Joint OECD-World Bank Meeting on the Institutionalisation of National Health Accounts

RESOURCE TRACKING FOR BETTER HEALTH OUTCOMES
6-7 October 2011, OECD Headquarters, Paris 

Participants | Objectives | Documents | Key Take-Aways | Photos 

With the support of the Bill and Melinda Gates Foundation and in collaboration with development partners, the World Bank has been coordinating a global initiative to improve resource tracking for better health outcomes and greater health systems accountability through institutionalisation of National Health Accounts. The preparatory phase of this global initiative culminated with a high-level meeting in Paris on 6-7 October 2011.

Participants

160 participants (PDF 262kb) joined the global NHA institutionalization event on 6-7 October, including five Ministers (Egypt, Tanzania, Senegal, Benin, Maldives), senior policy leaders (Secretaries of Health, Under Secretaries, Deputy Ministers and Secretary Generals) as well as technical experts from ~35 low and middle countries, and ~15 OECD countries, including Turkey, Mexico, USA, UK, Japan, Denmark, the Netherlands, France, Israel and Switzerland. Several development partners (WB, WHO, USAID, OECD, African Development Bank), donor agencies (BMGF, NORAD, JICA, AFD), regional observatories, civil society and academia facilitated the debates, listen and contributed to the country discussions.

Objectives

Day 1 (October 6th) specifically targeted producers of NHA who lead national institutionalization efforts. The main objective was to provide a platform for strategic and technical discussions on how to build financially sustainable country capacity for routine production and dissemination of NHA. It provided an opportunity to forge relationships across OECD/non-OECD countries and benefit from the expertise of countries who have institutionalized resource tracking.

Day 2 (October 7th) was geared primarily towards national policy makers. The objective was to provide a forum for senior policy makers to discuss NHA institutionalization in the context of national health sector reform and leadership accountability.

 Documents

• Agenda (PDF 1.07MB)
• Presentations 
• Strategic Guide: Where is the money and what are we doing with it? 

The October meeting was held co-jointly with the OECD, at the occasion of the annual OECD Meeting of Health Accounts Experts in Paris.

Key Take-Aways

Overall, there was a strong demand from participants to link NHA and resource tracking initiatives with key priority health policy issues. The consensus was that NHA has to be embedded within major policy initiatives, and cannot be done as an isolated exercise. There was also consensus that resource tracking activities need to be country owned and that any global activities or targets should support country activities, not drive them.

At least three priority policy issues emerged:

1. Financial protection and effective risk pooling mechanism (this discussion often led to interest in establishing or expanding health insurance as a mechanism)
2. Measuring and monitoring Equity in health resource allocation and use - especially in terms of geographic, income, special vulnerable groups
3. Resource tracking by priority programs (e.g., MCH/RH) and disease categories (HIV/AIDS, TB, Malaria, NCDs) in a consistent manner.

Furthermore, participants agreed that:

• NHA needs to be a country-owned rather than external agency-led process from the start;
• Institutionalization requires a full cycle of NHA activities that needs to be embedded within a country’s planning and budgeting processes. This includes demand for data by country leaders; production of NHA; dissemination and translation of NHA data; and finally, the use and application of NHA for policy decisions.
• When there is demand for data use, production problems and constraints are usually addressed;
• There is a need to combine NHA data with other sources of information to generate an evidence-based for country-led decision-making.
• NHA provide national decision makers with essential financial information on a country’s health system, and facilitate more sustainable, equitable and efficient allocation of resources. NHA thus represent a cost-effective, “smart” investment for countries.
• Development partners/external agencies could perhaps focus on capacity-building for evidence-based policy-making and integrate support for NHA under this broader approach.

 The day in images