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Afghanistan

Tracking Resources for Health Care

Afghanistan is taking a two-pronged approach to National Health Accounts (NHA): It is carrying out its first NHA estimation while simultaneously taking steps to “institutionalize” the methodology. Health Systems 20/20 is providing technical support to both processes.

NHA is a tool that more than 50 low- and middle-income countries use to measure and track the flow of public, private, and donor funds through the health sector.

In Afghanistan, health financing is shared by the Ministry of Public Health (MOPH) and international donors who contribute to funding the Basic Package of Health Services for primary care, and the Essential Package of Health Services for secondary care. NHA findings are intended to inform health care policy and program design, implementation, and evaluation, and to compare one country’s expenditures with those of other countries.

Health Systems 20/20 has trained two Afghan advisors, based at the MOPH, who will form the core of the country’s NHA technical team. The ministry and the Afghan Central Statistics Office (CSO) have agreed that, in the future, the CSO will house the team compiling the data and household health expenditure data will be collected through inclusion of a health expenditure questions in the biannual National Risk and Vulnerability Assessment survey. This will allow for NHA to be carried out, and results disseminated, biannually.

To simplify future NHA estimations and increase their accuracy, Health Systems 20/20 is working with the MOHP to standardize how data are reported from different sources. It is working with the ministry to collect service cost information, which, combined with utilization data currently reported by health facilities, will allow better understanding of the cost of delivering inpatient and outpatient services and thus better utilization of resources.