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National Health Accounts in Bolivia Main Policy Uses . Presenter: Marina Cárdenas Health Transformation Project - Bolivia. Main Policy Uses (1). NHA was used by the MoH in Bolivia as a tool to monitor the financial resources available to implement key public policies in the health sector

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national health accounts in bolivia main policy uses

National Health Accounts in Bolivia Main Policy Uses

Presenter: Marina Cárdenas

Health Transformation Project - Bolivia

main policy uses 1
Main Policy Uses (1)
  • NHA was used by the MoH in Bolivia as a tool to monitor the financial resources available to implement key public policies in the health sector
    • Basic Public Health Insurance
    • Budgetary negotiations with the Ministry of Finance
    • Agreements with Municipal Governments.
  • Analysis of health finance data from specific national programs
    • Expanded Immunization Program (EPI)
    • Inclusion as one of the 8 basic indicators tracked by the Health Reform Unit

Marina Cardenas NHA Bolivia

main policy uses 2
Main Policy Uses (2)
  • Succint tool that provides a complete picture of health financing in a few tables
    • Used extensively by main health authorities
  • Minister of Health, for example, included the tables in his main presentations
    • Showing the relative weight of different sub sectors and possible structural reforms that are needed to improve the efficiency of health expenditures

Marina Cardenas NHA Bolivia

main policy uses 3
Main Policy Uses (3)
  • Use of NHA data by donor agencies
    • Inclusion of NHA data in the health chapter of the World Bank’s Public Expenditure Review 1999
    • PAHO’s Country Health System Profiles

Marina Cardenas NHA Bolivia

relative weight of different subsectors possible structural reforms
Relative weight of different subsectors: Possible structural reforms

Marina Cardenas NHA Bolivia

insurance funds disparities in per capita expenditures
Insurance funds: Disparities in per capita expenditures

56

(Per capita expenditure in US$)

Marina Cardenas NHA Bolivia

policy decisions supported by this data
Policy decisions supported by this data
  • Ministry of Health uses the NHA to promote discussion on health sector reform
  • He used the NHA information to negociate with insurance funds the payment of contributions to the MOH for coverage of the Expanded Program of Immunizations
    • Up to 5% of the budget of the insurance funds transferred

Marina Cardenas NHA Bolivia

monitoring decentralization transfer of resources to municipalities
Monitoring decentralization: Transfer of resources to municipalities

in US$

Marina Cardenas NHA Bolivia

policy uses of municipal nha data
Policy uses of municipal NHA data
  • Based on annual NHA data, it is possible to built temporal series in order to monitor the continuous performance of a health system in its monetized dimension
  • Municipalities use same data to negotiate budgetary allocation from the MOH
    • Human resource allocation
  • Increased contribution of municipalities to the Universal Insurance for Mothers and Children
    • From 6.4% to 10%

Marina Cardenas NHA Bolivia

policy decisions supported by this data11
Policy decisions supported by this data
  • HIPC II funds earmarked for health
    • Previously, the health sector was executing less than 10% of HIPC I resources available for health projects

Marina Cardenas NHA Bolivia

institutional issues
Institutional issues
  • Responsibility for data collect lies with an inter-institutional NHA team
    • National Institute of Statistics, MOH/ Health Reform Project (WB), MOF, Health Transformation Project (DFID)
    • Challenge of institutionalization
  • Separation of functions: collection and policy analysis
    • Equity Health Observatory, UDAPSE (a social policy think tank)

Marina Cardenas NHA Bolivia

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