Incidence of Transaction Costs in Brazilian Health Ministry Programmes

In recent years, there has been a sustainable effort to apply a whole series of evaluative strategies and techniques to the assessment of the performance of social programmes in developing countries. Some of these attempts are clearly influenced by the ‘performance movement’ that has attempted to create more efficiency and effectiveness in governmental programmes. However, most of these efforts focus only on an analysis of these programme results. The purpose of this work is based on the supposition that ‘institutions matter’, emphasizing also the importance of taking proper account of the relevant managerial and institutional environments. These elements are especially crucial in such countries, and introduce a completely different perspective about the limits and possibilities of policy interventions. In order to do this, a taxonomy of transaction costs is proposed that is suitable to be applied to the analysis of governmental programmes in developing countries. This taxonomy is applied to an analysis of the ten most important Ministry of Health programmes in Brazil. These programmes represent almost three-quarters of the Ministry's total expenditure. The period studied covers the years 2001--6. The programmes studied are typically multifunctional and evince a high degree of transversality and with a high complex governance structure. Almost all types are transaction costs were found to be present and to influence, in an important way, the performance of these programmes.