2002年-世界发展银行全球_Brazil_-_Planning_for_Performance_in_the_Federal_Government___Review_of_Pluriannual_Planning_Volume_2_Annexes_100页_5mb

Summary of Report No. 22870-BR: Brazil - Planning for Performance in the Federal Government

Core Content

This report provides an analysis of the Plano Plurianual (PPA), a multi-year planning framework implemented in Brazil, focusing on its role in improving public expenditure management and promoting managerial reform. The PPA is designed to align planning with budgeting, and it introduces a new management model that emphasizes transparency, results orientation, and central coordination. The report evaluates the implementation of the PPA in two key sectors: Health and Transport, and discusses its broader implications for governance and public policy.

Main Views

1. PPA Management Model

The PPA management model consists of four key reforms:

• Program-based organization: All federal government actions are organized into programs that address specific problems, such as safety on federal highways or the production of maps. These programs focus on outputs rather than inputs, promoting a results-oriented culture.
• Linking programs to financial resources: Each program is associated with specific financial allocations, with some designated as priority programs.
• Appointment of Program Managers: A manager is appointed for each program, usually a ministerial appointment, who also has direct links with the Secretaria de Planejamento e Investimentos Estratégicos (SPI). These managers are responsible for program execution.
• Centralized monitoring and evaluation: A centralized system is used to monitor and evaluate the performance of programs, ensuring that they align with strategic goals.

These innovations were introduced in Brasil em Ação, a previous initiative, and the PPA model builds upon them. However, the scale-up from 42 small projects to 388 large programs and the shift of execution responsibility from the SPI to ministries represent significant changes.

Key Information

2. Health Sector and PPA

The Ministry of Health is a central player in the health sector, responsible for:

• Decentralized family health services: A program introduced in 1994, which has grown to cover over 20% of Brazil's population by 2000. It involves municipally-based health-care teams serving defined communities.
• Shift from service provision to financing and regulation: The Federal Government has moved from funding based on service delivery (e.g., number of hospital beds) to needs-based funding. This has been implemented through financial transfers based on population size.
• Challenges in the health sector:
  • Hospitals remain a core problem due to insufficient incentives for improved management and inadequate quality of care.
  • The Ministry faces administrative and planning capacity challenges, including a lack of policy expertise and overreliance on contracted personnel.
  • The Family Health Program has been successful, but the overall execution of programs in the health sector remains uneven, with some programs having low execution ratios.

3. Transport Sector and PPA

The Transport sector is also a key focus of the PPA, with specific programs such as:

• Araguaia-Tocantins Corridor: A program aimed at improving infrastructure and connectivity in the region.
• Maintenance of the Federal Road Network: A program focused on maintaining and improving the country's roads.

These programs are also linked to financial resources and managed by Program Managers appointed by the ministries, with the SPI providing oversight. The report highlights that the PPA model has been applied in a somewhat different manner in the transport sector compared to the health sector.

Alternative Perspectives on the PPA

The PPA is viewed as:

• A governance tool: It helps in improving transparency and accountability by linking programs to specific outputs and financial resources.
• A strategic plan: It outlines the government's long-term objectives and prioritizes resources accordingly.
• A public investment plan: It focuses on the allocation of financial resources to strategic programs.
• A vehicle for management reform: It introduces new structures and processes for program management and coordination, although these are flexible and subject to interpretation.

The report suggests that the PPA's flexibility may make it less threatening than other reform models, potentially increasing its chances of acceptance and implementation.

Budget and Execution Data

The PPA includes 30 Direct Programs, which cover a wide range of health-related activities and projects. The following data highlights the budget and execution status of these programs:

• Total initial allocation: R$20,371,762
• Total additional credits: R$3,172,782
• Total authorized budget: R$23,544,545
• Total liquidated: R$22,699,248

Some programs, such as Family Health and Quality and Efficiency of SUS, show high execution rates, while others, like Health of the Elderly and Health of the Young, have lower execution rates. The report also notes that strategic programs are often blocked in terms of execution, indicating a need for further reform and implementation.

Conclusion

The PPA has introduced a new management model in Brazil, aiming to improve the effectiveness and efficiency of public resource use. While the health sector has made significant progress, challenges remain in decentralization and hospital management. The transport sector has also been affected, with strategic programs being implemented to improve infrastructure. The PPA is seen as a flexible and adaptable model that may help in achieving better public governance and resource allocation.