While implementation of budget neutral service change is not dependent on resource release from elsewhere in the programme budget, "there were cost implications... if only opportunity costs, not recognised when the business cases had been written" [ 26].
For supervision and implementation support to be effective, sufficient flexibility needs to be foreseen in the project design and implementation arrangements to allow for reallocation of activities, budget lines and use of contingency funds where support needs are identified during supervision and review missions.
Centre for Budget and Governance Accountability The Centre for Budget and Governance Accountability works to promote transparent, accountable and participatory governance, and a people-centred perspective in preparation and implementation of budgets.
The lack of specific budget lines and fund identification, as well as no proper institutionalisation was identified by health managers as obstacles for the implementation of IMCI, with some stating that, "there is not much of a budget for training and follow ups", and "the IMCI health system component is too weak, and we need more support".
The implementation of DiHPART was designed to address the absence of a budget line for CHPS and the rational spending of health resources by districts.
Prior perceptions about the unpredictability of donor funding influenced the decision of some managers to refrain from using other budget lines and delay implementation.
To initiate implementation of the SDIP as quickly as possible, the central level government encouraged districts to start paying beneficiaries using funds from other budget lines or borrow money from local partners.
In Kenya, national stakeholders reported the lack of a specific budget line for child health.
The implementation of personal budgets has coincided with unprecedented cuts to local authority budgets, which has led to substantially reduced spending on care and support.
Forty-seven percent of countries reported having a budget line for research for health in the ministry of health budget.
The Parliament is also responsible for discharging the implementation of previous budgets based on the annual report of the European Court of Auditors.
