1 / 22

Harmonization of resource tracking initiatives: Experiences from the Africa region

Harmonization of resource tracking initiatives: Experiences from the Africa region. Bangkok, January 26 2010. Douglas M Glandon, MPH Health Systems 20/20 Douglas_Glandon@Abtassoc.com. Overview. Why harmonize resource tracking (RT)? Progress so far

bly
Download Presentation

Harmonization of resource tracking initiatives: Experiences from the Africa region

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. Harmonization of resource tracking initiatives: Experiences from the Africa region Bangkok, January 26 2010 Douglas M Glandon, MPH Health Systems 20/20 Douglas_Glandon@Abtassoc.com

  2. Overview • Why harmonize resource tracking (RT)? • Progress so far • Additional strategies that support harmonized RT • Looking ahead

  3. Why harmonize resource tracking?

  4. Multiple, uncoordinated RT and planning efforts are a tremendous burden on countries… • National Health Accounts (NHA) • NHA Subaccounts (HIV/AIDS, RH etc) • National AIDS Spending Assessments (NASA) • Public Expenditure Tracking Survey (PETS) • Development Assistance Database (DAD) • Quantitative Service Delivery Survey (QSDS) • Public Expenditure Review (PER) • Medium Term Expenditure Framework (MTEF) • Others…

  5. …and undermine the institutionalization of any of those activities, including NHA • At least 25 countries are completing or have done an NHA, some multiple times • Most NHA estimations still require external technical assistance Egypt Mali Niger Burkina Faso Nigeria Ethiopia Liberia Uganda DRC Cote d’Ivoire Kenya Ghana Rwanda Togo Tanzania Benin Malawi Zambia NHA countries Mozambique Zimbabwe Mauritius Namibia Madagascar Botswana South Africa

  6. What does RT harmonization mean? • Coordinating and combining data collection for different RT exercises to: • reduce the burden of data reporting on all partners • minimize time and money wasted on duplicative tasks • Build linkages between definitions and classifications used by RT systems so that they can “speak” to one another. • Example: In Rwanda, JAWP tracks planned expenditures while NHA tracks actual expenditures. • Synchronizing RT with the planning and budgeting cycle so that evidence is made available when it is most useful • Example: In 2009, Rwanda switched its fiscal year from the calendar year to the East African Community’s standard of July to June. RT exercises need to change accordingly to remain relevant.

  7. Harmonization of RT – part of Health Systems 20/20 strategy to institutionalize NHA Resource Tracking – Supply • Household expenditure questions as part of routine surveys (no more stand-alone surveys!) • Tool for mapping government expenditure categories to NHA • Incorporate expenditure tracking into DHIS • Donor and NGO online resource tracking databases • Harmonization of resource tracking activities in-country Resource Tracking - Demand • Country NHA websites with graphing tools • Global NHA database • Synergies between NHA and policy planning tools • Communications techniques to reach civil society audiences 7

  8. Progress so far…

  9. National Health Accounts (NHA) & National AIDS Spending Assessment (NASA) http://www.healthsystems2020.org/content/resource/detail/2321/ 9

  10. Harmonizing NHA & NASA in the field Rwanda (2007-8, 2010) NHA/NASA ‘crosswalk tables’ applied to NHA estimation Namibia (2010) Joint NHA/NASA data collection with UNAIDS DRC (2010) Joint NHA/NASA data collection with UNAIDS, PNMLS Ethiopia (2009-10) Collaboration with UNAIDS in NHA estimation; NHA figures to be used to generate UNGASS tables Vietnam (potential 2010 collaboration) Malawi (potential 2010 collaboration) 10

  11. Harmonizing NHA and the Public Expenditure Review (PER) in the field • NHA is a tool that can be used in the PER to map sources and used of funds in the health sector • Picazo and Zhao of the World Bank conducted PER in Zambia (2009), incorporating NHA results into the analysis http://www.healthsystems2020.org/content/resource/detail/2240/

  12. Harmonization of PETS and QSDS • Public Expenditure Tracking Survey (PETS) with Quantitative Service Delivery Survey (QSDS) • 2 micro-level surveys • Together give a more complete picture of efficiency and equity of public service delivery • 7 country experiences of joint PETS + QSDS* • Working group on PETS/QSDS harmonization 2007-2008 Bernard Gauthier 2006. PETS-QSDS in Sub-Saharan Africa: A Stocktaking Study. World Bank. September 7, 2006.

  13. Additional strategies that support harmonized RT

  14. Health expenditure questions in household surveys • Rwanda (2009) • Added health expenditure questions for next Demographic & Health Survey (DHS) • DRC (2009-10) • Joint Multiple Indicator Cluster Survey (MICS) with UNICEF, WFP, & UNFPA with health expenditure module http://www.healthsystems2020.org/content/resource/detail/2312/

  15. Harmonizing NHA and country HMIS • A key challenge for NHA is a lack of health expenditure data at the provider level • Health Systems 20/20 is developing a health expenditure module to incorporate into existing District Health Information System (DHIS) in Liberia • Module will collect data on unit costs of service delivery (drugs/commodities, provider time, etc.) to develop nationwide picture of health spending at public facilities

  16. Consolidating health expenditure data from donors and NGOs • Collecting donor & NGO health expenditure data currently requires surveys for each NHA estimation • Health Systems 20/20 is developing a system for routine collection of donor and NGO health expenditure data that will: • Increase the consistency, comparability, and availability of data for health policy planning • Facilitate inter-agency coordination of health spending • Feed directly into RT activities • Currently developing pilot activity in Liberia

  17. Looking ahead…

  18. Looking ahead, the Health Systems 20/20 Project is ready to: • Coordinate in-country activities • Contribute to future discussions • Collaborate on next action steps • Learn from others

  19. Health Systems 20/20 is USAID’s global health project to strengthen health systems in developing countries, focusing on integrated financing, governance, operational and capacity building. Thank you Reports related to National Health Accounts are available at www.HS2020.org

  20. Annex 1: Illustrative comparison of NHA, NASA and PER National Health Accounts (NHA) • Internationally-accepted framework for estimating health expenditures • Detailed classifications for categorizing health expenditures by financing source, financial agent, health provider, or function • Subaccount methodology allows for more detailed assessments of specific health areas – like HIV/AIDS, malaria, child health etc National AIDS Spending Assessment (NASA) • Developed by UNAIDS to track all financial flows for responding to HIV/AIDS • Detailed classifications for source, agent, function, provider, beneficiary population etc. Public Expenditure Review (PER) • Developed by World Bank to assess public spending in social sectors, including health • Policy review and analysis tool; examines whether spending is aligned with policy priorities • No fixed or standardized classifications and reporting requirements

  21. Annex 2: Illustrative comparison of general NHA, subaccounts, and NASA *As addendum

  22. Annex 3: HS 20/20 NHAs in 2009-2010 22

More Related