世界银行-中非共和国-主要人类发展部门的公共支出审查：摘要（英）-2023.9-26页_4mb

Central African Republic Public Expenditure Review: Key Findings and Recommendations

I. Overview of Human Capital Outcomes

• Education: Low learning-adjusted years (2.7 vs. SSA average 8.0), high student-teacher ratios (STR: 91 in CAR vs. 37 in SSA), high repetition and dropout rates.
• Health: Low life expectancy (52.9 years), high maternal mortality ratio (829 deaths/100k live births), HCI score of 29% (below FCV and SSA averages).
• Social Protection (SP): Coverage remains low (20.7% of population in 2020), heavily reliant on donors, lacking a coherent strategy.

II. Inadequacy of Spending

• Low Government Spending: Human capital sectors (health, education, SP) receive 21.4% of the budget (0.7% GDP for health), below SSA averages (4.6% GDP) and recommended benchmarks.
• Inequitable Allocation: Education favors higher education; health allocates funds to non-priority diseases; SP targets short-term humanitarian aid.

III. Inefficiencies and Equity Issues

• Technical & Allocative Inefficiencies: High STR, poor learning conditions, underfunded essential subsectors (e.g., pre-primary, TVET).
• Inequities by Region & Income: Significant disparities in access and outcomes between urban (Bangui) and rural areas. Poverty remains widespread (71.4% below poverty line in 2019).

IV. Human Resource Management (HRM) Challenges

• Teacher/Health Worker Shortages: Inadequate training capacity, deployment issues, and low motivation due to poor distribution and salary structures.

V. Recommendations

1. Increase Fiscal Space: Improve tax mobilization, reduce informal economy reliance, enhance revenue collection.
2. Strengthen Procurement & HRM: Develop transparent procurement systems, modernize HR information systems.
3. Enhance Education & Health Spending: Increase allocations (e.g., education to 20% of total spending by 2026), reconfigure spending to equity-focused subsectors.
4. Build Coordination for SP: Establish a national strategy to coordinate interventions, improve targeting, and leverage electronic disbursements.
5. Improve Data Management: Strengthen capacity for budget planning, execution tracking, and evidence-based decision-making.

VI. Financing Needs & Sustainability

• Significant Investment Gaps: ESP requires ~CFAF 7.4 billion annually (US$13.7M) through 2030; CHW programs may need 0.2% of health budget (~CFAF 97M).
• Develop Programmatic Approach: Shift from emergency funding to large, coordinated programs to improve sustainability and outcomes.