Linked NHA Tables-Examples

1. GENERATING NATIONAL HEALTH ACCOUNTS Njaramba P.J1; Mary Pat Selvaggio11Khulisa Management Services, P.O. Box 923, Parklands 2121, South Africa 26 - 7th Avenue Parktown North Johannesburg South Africa 2193 Tel: +27 11 447-6464 Fax: +27 11 447-6468 Web: www.khulisa.com Accurately Measuring Progress Funding for this Presentation was provided by Khulisa Management Services, South Africa BackgroundThe National Health Accounts (NHA) is a standardized methodology that describes flow of funds through the health care system in a given period of time. NHA provides decision makers with a comprehensive picture of the health sector, showing the actual emphasis of spending and the roles of different payers. They also provide a consistent framework for monitoring the effects of changes in financing and provision of health services. By linking expenditures to health outcomes in targeted populations, NHA function as powerful evaluation tools. They can be used to monitor and evaluate health expenditures related to disease-specific activities such as maternal and child health, or HIV/AIDS. • Data Management • Planning: A data plan setting out who will collect the data, how, when, and from where • Multidisciplinary team: with expertise in economics, statistics, accounting, health systems and policies • Steering Committee: made up of senior policymakers from: • Ministries of Health, Finance, and Planning, • National Statistical office, • Academic groups, • Provider and consumer organizations, and; • Social health insurance organization. • Minimum NHA Tables • Financing Sources to Financing Agents = FS x FA Tables • Financing Agents to Providers = FA x P Tables • Financing Agents to Functions = FA x F Tables • Providers to Functions = P x F Tables Presentation Objectives To describe the procedures followed in generating NHA that include collecting data on health expenditure from differing data sources, organizing the data into a series of matrices depicting sources and uses of resources, analyzing the results, and disseminating the information to the stakeholders. Linked NHA Tables-Examples • Collecting Data- The Sources • Production of NHA requires extensive data collection from: • Various Ministries, • Donors, • Households, • Providers, and • Industry groups e.g. Private insurers, Employers, and Pharmaceutical companies • Analysis and Report Writing • Compare health expenditure with other countries • Look at trend in health expenditures • Diagnose inequitable distribution of funds • Evaluate impact of interventions e.g. decentralization • Report Source of Funds • Report Expenditure by Departments • Report Expenditure in Public and Private facilities • Dissemination To all stakeholders. NHAs primary users are health system policymakers and managers, in their efforts to improve health system performance and management through policy design and implementation, policy dialogue, and M&E of Health care interventions. Conclusions In order to develop policies that enhance the performance of health systems, resource mobilization and allocation need to be designed, monitored, and evaluated in terms of the sources of finances, who receives them, how they are spent, and the resultant outputs and outcomes. Tracking of flow of funds is particularly important in pluralistic health care systems, where finance comes from multiple sources and where providers receive payment from more than one source. • References • WHO: National Health Accounts Producers Guide • WHO: Guide to producing National Health Accounts with Special Applications for low-income and middle-income countries, 2003 • Partnership for Health Reform. Kenya National Health Accounts 1994, May 1999