2000年-世界发展银行全球_Nepal___Public_Expenditure_Review_Volume_3_Social_Sectors_64页_4mb

Summary of Nepal Public Expenditure Review (Volume III: Social Sectors)

Core Content

This report, Nepal Public Expenditure Review (In Five Volumes) Volume III: Social Sectors, evaluates the effectiveness and equity of public expenditures in education and health in Nepal. It provides an overview of the country's economic and social conditions, analyzes current spending patterns, and offers recommendations for improving resource allocation.

Main Points

Economic Development Data

• GNP per capita (1998): US$ 210.
• GDP (FY99): US$ 4,754 million, representing 96.5% of total GDP.
• GDP Growth Rate (constant prices):
  • FY86-90: 4.8%
  • FY91-94: 5.6%
  • FY95-99: 3.9%
• Gross Domestic Investment: 956 million NRs (19.4% of GDP).
• Gross National Saving: 700 million NRs (14.2% of GDP).
• Current Account Balance (FY99): -256 million NRs (-5.2% of GDP).
• Consumer Price Index (1983/84=100):
  • FY94: 284
  • FY99: 417
• Exchange Rate (US$/NRs):
  • FY94: 57.03
  • FY99: 67.95

Social Indicators

• Population Growth Rate (1992-97): 2.5% annually.
• Urban Population (%): Increased from 7.8% to 10.9%.
• Total Fertility Rate (1992-97): 4.4 births per woman.
• Poverty Headcount Index (1992-97): 44.0% of the population.
• Rural Poverty: 44.0%.
• Urban Poverty: 23.0%.
• GNP per capita (US$): Increased from 120 to 220.
• Life Expectancy at Birth (1992-97):
  • Total: 57 years
  • Male: 58 years
  • Female: 57 years
• Infant Mortality Rate (per 1,000 live births): 83.
• Under 5 Mortality Rate: 117.
• Access to Safe Water:
  • Total: 59%
  • Urban: 61%
  • Rural: 59%
• Immunization Rates (% under 12 months):
  • Measles: 85%
  • DPT: 78%
• Child Malnutrition (% under 5 years): 47%.

Education Sector

Status of Education

• The education system in Nepal is one of the youngest in the world and operates within a recent political democracy.
• While access has improved significantly over the past four decades, the quality of schooling remains a major concern.
• Low participation and retention rates and high examination failure rates indicate inefficiencies in the system.
• Primary education is the most critical for the poor, as they lack access to private alternatives.

Public Expenditure Trends

• Government expenditure on education as a share of GDP: Increased from 1.4% in 1981 to 2.7% in 1997, but has since stabilized.
• Education expenditure as a share of total government expenditure: Rose from 9.4% to 13.9% between 1981 and 1997, then declined slightly.
• Primary education: Increased from 38% of total education expenditure in 1980 to 54% in 1999/2000.
• Secondary education: Increased from 15.6% to 23.0%.
• Tertiary education: Decreased from 30.9% to 20.3%.
• Unit costs per student:
  • Primary: Rs. 1,270 (65% increase from 1990/91).
  • Secondary: Rs. 1,644 (54% increase from 1990/91).
  • Tertiary: Varies by field, with Medicine being the most expensive at Rs. 46,000.

Efficiency and Equity

• Education subsidies are disproportionately allocated to tertiary education, which has a retrogressive effect on income distribution.
• Only 6% of higher education students come from the poorest 50% of households.
• Primary education is the most equitable and beneficial, as it is the only option for the poor.
• The system is highly centralized, with weak community involvement. However, recent decentralization efforts show potential for improvement.

Health Sector

Status of Health

• The health system faces challenges in addressing the burden of disease and improving social equity.
• Public expenditure on health as a share of GDP is 1.2%, which is low compared to other sectors.
• Health equity is a major concern, with limited access to services for the poor.

Public Expenditure Trends

• Health expenditure as a share of total government expenditure: Around 1.0%.
• Public health expenditure is relatively low, and cost recovery mechanisms are underdeveloped.
• Non-government health services are growing, but their impact is not yet fully understood.

Efficiency and Equity

• The allocation of health resources is often inefficient and inequitable.
• Government interventions and subsidies are needed to address market failures and improve access for the poor.

Remaining Issues

• The report highlights the need for policy analysis and strategic planning to ensure that public resources are used effectively.
• Decentralization is seen as a promising approach to improve accountability and community involvement in education.
• Donor funding and internal resource generation are essential to sustain and improve education and health services.
• Cost recovery and household contributions are recommended for higher education to reduce the burden on public funds.

Key Recommendations

• Increase the effectiveness of current public expenditures.
• Shift subsidies from tertiary to primary and secondary education.
• Strengthen decentralization and community involvement in education management.
• Enhance donor funding and improve the absorptive capacity of the education system.
• Develop cost recovery mechanisms for tertiary education to reduce reliance on public funds.

Conclusion

The report emphasizes the importance of prioritizing education and health expenditures to improve social welfare and equity. It calls for a reassessment of resource allocation, policy reforms, and increased investment to ensure that these sectors function effectively and equitably.