This helpdesk response aimed to discover what the recommended proportion of an annual national health budget in sub-Saharan Africa is for the maintenance of primary health facilities. From both a rapid review of the evidence available and from correspondence with experts in public health financing, it is clear that no such recommendation exists.

In light of the lack of a specific recommendation, this report presents some background information on health budgeting. It provides a brief history of health system strengthening, including the 1978 Alma Ata Declaration that called for primary health care to be included as part of a comprehensive national health system, and the 2001 Abuja Declaration, which pledged to set a target of allocating at least 15% of each national budget to improve the health sector annually. Some budgeting options are discussed and cases studies on health financing are highlighted.