世界银行-中非共和国主要人类发展部门的公共支出审查（英）-2024.2-106页_11mb

Summary of Public Expenditure Review in Key Human Development Sectors in the Central African Republic (CAR)

Core Content

This report provides an in-depth analysis of public expenditure in the Central African Republic (CAR) across key human development sectors: education, health, and social protection (SP). It outlines the challenges and opportunities for improving human capital development, which is critical for reducing poverty, achieving Sustainable Development Goals (SDGs), and building long-term stability and growth in the country.

Main Challenges

1. Fragility and Conflict

• CAR is one of the poorest and most fragile countries globally.
• The country has experienced repeated cycles of conflict and violence, undermining social cohesion and governance.
• The Political Agreement for Peace and Reconciliation (APPR) failed to bring lasting peace, and post-election unrest in 2020 led to widespread violence and displacement.
• As of May 2021, over 700,000 people were internally displaced, and approximately 14% of the population were refugees.

2. Human Capital Deficits

• Health:
  • Life expectancy is among the lowest globally at 52.9 years (2017).
  • Maternal mortality ratio (MMR) is one of the highest in the world at 829 deaths per 100,000 live births (2017).
  • Only 60.2% of children under five in CAR have healthy growth (i.e., not stunted), which is higher than the FCV and SSA averages.
  • The country’s Human Capital Index (HCI) score is below the regional average and its peers.
• Education:
  • Average years of schooling by age 18 is 4.6, less than half the SSA average.
  • Learning-adjusted years of schooling are only 2.7, significantly lower than peers like Cameroon and the Republic of Congo.
  • Early Grade Reading Assessment (EGRA) results show poor literacy levels, with 57% of grade 2 students unable to read a single French word in one minute.
  • Access to education is limited, especially for girls, and quality is extremely poor.
• Social Protection:
  • Public spending on social protection is low and insufficient.
  • Only about 20% of the population received social security net (SSN) benefits in 2020, and these are mainly emergency projects.

3. Spatial and Social Inequalities

• Disparities exist between Bangui and the rest of the country in access to basic services.
• District administration offices are understaffed and underfunded.
• Access to infrastructure such as electricity, mobile coverage, and roads is limited, especially in rural areas.
• Clean water and sanitation are lacking even in district capitals.
• The Gini coefficient in 2008 was 0.543, indicating high inequality.

4. Impact of the Pandemic

• The pandemic has disrupted basic services, worsened food insecurity, and increased the prices of essential commodities.
• It has led to increased child stunting and learning losses.
• Education and health budgets have been cut in many low-income countries, including CAR.
• Public spending on health and education is below the regional average and the country’s income group.

Key Findings

• Public spending on education and health in CAR is less than 2% of GDP, well below the regional average.
• The country relies heavily on external assistance, with official grants accounting for 9.6% of GDP in 2019.
• Domestic resource mobilization (DRM) is weak, and tax revenue performance is expected to decline further due to the pandemic.
• Human capital development is essential for achieving economic growth, reducing poverty, and improving social outcomes.

Recommendations

• Prioritize Human Capital Development: Ensure that human capital development is at the center of the budget process.
• Strengthen Public Financial Management (PFM): Improve budget preparation, approval, and execution to enhance efficiency and effectiveness.
• Enhance Equity and Access: Address spatial and social disparities in access to education and health services, especially for rural and marginalized populations.
• Invest in Human Resources: Focus on recruiting and training qualified personnel in education and health sectors.
• Protect Spending Amid Fiscal Constraints: Implement multi-year, outcome-oriented budgeting to safeguard essential expenditures, especially in health and education.
• Leverage International Partnerships: Deepen collaboration with development partners to support long-term reforms and sustainable recovery.
• Strengthen Social Protection Systems: Expand the coverage and effectiveness of social protection programs to support vulnerable populations, including internally displaced persons (IDPs), food-insecure households, and youth-at-risk.

Conclusion

The Public Expenditure Review (PER) highlights the urgent need for increased and more efficient spending on human development in CAR. The country’s fragility, coupled with its weak governance and limited domestic revenue, makes it particularly vulnerable to shocks and undermines long-term development. A strategic and sustainable approach to public expenditure, with a focus on human capital, is essential for restoring state legitimacy, improving social cohesion, and achieving lasting peace and economic growth.