This study examines how configurations of public financial management performance, sectoral spending, and governance context shape education and health outcomes across developing and middle-income economies. Using fuzzy set qualitative comparative analysis and Bayesian robustness checks, the analysis identifies multiple sufficient pathways linking budget execution credibility to primary education, secondary education, universal health coverage, and under five mortality outcomes. The findings confirm that public financial management conditions operate through conjunctural combinations rather than linear channels, their explanatory reach is stronger for intermediate than longer term outcomes, and strong aggregate and revenue execution can compensate for low sectoral spending. Budget credibility at the execution stage emerges as the central operative mechanism.