Promoting equity in primary healthcare expenditure across districts in the North West Province, using a needs-based resource allocation approach

Master Thesis

2016

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University of Cape Town

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The North West Department of Health requested that research be conducted on ways of addressing the inequity in district Primary Healthcare (PHC) spending. Literature has shown that using a needs- based approach to allocate resources may have a positive effect on equity across geographic areas. This study aimed to examine inequity in current district PHC expenditure, to examine the effect of using a needs-based methodology on equity in resource allocation (by examining different needs-based formulae) and finally to make recommendations on how to promote equity in PHC spending in the province. Mid-to-senior level district and provincial management were interviewed to gain insights into their views on equity, needs-based resource allocation and the indicators of need to be included in the study. The suggested indicators of need were examined and appropriate data sources for each indicator were identified. Two sets of financial data were interrogated: 2013/2014 district PHC expenditure and the total provincial PHC budget from 2009/10 to 2013/14. Finally four needs-based resource allocation formulae were created and the possible effects on equity investigated.
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