Resource Tracking for RMNCH - WHO · 3 | Tracking RMNCH expenditure | Manila, 19-21 March 2012 Hold...
Transcript of Resource Tracking for RMNCH - WHO · 3 | Tracking RMNCH expenditure | Manila, 19-21 March 2012 Hold...
Tessa Tan-Torres Edejer
[email protected] WHO Health Systems Financing Department
Resource Tracking for RMNCH:
(reproductive, maternal, neonatal and child health)
Country Level Recommendations from Commission
4. By 2015, all 74 countries where 98% of maternal and child deaths take place are
tracking and reporting, at a minimum, two aggregate resource indicators: 1)
total health expenditure by financing source, per capita; and 2) total
reproductive, maternal, newborn and child health expenditure by financing
source, per capita.
5. By 2012, in order to facilitate resource tracking, “compacts” between country
governments and all major development partners are in place that require
reporting, based on a format to be agreed in each country, on externally
funded expenditures and predictable commitments.
6. By 2015, all governments have the capacity to regularly review health spending
(including spending on reproductive, maternal, newborn and child health) and
to relate spending to commitments, human rights, gender and other equity
goals and results.
8. By 2013, all stakeholders are publicly sharing information on commitments,
resources provided and results achieved annually, at both national and
international levels.
3 | Tracking RMNCH expenditure | Manila, 19-21 March 2012
Hold decision makers accountable to their commitments as
expressed in their national health strategic plans and also on
MDGs 4 and 5 (and/or other RMNCH goals), and MDG6.
– Assess the level and distribution of resources regarding alignment with
health sector priorities.
– Evaluate sustainability of financing over time
– Improve allocation of current spending, reduce waste of resources and
improve efficiency.
Why monitor expenditures on health and RMNCH?
4 | Tracking RMNCH expenditure | Manila, 19-21 March 2012
Country level Commitments to implement the Global Strategy Examples from WPRO
5 | Tracking RMNCH expenditure | Manila, 19-21 March 2012
THE BUDGET PROCESS
II- Operational
plan and budget
proposal
III- Budget
negotiation
IV- Budget
consolidation and
approval
V- Financial
tracking and
audit
Activity plan
Input
requirements
Input costs
Preliminary
budget
Internal revision
Negotiation with
Ministry of
Finance
Budget approval
by Ministry of
Finance
Distribution of the
budget by line
items
Monitoring of
financial
disbursements
by budgetary
line items
I- Strategic
plan
Timeline
Strategic
areas
Policies
Targets
Slide taken from a presentation by
Tania Dmytraczenko
6 | Tracking RMNCH expenditure | Manila, 19-21 March 2012
Reproductive and Maternal Health
Includes 5 priority areas identified in the Global
Reproductive Health Strategy
– Antenatal, delivery, post-partum and newborn care
– High-quality services for family planning, including infertility
services.
– Eliminating unsafe abortion.
– Combating STIs including HIV, reproductive tract infections,
reproductive health-related cancers, and other gynaecological
morbidities.
– Promoting sexual health.
7 | Tracking RMNCH expenditure | Manila, 19-21 March 2012
Child Health
Expenditures during a specified period of time on:
– goods, services and activities delivered
– to the child after birth or its caretaker
– whose primary purpose is to restore, improve and maintain the
health
– of children between zero and less than five years of age.
8 | Tracking RMNCH expenditure | Manila, 19-21 March 2012
Three levels of reporting
There are three main sources of funding for health and
RMNCH
– External resources (ODA), government and private (household)
Depending on current level of health expenditure
reporting:
– Minimum all countries, annual: RMNCH government
expenditure tracking tool; to include ODA outside of
government once compacts are developed
– If with periodic national health accounts, full distributional table,
including RMNCH
– If already with yearly NHA, full distributional table and
subaccounts (RMNCH)
9 | Tracking RMNCH expenditure | Manila, 19-21 March 2012
Examples of preliminary estimates presented by participants on 3rd day of workshop
10 | Tracking RMNCH expenditure | Manila, 19-21 March 2012
Cambodia
The Philippines
Example: government and external resource funding (annual)
11 | Tracking RMNCH expenditure | Manila, 19-21 March 2012
NHA Distributional Tables: Preferable to stand-alone subaccounts
12 | Tracking RMNCH expenditure | Manila, 19-21 March 2012
13 | Tracking RMNCH expenditure | Manila, 19-21 March 2012
Reproductive Health subaccounts:
Egypt
Ethiopia
Georgia
Jordan
Karnataka State, India
Malawi
Increasing demand for child and reproductive health subaccounts at country level, but limited implementation to date
Child Health subaccounts:
Bangladesh
Ethiopia
Liberia
Malawi
Sri Lanka
Tanzania
• Mexico
• Morocco
• Rwanda
• Senegal
• Sri Lanka
• Tanzania
• Ukraine
www.who.int/nha/developments/en/
14 | Tracking RMNCH expenditure | Manila, 19-21 March 2012
Service utilisation data used to apportion % budget / expenditure to RMNCH
Direct estimates and/or a % share allocated to RMNCH
Direct estimates
Direct estimates
1. Shared Resources (e.g., Service delivery costs,
HRH, general care)
2. Commodities (e.g., vaccines, ITNs)
3. Programme-management
specific activities (i.e., national programme budget)
Type of RMNCH expenditure / budget data
4 components
4. Incentives
15 | Tracking RMNCH expenditure | Manila, 19-21 March 2012
Total amount: Government expenditure/budget Child Health
Maternal health
Reproductive health (+ Family Planning (as a subset of RH))
RMNCH share of Government health exp (%) Child Health
Maternal health
Reproductive health
Amount spent per beneficiary Government expenditures per capita on MH, RH, CH
Government expenditures on child health per child under five years old
Government expenditures on MH per live birth
Government expenditures on RH per woman of reproductive age
Indicators for RMNCH
16 | Tracking RMNCH expenditure | Manila, 19-21 March 2012
17 | Tracking RMNCH expenditure | Manila, 19-21 March 2012
NATIONAL HEALTH ACCOUNTS (NHA) FRAMEWORK AND
GOVERNANCE
There is an officia l ly approved NHA framework bui l t upon
international guidel ines
There is a formal governance mechanism that speci fies
coordination, management, national indicators and
budget for implementing the NHA
COMPACT
There is a formal agreement (or compact) between
government and partners that requires reporting on
partner commitments and disbursements , and donor
funded expenditures on health, (including on RMNCH).
COORDINATION
There is an NHA steering committee that provides
technica l overs ight on data needs , methods of production
and data use
Key s takeholders are actively involved in the production
of NHA (including government s takeholders at national
and subnational level , CSOs , NGOS, partners , health
insurance companies )
18 | Tracking RMNCH expenditure | Manila, 19-21 March 2012
PRODUCTION
There is adequate human capacity at national and
subnational levels to produce NHA data and core
indicators .
Government expenditure data convers ion into NHA format
i s automated
There is a centra l database for automated production of
s tandard NHA tables , and methods and sources are wel l
documented and access ible
ANALYSIS
Analytica l summaries are produced annual ly including
time series , pol icy and equity analyses
NHA indicators and analyses are publicly accessible
DATA USE
NHA data including RMNCH data are an essentia l
element of annual reviews and are used in the
development of national pol icies , including RMNCH-
speci fic pol icies .