How to do (or not to do) … translation of national health accounts data to evidence for policy making in a low resourced setting

Abstract

For more than a decade, the Organization for Economic Co-operation and Development (OECD), the World Health Organization (WHO) and the World Bank have promoted the international standardization of National Health Accounts (NHA) for reporting global statistics on public, private and donor health expenditure and improve the quality of evidence-based decision-making at country level. A 2010-2012 World Bank review of NHA activity in 50 countries found structural and technical constraints (rather than cost) were key impediments to institutionalizing NHA in many low- and middle-income countries (LMICs). Pilot projects focused resources on data production, neglecting longer-term capacity building for analysing the data, developing ownership among local stakeholders and establishing routine production, utilization and dissemination of NHA data. Hence, genuine institutionalization of NHA in most LMICs has been slow to materialize. International manuals focus on the production of NHA data and do not include practical, incremental and low-cost strategies to guide countries in translating the data into evidence for policy-making. The main aim of this article is to recommend strategies for bridging this divide between production and utilization of NHA data in low-resource settings. The article begins by discussing the origins and purpose of NHA, including factors currently undermining their uptake. The focus then turns to the development and application of strategies to assist LMICs in 'unlocking' the hidden value of their NHA. The article draws on the example of Fiji, a country currently attempting to integrate their NHA data into policy formulation, despite minimal resources, training and familiarity with economic analysis of health systems. Simple, low cost recommendations such as embedding health finance indicators in planning documents, a user-friendly NHA guide for evaluating local health priorities, and sharing NHA data for collaborative research have helped translate NHA from raw data to evidence for policymaking.

How to do (or not to do) … a health financing incidence analysis

“… , and ) should be obtained from NHA data. An earlier paper in this series shows the various uses of the NHA ( Price et al 2016 ). Generally, for countries where data are available, NHA country tables can be found at http://www.who.int/health-accounts/en .…”

How Do Countries Use Resource Tracking Data to Inform Policy Change: Shining Light into the Black Box

“…19 Participants in the November 2016 HFG-WHO peer learning workshop 20,21 cited (1) effective dissemination to ensure that decision makers who can influence policy change get the data, (2) engaging those stakeholders regularly and continuously, and (3) presenting results and products that clearly link data directly to policy as the driving factors that influence the use of health accounts data in their countries. We did find a set of factors associated with data playing a greater role in decision making.…”

“…Some countries including Fiji have included "output" indicators such as the production of health accounts data to ensure the production of resource tracking data. 19 Some factors that facilitate the use of data will always remain outside of the local country resource tracking team's control. Some of these emerged from the literature review and the key informant interviews.…”

Apuntes para una estrategia de medicamentos “esenciales” para Latinoamérica

“…Desde esa lógica, el destino de las poblaciones y su acceso al derecho a salud es una "variable" que no tiene deadlines urgentes: 2015… 2030… Los seres vivos que en estos tiempos flexibles son excluidos, y mueren sin dignidad, son efectos adversos indeseables. Es importante utilizarlos como datos -posiblemente retrospectivos, neutros, globales, no vinculables a responsabilidades precisas-para medir outcomes de programas-promesas, que sean éxitos o fracasos: el problema de la accountability no es pertinente para los que deciden y mandan (12,13,14,15,16,17,18) .…”