Budget Approval Dynamics: Why Primary Health Care Is Frequently Deprioritized

Primary Health Care (PHC) is fundamental to building equitable health systems and advancing Universal Health Coverage (UHC), yet it remains underfunded across Low- and Middle-Income Countries (LMICs). This underfunding is less about a lack of policy commitment and more about systemic challenges in how budgets are developed, allocated, negotiated, and approved. The budget approval stage within public financial management (PFM) is particularly opaque and under-examined, limiting understanding of why planned resources for PHC often fail to appear in the final allocation.