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Timor-Leste
The south-east Asian nation has made notable strides in its health system since gaining independence from Indonesia in 2002, at which time it had just 20 doctors for a population of one million.
However, it still has a considerable deficit in areas like health infrastructure or immunisation. At the same time, the country’s largely oil-reliant economy has been hit hard by a collapse in prices spanning the past two years.
The country’s petroleum revenues declined by 40% in 2015, which the IMF expects could plunge the public finances into deficits worth more than 20% of GDP this year, from a 25.9% surplus in 2014.
After more than doubling between 2008 and 2014, health expenditure is now being cut as the government looks to rein in its spending. Funds from donors are also predicted to decline considerably.
“With that in mind, now, more than ever, strategic planning and proactive health policies are critical to the continued and sustained improvement of the Timor-Leste health system,” said Bolormaa Amgaabazar, the World Bank’s country representative for Timor-Leste.
The bank’s report recommended developing a strategy to maximise the value of the current health workforce rather than focusing on expansion, considering the health sector wage bill is expected to continue rising after growing by 344% between 2008 and 2014.
It also recommended fixing “significant inefficiencies”, especially with regards to pharmaceutical costs. This could be achieved by collecting better data, strengthening management and execution and through public financial management reforms.
The ministry of health and health centres should also “systematically” document the budget, spending and use of resources in order to provide a basis for sound decision making, and develop long-term sustainability plans.
“The pressures that Timor-Leste is facing present an opportunity,” the bank said, urging the government to look critically at its health system, identify challenges and improve service delivery and distribution.
