Evaluation of the Pan American Health Organization Program Budget Policy 2020–2025. Final report

Abstract

The Pan American Health Organization (PAHO) introduced the BP20-25 in 2019 to guide budget allocations from 2020 to 2025, aiming to ensure equity, fairness, and transparency. This evaluation examines the policy’s effectiveness in meeting Member States’ needs, focusing on improvements in budget allocation processes across PAHO’s country, subregional, and regional levels. The evaluation highlights that while BP20-25 provides a structured framework for budget formulation, its impact on actual budget allocations was limited due to significant deviations during implementation.

The evaluation employed a mixed-methods approach, combining quantitative and qualitative analyses, to assess the policy’s influence. Findings indicate that although BP20-25 offers a consistent structure that reduces subjectivity and fosters trust among stakeholders, its effectiveness is hindered by outdated data, lack of clear metrics for compliance, and insufficient communication about the policy’s specifics. Many stakeholders were unaware of the policy details, impacting its transparency and overall effectiveness.

Key recommendations include setting functional allocation targets that exclude special programs, simplifying country-level guidance to reflect marginal budget changes, and updating the policy every two years with the latest data. Additionally, recalibrating the policy’s components to better assess changes in each country’s needs, producing biannual transparency reports, and developing accessible educational materials are suggested to enhance understanding and transparency.

Despite its limitations, the BP20-25 has contributed to a more orderly and efficient budget process within PAHO. The evaluation underscores the importance of continuous improvement and adaptation to ensure the policy remains relevant and effective in guiding budget allocations.