approach may be selected in order to avoid macroeconomic budget ceilings, to conform to guidelines of donor countries, to strengthen civil society, or because of the belief that government agencies are inefficient or corrupt. This funding approach utilizes financial management systems outside the existing government structures and may create parallel implementation units.
• Global Alliance for Vaccines and Immunizations (GAVI)
Health education and school health
Support systems
• Personnel development
• Infrastructure
   • Administration