Briefing note on local government health service financing and expenditure and moving towards monitoring equity in local government health services

With the move to create a functioning district health system, there is a long-term commitment to integrated district health services being provided by the local government sphere, although there is still considerable debate about the constitutional responsibility of municipalities for health service provision. However, given the differential capacity across municipalities to provide health services, there will continue to be variable district health organisation across the country, ranging from district services being fully devolved to local government level in some areas to district services being fully provided by provincial health departments in other areas.

The purpose of this document is to provide a brief overview of what is currently known about health care financing and expenditure at local government level. It also outlines what is required to obtain accurate baseline information on financing sources, expenditure levels and resource allocation decision-making processes and information requirements for evaluating and monitoring the equity of local government health care financing and expenditure.