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An Introduction to Expenditure Analysis ~ an overview of the NASA methodology. Teresa Guthrie Centre for Economic Governance and AIDS in Africa OSI Workshop, Istanbul Sept 2006. Presentation based on slides provided by UNAIDS, Resource Tracking and Projections Unit.
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An Introduction to Expenditure Analysis ~an overview of the NASA methodology Teresa Guthrie Centre for Economic Governance and AIDS in Africa OSI Workshop, Istanbul Sept 2006 Presentation based on slides provided by UNAIDS, Resource Tracking and Projections Unit
National AIDS Spending Assessment • NASA is a generic term currently used for all country’s HIV/AIDS resource tracking activities • It provides a framework and tools for undertaking a comprehensive analysis of actual expenditures for HIV/AIDS - which can be applied to any health issue or beneficiary group.
Resource Tracking: Purposes • To provide indicators of the financial country response to HIV/AIDS or health • To support monitoring resource mobilization • To obtain information in order to improve decision- making • To define priorities regarding the distribution of resources
NASA Framework for HIV/AIDS NASA is not limited to health expenditures for HIV/AIDS, but emphasizes the tracking of non-health expenditure such as social mitigation, education, labour, justice and other sectors’ expenditure related to HIV/AIDS
Classifications for Resource Tracking R.T. aims to collect comprehensive data regarding: • Sources – who pays • Agents – who manages the funds • Service Providers – who provides the services • Functions – what is provided • Beneficiaries – who benefits • Objects of expenditure – what are the components of expenditure The primary responsibility of the resource tracking team is to ensure that the classification scheme used is made of mutually exclusive and exhaustive categories within each of the classifications.
Financial Source Entity which generates the funds and makes the decision for assigning resources to functions, or agents e.g. Ministries of Finance/ Treasury - Global Fund - World Bank
Financial Agent Intermediary flow in the context of health financing. If a financial agent assigns resources to confront AIDS, for NASA purposes, becomes a financial source as well e.g. Ministry of Health, National AIDS Commission
Provider Entity responsible for delivering goods or services in response to HIV/AIDS or health e.g. Blood bank - Ambulatory care center (OPD) - Hospital
Functions All the interventions, services and activities undertaken/ provided in response to the health issue They are comparable acrossresource needs and resource tracking – i.e. must be standardised across studies and between countries for comparison purposes.
NASA Functions for HIV/AIDS Classified for eight HIV/AIDS programmatic areas • Prevention - Mass media, condoms, HRPs etc. • Treatment & care – ARVs, OI Rx, palliative care etc. • Orphans and vulnerable children – education, family support, nutrition etc. • AIDS programme costs – program management, monitoring, training, upgrading/new buildings etc. • Human resources for AIDS – monetary incentives • Social mitigation – social/financial support, human rights etc. • Community development – institutional development, IGAs, women’s programmes etc. • Research – biomedical, social, psychological, behavioural, vaccine etc.
Target Group orBeneficiaries Population of interest addressed with actions included in service functions: • People living with HIV and AIDS • Most at risk populations • Vulnerable groups • OVCs • Women – reproductive health clinics • STI clinic patients • Migrants • Refugees • Blood donors • Men who have sex with men (MSMs)
Object of Expenditure Production factors purchased to produce a good or deliver a service, under any determined production function e.g. • Health personnel • Pharmaceutical products • Reagents and materials • Administrative • Transport
Tracking the Transaction Is the basic unit of the financial flow, that describes the transit of resources from a source to a provider, who purchases objects of expenses to develop one or more functions benefiting target groups, specified or not.
Source Provider Functions A C B Objects of Expenditure Target Groups Flow of resources from origin to end users: reconstruction of transactions Non Specific
Exercise – mapping ‘the response’ • Identify your health topic to be examined (or beneficiary group) • Identify the broad categories of programmes that are involved in your topic • Under each category list the services delivered • Identify the beneficiaries of the services
Exercise – determining the purpose • What are the gaps in existing information that will be addressed by the research? • What is the purpose of the data and report? (eg. to contribute accurate data on an issue, or to highlight areas of corruption, under-spending?) • Who will be the key audience of the findings?
Exercise – determining the scope (1) • For which year/s will data be collected? • Financial years or calendar years (if different in the country)? • Focus on budgets i.e public allocations, or on actual expenditure, or both? • Quantitative and/or qualitative data – e.g. figures alone (ie. Allocations or actual expenditures) and/or descriptive data, such as analysis of budget processes, procurement systems, challenges, bottlenecks, case studies etc.
Determining the Scope (2) • If including expenditure - only public sources, or also external aid (donor funds), and private (business, private health insurances, out-of-pocket expenditure)? • Or specific focus on one (or more) key external sources of aid (e.g Global Fund assessment). • To what level will the analysis be undertaken – national, provincial and district?
Determining the Scope (3) • Will the study include allocations and/or expenditure made to health activities outside of the Ministry of Health e.g in Correctional service? • Will the outputs and outcomes measured? Against what? • Efficiency analysis? (CBA, CEA, CUA?) • Is analysis of the beneficiary groups required? • Is analysis of the objects of expenditure required?
Thank you! Teresa Guthrie Centre for Economic Governance and AIDS in Africa guthrieteresa@yahoo.com teresag@cegaa.co.za Tel: -27-82-872-4694 Fax: +27-21-552-0208