Bucharest September 17-18, 2008

1. Budgetary process in Azerbaijan Gubad Ibadoglu NGO Alliance«Call for Health» BucharestSeptember 17-18, 2008

3. Growth Dynamics of Budget Allocations for Health (mln.man.) ? ? 450 385,8 400 350 300 257,2 250 200 162,0 150 115,3 100 73,5 55,3 40,9 42,0 44,8 50 0 2000 2001 2002 2003 2004 2005 2006 2007 2008 (prog)

4. Share of Health Expenditure in Total Budget Expenditure ( %) ? ? ? S ? ? ? 8 7 6 5 5,4 5,4 5,2 4,9 4,8 4,8 4 4,3 4,2 3,5 3 2 1 0 2000 2001 2002 2003 2004 2005 2006 2007 2008 (prog)

5. State Programs in the Health SectorFunded from the State Budgetin 2007-2008

6. Health Funding in Azerbaijan: Current Situation Hospitals 61% Centralized spending- 5% Per capita 4 $ Government share in expenses 25% Preventative Care 25% Local spending Per capita16$ Medicaments etc. 14% Formal and undocumented private expenses75% Private spending- Per capita96 $ Hospitals 45% Preventative Care 15% Medicaments etc.40% Source: World Bank Review – Health Sector in Azerbaijan

7. What is the budgetary process? • Budgetary process – is a regulated by legislature activity of state organs on preparation, consideration, approval and performance of state budget. Its content is defined with country’s state and budget structure, as well as, concerned organs and persons’ budget rights.

8. Stages of budgetary process • Preparation of project budget • Review and approval of project budget • Budget performance • Preparation and approval of the report on budget performance

9. Regulation of budgetary process • When starts budgetary process and its separate stages • How long a stage continues and when it finishes • Who are the participants of each stage • Rights and duties of participants

10. Budget cycle Budget year Next year Current year Ы ЫЫ ЫЫЫ ЫВ В ВЫ ВЫЫ ВЫЫЫ ЫХХ ХЫ ХЫЫ Ы ЫЫ ЫЫЫ ЫВ В ВЫ ВЫЫ ВЫЫЫ ЫХ Х ХЫ ХЫЫ Ы ЫЫ ЫЫЫ ЫВ В ВЫ ВЫЫ ВЫЫЫ Discussion and Approval of Project budget Preparation of project budget For next year. Budget performance Performance report Budget performance of current year Report of previous year Discussion And approval Preparation of project budget For next year Budget performance of current year Report of budget performance of previous year Preparation of project budget For next year

11. Budget rules are not enough to provide expected results… Gaps in budgetary process • gaps and contradictions in current budget legislature and in standard-legal basis of budgetary process (“gap in law”); • lack of efficient proceeding of budget resource allocation; • maintenance of all budgetary process stages with law-breaking • low level of administrative and legal liability of officials and MPs • lack of efficient state and public controlling mechanisms in developing and using process of budget resources; • Lack of transparency and development of public participation and etc. in budget decision-making process.

12. Budget rules are not enough to provide expected results… Full preparation of the budget and budget control and managing rules + Stimulating factors for its continuation = Expected budget indicators

13. Respectable controlling institutions • Legislative power • Citizen society • Chamber of Accounts • Mass Media • Court

14. Budget information that must be open to public • Initial budget report • 3 year prognosis of incomes and expenses • Prognosis of perspective indicators • Allocated financial amounts (in detail) • Reports made in a year (quarterly) • Year-end report (including information concerning budget performance) • Opinions of Chamber of Accounts • State debt • And etc.

15. Health Sector Information Inaccessible to Public 1. What funds and resources are available to State authorities; what are ways of spending these resources? 5. How and what regulatory authority are State authorities accountable to? Public law Information acquisition, public control implementation, opportunity for facts-based and advocacy activities 2. How effectively are funds used? 3. How well and to what extent do State authorities fulfill their obligations? 4. What activities addressing ineffective use (disbursement) of funds are needed?

16. Ways to obtain information • Access to preliminary and final (annual) reportson the extent of the implementation of the Programs; • Dispatch of questionnaires; • «In-depth» interviews; • Discussions in focus groups; • Open-ended surveysin focus groups; • Surveys among experts; • Questionnaires; • Analysis of interviews of persons responsible for the implementation of the Program; • Observations anddiscussions with various community groups (doctors, patients, etc.)

17. State Programs Monitoring Target Model Human Resources Equipment Problem Problem solution Process Environment Materials Technology Monitoring and Assessment

18. The International Budget Project Open Budget Initiative for 2006 Azerbaijan is in the 45th place among the 52 countries

19. National Budget Group (www.nbg.az) NBG is an NGO alliance established on February 22, 2006. NBG is specialized mainly in budget and finance issues, and in 2006 had different projects for monitoring and tracking different budget expenses, trainings and seminars for NGO and Mass Media Groups. NGO Alliance «Call for Health» (www.healthalliance.az ) was established on May 7, 2007 by a specialized NGO group. Currently the Alliance is made up of 22 NGOs,famous in Azerbaijan in the field of research and healthcare advocacy. NBG’s mission is Transforming Initiatives on Effective and Transparent Usage of the Budget into Public Interest Analyses, Expertise, Advocacies NGO Alliance «Call for Health» Mission is reinforcement of effectiveness of the public health system of Azerbaijan with the participation of civil society

20. Others stakeholders Network Trancparency Budget NGO & Mass Media Education Health Regions NBG Social Protection Bank of experts Investment Innovation NBG, other NGO, journalists, experts Institutional Project Program project Publication Budget analyses and expertise Data bank Capacity Building PR & Mass media Cooperation with international organizations Coordination of region projects Popularization of budget problems External relation Public hearings Fundraiser Advocacy

21. Participation of the National Budget Group (NBG) in Budgetary process in Azerbaijan

22. Targets • Presidential candidates • International Financial Agencies • Parliamentarians • NGOs • Ordinary people

23. Goals • Popularizing of the NBG • Inclusion of budget problems into election campaigns • Closer cooperation with members of parliament • Popularizing of problems • To draw public attention

24. Events • Preparation of opinions • Publicizing opinions • Meetings with candidates • Simple articles and calendars • Spread of opinions and researches among interest and impact groups • Discussion of problems and recommendations • Radio and TV speeches • Public hearings

25. End of presentation Baku, Azerbaijan AZ1065JaffarJabbarli 44 Str, CaspianPlaza 3, 9th floorPhone: (+99412) 437 32 30Fax: (+99412) 437 32 40web-site: www.erc-az.orge-mail: office@erc-az.org,erc-az@azeurotel.com Thank you very much!