Health priorities and investments in Senegal

E4A flew to Senegal this week to support CICODEV Africa at the first national round table on budgeting for health and to hold training in health budget advocacy.

Three days of attentive and constructive participation in discussions on health priorities and investments were enjoyed among ministries and local authorities’ as well as civil society organisations (CSO's); a great step towards greater dialogue between the government and its citizens on health priorities and investments in Senegal. 

Under the leadership of the Ministry for African Integration and Promotion of Good Governance (MIANPBG) Wednesday was spent at a one day Round Table on Health Budgeting. An event that brought together members of civil society, national and local government, Ministry of Health and Social Action (MSAS), trade unions, hospital directors, the press and development partners.

Official presentations on health budgeting and the next health financing strategy (expected to be discussed with civil society representative ahead of final validation later this year), were followed by a very lively discussion on both challenges and opportunities for civil society participation, as well as expectations on future collaboration.

For our E4A team, it was a crash course in specific strategies and approaches for engaging civil society in Senegal, and to share our strategic approaches in other E4A countries.

The event was also a great opportunity to have the press talk about health budgeting just a few days ahead of the national elections (see some articles here: Le Soleil; Enqueteplus, and  Le Quotidien). 

At the end of the day participants left the round table together and, as the bus was leaving the busy streets of Dakar, the atmosphere relaxed, leaving room to informal discussions, exchanges of phone numbers, and some power naps.

E4A - MamaYe training on the budget cycle

A great tone had been set during Monday’s round table and expectations were high for the following two days as E4A led interactive training, tailored to the Senegal context, on the national budgeting cycle, highlighting key practical steps civil society organisations can follow to perform budget analysis. This training was a targeted follow up from the multi-country training E4A and the Africa Health Budget Network hosted in Nairobi in April.

Participation included officials from the Ministry of Health - a first for us and we definitely felt the extra pressure, MIANPBG and many local authorities. Participants had to reconstruct the budget cycle and its key steps, browse through the Financial Law to find references to health and become familiar with the document so that as soon as the 2018 version is published they can start the analysis and advocacy efforts. They used the Citizens Budget to find information relevant to their engagement strategies and, most importantly, as one participant said, for the first time they were not intimidated by the “big budget documents full of numbers”!

Each civil society member brought their specific interests and experiences to the table, we had examples from family planning, access to services for the poorest and transparency of information, just to mention a few. The second day, we focused on budget analysis, interpretation and presentation of the results. We looked at spending trends in the region, rates of out of pocket spending and overall public investment in health. 

  • African spending on health per capita

What surprised us the most was the attentive and constructive participation from national and local government officials. Throughout the training sessions, they sat with civil society, explained on going processes, provided insights on the various opportunities for CSOs engagement across the budget cycle and key decision makers.

The training provided civil society organisations the tools and methods to comfortably base their advocacy strategies on evidence, find the answers to their questions in the budget documents and identify the best entry point for their engagement. Thanks to the ministries and local authorities’ attendance, it was also a great step towards greater dialogue between the government and its citizens on health priorities and investments. 

We wish our friends at CICODEV, the Citizen Network for Budget Transparency (RCTB) and the rest of civil society in Senegal the best of luck as the country continues its path towards universal health coverage and prepares the investment case for the Global Financing Facility.

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