ABSTRACT

The study focused on utilization of fiscal resources in health sector in Somalia as the case study.

The study objectively thought to; identity the forms fiscal resource utilization on health sector in

Somalia, to establish whether normal procedures are used in fiscal resources utilization in the

health sector in Somalia and to identify the challenges of fiscal resource utilization in the health

sector in Somalia. The study adopted a descriptive research design. Descriptive was used

because of its ability to describe results from questionnaires and interviews and employs both

quantitative and qualitative methods which were used because of its flexibility for instance. A

sample of 167 respondents was selected. Using, purposive sampling and simple random data

was analyzed using the computer package called SPSS to generate tables and graphs. The

findings of the study were that there was Coordination, collaborate, and do no harm were as

(mean=2.54, agreed) implying that there was a good relationship between the workers and team

work was exercised. In addition, Respondents appeared reserved surprisingly on support

improvements in the ability of developing country governments to develop sound budgets and

repmi on their execution (mean= i.20, strongly disagreed) there should be planning purposes

loosely linking planned performance to funding: were as follows; (mean= 1.22, strongly

disagreed) The study concluded that the Ministry of Health has to make efforts to ensure

equitable access, through the regional allocations for public health services, for which user fees

have been abolished. Performance budgeting should be more than the development of

performance information: it is concerned with the use of this information in budget processes and

resource allocation. PI can be used by the MOF for plmming purposes and/or accountability

purposes. The study recommends that govemment should stimulate the fonnation of a social

health insurance scheme by pooling the large out-of-pocket expenditure that goes to private care

and extending the revenue collected to low income groups. The ministry of Health should use

resources more optimally by being more specific as to the drugs offered under the new

Govemment. The low wage packages and lack of incentives has compromised the delivery of

health services. Its recommended creating a link between public health workers' remuneration

packages and performance, For example, provide nonmonetary rewards such as oppmiunities for

leaming and career progression, subsidized housing and education for dependents.

TABLE OF CONTENT

DEC LARA Tl ON .................................................................................................................... ii

APPROVAL.. ......................................................................................................................... iii

DEDICATION ....................................................................................................................... iv

ACKNOWLEDGEMENTS ..................................................................................................... v

ABSTRACT ............................................................................................................................. 1

CHAPTER 0 NE ...................................................................................................................... 2

INTRODUCTION .................................................................................................................... 2

1. 0 Introduction ........................................................................................................................ 2

1. 1 Background to the Study .................................................................................................... 2

1.1.1 Historical Perspective ...................................................................................................... 2

1. 1.2 Theoretical Perspective ................................................................................................... 5

1.1.3 Conceptual Perspective ................................................................................................... 5

1.1.4 Contextual Perspective .................................................................................................... 8

1.2 Statement of the Problem ................................................................................................... 9

1.3 Objectives of the study ..................................................................................................... 1 0

1.3 .1 General Objective .......................................................................................................... 1 0

1 .4 Specific objectives ........................................................................................................... 1 0

1. 5 Research Questions .......................................................................................................... 11

1. 6 Scope of the study ............................................................................................................ 11

1. 6.1 Geographical scope ....................................................................................................... 11

1.6.2 Content scope ................................................................................................................ 11

1.6.3 Time scope ..................................................................................................................... 11

1. 7 Significance of the Study ................................................................................................. 12

1. 8 Operational definition ...................................................................................................... 12

vi

CHAPTER TWO ................................................................................................................... 13

LITERATURE REVIEW ....................................................................................................... 

2.0 Introduction ...................................................................................................................... 13

2.1 Theoretical review ............................................................................................................ 13

2.2Conceptual review ............................................................................................................. 

2.2.1 Conceptual frame work showing the relationship between utilization of fiscal resources

and health sector ..................................................................................................................... 15

2.3 Review of the Related Literature ..................................................................................... 16

2.3 .IF orms fiscal resource utilization on health sector. ......................................................... 16

2.3.2 Procedure used in fiscal resources utilization in the health sector. .... Error! Bookmark

not defined.

2.3.3 Challenges of fiscal resource utilization in the health sector ........................................ 19

2.4 Related studies ................................................................................................................. 25

2. 5 Research Gap ................................................................................................................... 28

CHAPTER THREE ................................................................................................................ 29

METHODOLOGY ................................................................................................................. 29

3.0 Introduction ...................................................................................................................... 29

3.1 Research design ................................................................................................................ 29

3.2 Study population .............................................................................................................. 29

3.3 Sample size ....................................................................................................................... 29

3.4 Sampling Procedures ........................................................................................................ 30

3.5 Research Instmment ......................................................................................................... 30

3.5.1 Questionnaires ............................................................................................................... 31

3.6 Validity and reliability ..................................................................................................... 31

3.6.1 Validity .......................................................................................................................... 31

vii

3.6.2 Reliability ..................................................................................................................... .32

Table 3.2; Results of the Cronbach's Alpha Reliability Coefficient for Likert-type Scale test

for Questionnaire .................................................................................................................. 32

3.8 Data analysis .................................................................................................................... 33

3. 9 Ethical Considerations .................................................................................................... .34

3.9 Limitations of the study ................................................................................................... 34

CHAPTER FOUR .................................................................................................................. 36

DATA PRESENTATION, ANALYSIS AND INTERPRETATION ................................... 36

4.0 Introduction ...................................................................................................................... 36

4 .I Characteristics of the respondents .................................................................................... 3 6

Classification of respondents by gender ................................................................................ 37

4.3.1 The procedure used in fiscal resources utilization in the health sector in Somalia ...... .44

4.4.1 Challenges of fiscal resource utilization in the health sector in Somalia ..................... .48

CHAPTER FIVE .................................................................................................................... 50

5.1 Discussion of the finding ................................................................................................. 50

5.1.1 The forms fiscal resource utilization on health sector in Somalia ................................ 50

5.1.2 Procedure used in fiscal resources utilization in the health sector in Somalia .............. 51

5.1.3 The challenges of fiscal resource utilization in the health sector in Somalia ............... 52

5.2 Conclusions ...................................................................................................................... 53

5.2.1 Fonns fiscal resource utilization on health sector in Somalia ....................................... 53

5.2.2 Procedure used in fiscal resources utilization in the health sector in Somalia .............. 53

5.2.3 Challenges of fiscal resource utilization in the health sector in Somalia ...................... 54

5.3 Recommendations ............................................................................................................ 55

5.3.1 Forms fiscal resource utilization on health sector in Somalia ...................................... .55

5.3.2 Procedure used in fiscal resources utilization in the health sector in Somalia .............. 55

viii

5.3.4 Challenges of fiscal resource utilization in the health sector in Somalia ...................... 55

5.4 Areas for further study ..................................................................................................... 55

REFERENCES ....................................................................................................................... 56

APPENDIX I .......................................................................................................................... 61

APPENDIX II ........................................................................................................................ 65

APPENDIX III: ...................................................................................................................... 66