2018年-IMF国际货币组织全球_Malawi_Selected_Issues_36页_1mb

Summary of IMF Country Report No. 18/116: Malawi

Core Content

This report evaluates the efficiency of public spending on health and education in Malawi, as well as the role of credit to the private sector in supporting growth. It also outlines a path toward higher and more inclusive growth by addressing challenges in diversification and resilience.

Key Findings on Public Spending Efficiency

A. Background

• Malawi has significant development needs but limited fiscal space.
• The Malawi Growth and Development Strategy (MGDS) III emphasizes education and health as key pillars for inclusive growth and poverty alleviation.
• The strategy aims for a 4% annual increase in total education and health spending over the next five years.
• Without increased revenues or donor assistance, achieving these targets is challenging due to debt sustainability constraints.

B. Public Spending Trends and Impact

• Public spending as a share of GDP has stagnated, with interest spending crowding out priority areas.
• Health and education spending has increased, but outcomes have not always improved proportionally.
• Public health spending per capita is below the Sub-Saharan African (SSA) average, and outcomes are mixed relative to similar spending levels.
• Education spending is above the LIC average, but performance remains largely unchanged despite increased investment.
• Primary education enrollment rates are high, but secondary and tertiary enrollment rates lag, indicating inefficiencies in resource allocation.

C. Public Spending Efficiency in Health and Education

• A Data Envelopment Analysis (DEA) approach is used to measure efficiency, comparing inputs (spending) with outputs (health and education outcomes).
• Health sector efficiency score for 2010–15 was 0.82, implying a 18% potential increase in health-adjusted life expectancy (HALE) if no inefficiencies existed.
• The score was significantly below the sample average, but improved from 0.66 in 2000–05.
• Education sector efficiency was high for primary education but low for secondary and tertiary, with inefficiencies costing up to 40% of output in the latter.
• Inefficiencies stem from:
  • Insufficient resources: Low per capita health spending and poor teacher-pupil ratios.
  • Misallocation: High recurrent spending (salaries) and low investment in infrastructure and preventative measures.
  • Corruption and leakages: Significant underutilization of funds, especially in health facilities.
  • Weak monitoring and evaluation systems: Delays in fund disbursement and poor tracking of resource use.

Credit to the Private Sector

A. Background

• Malawi has one of the lowest levels of credit to the private sector in the world, which hinders economic diversification and growth.
• Financial deepening is crucial for growth, as it improves resource allocation, risk management, and economic resilience.
• Only 16% of the population has access to financial institutions, far below SSA and LIC averages.

B. Measuring the Credit Gap

• The ratio of private sector credit to GDP is below what is implied by Malawi's economic fundamentals.
• Weak credit growth is attributed to:
  • High real interest rates: Making borrowing expensive for private entities.
  • Large spread between deposit and lending rates: Indicating inefficiencies in the financial system.
  • Limited financial depth: Broad money to GDP ratio is low, suggesting underdeveloped financial systems.
• These factors limit the ability of the private sector to access credit and grow.

Policies for Improvement

A. Enhancing Health and Education Budgets

• Rebalancing spending to prioritize low-cost, high-impact interventions (e.g., preventative health and ECD).
• Improving allocative efficiency and equity in budget distribution across primary, secondary, and tertiary levels.
• Balancing capital and recurrent spending to ensure long-term sustainability.

B. Strengthening Procurement and Supply Management

• Enhancing the capacity of the Central Medical Stores (CMST) to reduce leakages.
• Implementing the new Procurement Act (2017) to improve transparency, forward planning, and timeliness.
• Encouraging program-based budgeting (PBB) to align spending with sector plans and improve monitoring and evaluation.

C. Fiscal Transparency and Accountability

• Increasing transparency in budget allocation and implementation at both national and sub-national levels.
• Ensuring public availability of budget documents, including in-year reports and audit findings.
• Strengthening enforcement mechanisms and sanctions for non-compliance.

D. Supporting Private Sector Credit

• Policy reforms should focus on reducing real interest rates and the spread between deposit and lending rates.
• Improving financial inclusion through better access to banking services and credit.
• Encouraging public participation in budgeting and promoting social accountability to ensure effective use of public funds.

Conclusions

• There is significant room for improvement in public spending efficiency in health and education.
• Addressing inefficiencies can increase fiscal space for further investment in these and other growth-enhancing areas.
• Four key reforms are recommended:
  1. Rebalancing health and education spending.
  2. Strengthening public expenditure management, especially procurement and supply systems.
  3. Enhancing fiscal transparency and accountability.
  4. Implementing program-based budgeting and improving incentive systems for frontline staff.
• These reforms are essential for achieving higher and more inclusive growth in Malawi.

References

• Chirwa L., 2013, Knowledge synthesis on Malawi health system: Literature review, ChRAIC.
• Civil Society Education Coalition (CSEC), 2017, Public expenditure tracking survey with focus on School Improvement Grant.
• Clinton Health Access Initiative (CHAI), 2013, Health Commodity Leakage in Malawi.
• Government of Malawi, 2006, Assessment of drug and medical supplies leakages.
• Government of Malawi, 2017, Malawi Education Statistics 2015/16.
• Grigoli, F. and J. Kapsoli, 2013, Waste Not, Want Not: The Efficiency of Health Expenditure.
• Gupta, S. and M. Verhoeven, 2001, The Efficiency of Government Expenditure.
• Herrera, S. and G. Pang, 2005, Efficiency of Public Spending in Developing Countries.
• Sahay, R. et al., 2015, Financial Deepening and Growth.
• Swaroop, Vinaya & Rajkumar, Andrew, 2002, Public Spending and Outcomes.
• UNICEF Malawi, 2017, 2016–17 Health Budget Brief.
• UNICEF Malawi, 2018, Education Budget Brief.
• World Bank, 2013, Malawi Public Expenditure Review.