better systems, better health
National Health Accounts Production Tool OVERVIEW
IMPACT
The National Health Accounts (NHA) framework is an internationally standardized methodology for measuring financial resource flows in the health sector. NHA is designed to provide health expenditure information to policymakers and stakeholders in ways that can be clearly and directly linked to a country’s health financing concerns and health system performance. It has therefore been accepted as a critical policy input in many countries.
Health Systems 20/20 has supported 17 countries in conducting their NHAs. These experiences culminated in the creation of the NHA Production Tool. In addition to improving data quality and consistency, the NHA Production Tool is expected to reduce the time, labor, and financial resources required to produce a NHA estimation. A projected 30 percent cost savings is anticipated, primarily because less external assistance is needed by the host country when they utilize the tool. NHA Production Tool trainings for in-country NHA teams have taken place in Liberia, Ethiopia, Botswana, Malawi, and Trinidad and Tobago. Additionally, the tool is currently being used to produce NHA estimates for St. Kitts and Nevis and Dominica.
The complexity of the NHA methodology, however, has been an important deterrent to routine, consistent, and low-cost production of NHA estimates. As a result, many lowincome countries have come to rely on foreign technical assistance to implement NHAs. Further, inconsistencies in estimation techniques compromise the quality and comparability of NHA results. Together, these challenges have prevented many low-income countries from fully institutionalizing NHA. The NHA Production Tool lessens the complexity of the NHA exercise by providing step-by-step guidance to in-country NHA teams, reducing the need for technical assistance and increasing local capacity for NHA production.
FEATURES Health Systems 20/20 developed the NHA Production Tool software with input and support from NHA country teams and key stakeholders including the World Health Organization and the World Bank. Key features of the tool include: yy Step-by-step directions to guide country teams through the NHA which methodology greatly simplify the data collection and entry process and allow non-NHA experts to complete an estimation with reduced external assistance yy Screen by screen video tutorials to make the tool more user friendly
The NHA Production Tool uses core classifications as provided by the Organization for Economic Co-operation and Development (OECD) System of Health Accounts (SHA). Additionally, local teams can create countryspecific codes to be used in their NHA. This ensures that the data will be internationally comparable while allowing the data to address country-specific policy questions. The English and French language versions of the NHA Production Tool are currently ready for use by country NHA teams. The tool should be available for download from the World Health Organization’s website later in 2012. A Spanish language version of the application will also be available in the near future.
yy Platform to manage complex datasets to reduce the burden of data management yy Survey creator and importer to streamline data collection and the data analysis process yy Built-in auditing function to facilitate review and correction for possible double-counting yy Report generator for simplified NHA table creation yy Interactive diagram feature to assist NHA teams visualize and critically analyze the flow of funding through the health sector, providing an easily understandable medium for explaining expenditure flows in a way that is more accessible to those unfamiliar with NHA terminology
For further information, please contact Douglas Glandon at Douglas_Glandon@abtassoc.com.
yy Data sharing feature to allow multiple users to work together on the same NHA estimation and to facilitate remote quality assurance if required
Health Systems 20/20 is USAID’s flagship project for strengthening health systems worldwide. By supporting countries to improve their health financing, governance, operations, and institutional capacities, Health Systems 20/20 helps eliminate barriers to the delivery and use of priority health care, such as HIV/AIDS services, tuberculosis treatment, reproductive health services, and maternal and child health care. Abt Associates leads a team of partners that includes: Aga Khan Foundation | Bitrán y Asociados | BRAC University | Broad Branch Associates | Deloitte Consulting, LLP | Forum One Communications | RTI International | Training Resources Group | Tulane University School of Public Health
DISCLAIMER:The author’s views expressed here do not necessarily reflect the views of the United States Agency for International Development or the U.S. Government. For more information about Health Systems 20/20 please contact: Health Systems 20/20 | Abt Associates | www.abtassociates.com 4550 Montgomery Avenue | Suite 800 North | Bethesda, MD 20814 | USA E-mail: info@healthsystems2020.org | www.healthsystems2020.org July 2012