This report reviews, synthesises and critically discusses the findings of the existing academic literature on the potential and actual contributions of public inancial management (PFM) systems and PFM reforms to improving the effectiveness of health service delivery. It describes the current state of the evidence on the link between PFM quality and health service delivery, and adds a judgment on the strength of this evidence. It analysis and synthesis the theoretical literature, which provides hypotheses on the impact of various aspects of PFM quality on health service delivery, and the empirical literature, which was used to scrutinise the validity of the hypothesised links.