Resource Tracking for Financial Accountability. Nirmala Ravishankar Washington, DC January 25, 2010. Outline. Brief Introduction to National Health Accounts NHA as one of many Resource Tracking Tools Harmonizing Resource Tracking Tools to Improve Planning and Financial Accountability
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Resource Tracking for Financial Accountability
January 25, 2010
NHA: An Introduction
Method for measuring total expenditure on health in a country including public, private, and donor contributions
Builds on OECD’s system of health accounts
Internationally accepted and tested (100+ countries)
Application to priority areas has led to development of NHA subaccounts
MANAGERS of funds: Have power and control over how funds are used i.e., programmatic responsibilities: e.g. MOH, insurance companies
End USERS of health funds: Entities that provide/ deliver health service . e.g., hospitals, clinics, health stations, pharmacies
Originators of health funds: e.g., MOF, households, donors
Actual USE of funds: Service and/or product delivered. e.g. preventive programs, curative care, admin
But NHA estimations continue to be costly,
time-consuming, and require considerable external technical assistance.
At least 25 countries are completing or have done an NHA.
Some – like Rwanda – have done multiple rounds.
Use of NHA needs to be enhanced.
Harmonized resources tracking is a key part of the institutionalization agenda.
Viewing NHA in Larger Context of Health Resource Tracking
*Sources: Powell-Jackson & Mills, A Review of Health Resource Tracking (2007); Berman, National health accounts in developing countries (1997), Schieber and Poullier, International health care spending (1986); Levine and Blumer, Gaps and Links: What do we know about resource flows in global health (2004); Ravishankar et al., Financing Global Health (2009).
Some are focused on the health sector while others are not
Some are disease-specific
Some assess past expenditures while others focus on budgets
Health Sector Planning
e.g., Health sector plans,
national AIDS strategies
Health Sector Assessment
e.g., Health PER
HIV/AIDS costing tools
e.g., NHA, NASA,
To generate evidence that can:
Harmonizing Resource Tracking Tools to Improve Policy Planning and Financial Accountability
Rationalizing data collection systems so as to reduce the burden of data reporting and increase efficiency
Greater coordination between donors and government agencies
Build linkages between RT systems to increase financial accountability
Rwanda’s Resource Tracking Harmonization Initiative
We need the Ministry’s detailed planned and executed budgets.
If we don’t coordinate data collection, we will be approaching partners 3 times!
When is MOH’s budget for upcoming FY finalized ?
Government of Rwanda
When is MOH’s executed budget for past FY finalized?
Is it correct to assume that on-budget support will follow same planning and execution cycle?
When can implementing partners report their planned expenditures for the next FY?
USG and all its implementing partners
When can implementing partners report expenditures for past GoR FY?
Using NHA data for policy use and policy reform
On harmonization of resource tracking tools:
Reports related to this presentation
available at www.healthsystems2020.org