The budget has been and continues to be a tool for effectuating fiscal policy goals of governments worldwide. The case of developing countries in sub-Saharan Africa, including Ghana is no exception. The arguments in support of systematised budgeting and budgetary control regimes in the public sector of economies, both developed and developing are overwhelmingly persuasive. The aforementioned arguments have been normalised in practice and application to the extent of being unfairly characterised as ritualistic in some cases. Interestingly however, inherent in the ritualistic nature of budgets are useful opportunities for leveraging on the strengths of budgeting and budgetary control for effective service delivery for value-for-money and value-for-many. Polemic evidence suggests that health service delivery remains a major challenge to many economies of the world, especially those of the developing world. This qualitative study relies on interviews and document reviews to analyse the practical challenges of budgeting and budgetary control from the perspective of a developing country, using the health service sector of Ghana as a case in point. The paper argues that harnessing the opportunities for improvement inherent in systematised budgeting and budgetary control could produce synergistic effects in the face of the apparent challenges.
Key words: Budgeting, budgetary control, public financial management, health care delivery.
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