.Public Finance Management (PFM) is the foundation of the modern system of governance, which entails the mechanisms by which governments seek, distribute, and use public resources to fulfill developmental objectives. Fundamentally, PFM is a mechanism that guarantees the management of national funds in an efficient and transparent manner and in line with national priorities (Gamaliel & Ali, 2019).
Budgeting, which is one of the key elements of PFM, is a decisive factor in establishing how much governments are able to provide necessary services, such as healthcare, education, and infrastructure. Where budgets fail—either due to poor formulation, implementation, and/or corruption—the effects are felt throughout society, and health results and overall well-being become compromised (Abekah-Nkrumah et al., 2009).
Budget failures are not exclusive to developing countries, but a worldwide phenomenon. Africa has had to deal with budget deficits in health systems, which have resulted in the inadequacy of service delivery and poor health outcomes in countries such as Nigeria, Kenya, and South Africa (Musiega et al., 2023).
In the Western world, budgetary crises have also been experienced, especially when there is economic recession or austerity. For instance, the austerity policies imposed on the United Kingdom in the wake of the 2008 financial crisis resulted in the implementation of severe healthcare budgets, which researchers attribute to increased mortality rates and poorer wellbeing (Stuckler & Basu, 2013). Equally in the United States, healthcare programs have been blocked by budget impasses and government shutdowns, which have impacted vulnerable populations (Nguyen et al., 2020).
