Analysis of the Causes of Low Budget Line Liquidation Rates for PRODESS and Cesarean Sections in Mali

This analysis is based on recommendations from previous HP+ evaluations of budgetary efficiency and public financial flows in Mali’s health sector, which uncovered low liquidation rates for various budget lines. Building on this foundation, this document examines the underlying causes and contributing factors leading to low budget line liquidation rates for the National Health Directorate’s implementation of Mali’s Five-Year Plan for Social and Health Development (PRODESS) and for regional-level Cesarean section grants. The analysis included consultations with key informants at the central and regional levels, followed by qualitative analysis and data synthesis to produce actionable recommendations for health system stakeholders. These evidence-based recommendations are intended to aid health sector decisionmakers and advocates in increasing budgetary efficiency by combating under-liquidation, which will ultimately support efforts to strengthen Mali’s health system at all levels.

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