Big Problems, Simple Solutions
Estimation Year
2006
Intended Policy Goals
As Yemen began implementing decentralization policies it saw the need to initiate governorate health accounts (GHA) pilots in several of its governorates. Amran, also known as the golden governorate because of the close links between its population and the government, carried out a GHA in 2006. Being the “golden” governorate and also a favorite among donors because of its close proximity to the capital and therefore the perfect location for pilot studies, the governorate expected the GHA to show exceptional results in comparison to other governorates. The GHA, however, carried a surprise for the Amran health officials in that 34.7% of total household expenditure was leaking out of the governorate; 21.7% into neighboring governorates and 13% to the rest of the world. This problem was magnified by the fact that the GHA also showed that household expenditure made up over 60% of the total health expenditure per capita, which meant that Amran was losing approximately $4.5 per capita to neighboring governorates.
Actual Policy Use
These findings in turn led to yet a bigger surprise. After a deeper look into the situation, the Amran health officials found that its citizens were going into neighboring governorates to seek reproductive health services. This discovery led to a discussion among officials regarding possible solutions. Eventually two gynecologists were hired to work in Amran's main hospitals which led to retention of 70-90% of the HH expenditure per capita previously lost to neighboring governorates. While the loss of approximately 1/4 of HH expenditure to neighboring governorates could have remained a problem for years, this "big" problem was discovered through the GHA and promptly followed by the implementation of a "simple" solution, exemplifying the importance and necessity of conducting health accounts.
Source
Pathfinder International - Yemen
