Skip to Content

NHA

Using National Health Accounts to Inform Health Sector Decision Making in Egypt

National Health Accounts (NHA) estimation tracks the flow of funds through the health sector, from their sources, through financing agents, to health care providers and end uses. It does so in a comprehensive manner, attempting to capture public, private, and donor contributions. Egypt pioneered the application of the NHA framework in the Middle East region in the early 1990s, and NHA estimation is emphasized by the Ministry of Health (MOH) in Egypt as an important component of its health sector reform strategy that will help inform the policy process.

USAID, through technical assistance from Health Systems 20/20, is collaborating with the MOH to implement two consecutive rounds of NHA:

  1. A general NHA estimate for the year 2007-2008, focusing on the flow of funds from financing sources to agents and from agents to providers, and
  2. A more comprehensive round of NHA for the year 2008-2009 covering all four matrices. For this purpose a household survey as well as a survey of NGOs and public and private firms are currently being conducted.

These activities will build the capacity of the MOH in institutionalizing and replicating the NHA without donor support.

NHA 2007/2008

In late 2009, the MOH Department of Planning (DOP) with technical assistance from the Health Systems 20/20 team, finalized the NHA 2007/2008 analyses and submitted the findings to H.E. the Minister of Health. Health Systems 20/20 presented these results to MOH senior officials and to USAID. During the presentation, NHA findings and the policy implications were discussed with senior officials who gave favorable feedback and suggestions for further analyses and policy implications. Currently the DOP is preparing the final NHA 2007/2008 report.

NHA 2008/2009

Parallel to the work on NHA 2007-2008, the MOH Department of Planning (DOP), with technical assistance from the Health Systems 20/20 team, has been working to collect the data needed for a comprehensive NHA analysis for the year spanning 2008/2009. This includes the following activities:

Household Health Expenditure and Utilization Survey

Health Systems 20/20 has subcontracted with the Central Agency for Public Mobilization and Statistics (CAPMAS) to conduct a household survey covering 12,000 households in two seasons. The survey will provide comprehensive information on the type and frequency of health services used, the level and distribution of out-of-pocket spending on health care, and the factors that influence the use of and expenditures on health care. CAPMAS is considered the official Egyptian source for providing all state bodies and organizations with information that can help them make informed decisions. This partnership with CAPMAS will help ensure sustainability and promote Egypt’s ability to replicate NHA estimations in the future.

Hospital Costing Studies

With technical assistance from Health Systems 20/20, the DOP is conducting a costing study for a sample of seven hospitals selected from different governorates. As of March 2010, studies have been completed in three hospitals and the results shared with the hospital directors. Results from all seven hospitals are expected to be finalized by June 2010. As part of efforts to strengthen DOP staff’s technical capacity and to institutionalize NHA, Health Systems 20/20 is conducting 14 on-the-job training sessions on hospital costing. By the end of these trainings, the central-level DOP team will be able to conduct hospital costings and train DOP staff at the governorate level.

Survey of NGOs and Firms

Health Systems 20/20 will also work with CAPMAS to conduct a survey of NGOs and public and private firms. The objective will be to estimate their total expenditures incurred as sources, financing agents, and providers of health services. This survey will give a better picture of the current contribution of Egyptian NGOs and firms to the Egyptian health sector.

Expenditure Tracking System

Health Systems 20/20 provided technical assistance to the DOP to develop an expenditure tracking system (ETS). The ETS tool tracks expenditures by vertical programs divided into activities at different levels: central/national, governorate, district, and facility. This methodology will be applied in a representative sample of selected governorates. Information derived from this activity will be utilized in NHA 2008/2009.

Expenditure Tracking System Workshop in Egypt, September 26-29, 2009

Fifty representatives from the Department of Planning and Ministry of Health were trained in use of the Expenditure Tracking System (ETS), a tool that tracks health care expenditures at the provider level. Information collected will help policymakers make more informed decisions concerning health care expenditures and identify problem areas that require immediate attention.

At the workshop Health Systems 20/20:

  • Introduced the concept of expenditure tracking of primary care facilities and its relation to hospital expenditure and National Health Accounts (NHA)
  • Introduced the ETS methodology for primary care facilities and its use in planning and decision making
  • Equipped the trainees with the technical skills in both data collection and analysis of expenditures with an emphasis on data quality control tools
  • Equipped the trainees with the analysis skills of functional classification of health expenditures and how the results will feed into the NHA

Workforce Planning Tool in Use by MOH

Jun 7 2010

The past year marked significant efforts by the Health Systems 20/20’s Workforce Planning activity team to finalize the Workforce Planning Tool (WPT). The WPT is an Access-based application developed to assist Egypt’s Ministry of Health (MOH) to estimate health facilities’ staffing gaps.

More...

Building the Capacity of Egypt’s Health Insurance Organization (HIO) for Effective Budgeting and Financial Forecasting

Apr 1 2010

As part of efforts to support Egypt's Health Insurance Organization (HIO) to strengthen and reorganize its health care purchasing and payment functions, Health Systems 20/20 led financial management and cost accounting workshops with HIO's financial department.

More...

Meeting Health Workforce Needs in Luxor, Egypt

Dec 14 2009

Credit: Health Systems 20/20 Egypt The Egyptian Ministry of Health (MOH) is working to strengthen its capacity to roll out and sustain health sector reforms. Challenges faced include excess workforce capacity in some facilities, imbalances in the geographic and specialty distributions of health workers, and sub-optimal quality of the graduating workforce.

More...

USAID Evaluation Team Visits Egypt's Gharbia Governorate

Nov 20 2009

The U.S. Agency for International Development (USAID) has recently engaged in a 30-year retrospective of Egypt's achievements in population, health and nutrition, including an assessment USAID's role in those accomplishments. As part of this process, an evaluation team met with representatives of the agency's Health Systems 20/20 project based in Cairo. Project staff accompanied the evaluators on a visit to Gharbia Governorate in late October 2009 to showcase the project’s recent achievements in the area of workforce planning.

More...

Ensuring Adequate Human Resources for Health in Egypt

Jul 21 2009

One of the key challenges facing the Egyptian Ministry of Health (MOH) in its reform efforts is ensuring that the country has the right human capacities and workforce in place to roll out and sustain reforms. On several occasions, the Minister of Health has iterated that improvements in human capacity are key strategic priorities. Challenges facing the MOH in its efforts to manage its workforce include: excess workforce capacity; imbalances in the geographic and specialty distributions of health workers; and sub-optimal quality of graduating workforce and MOH staff.

More...

View All