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National Health Accounts

Expanding Use and Understanding of National Health Account Data in Liberia

The first National Health Account (NHA) in Liberia was conducted in 2008 for financial year 2007/08 by the Ministry of Health and Social Welfare (MOHSW) with technical support from Health Systems 20/20. The aim of the NHA was to provide a body of evidence to guide policymakers. The NHA indicated that in the government fiscal year 2007/2008, $100.5 million USD was spent on health in Liberia. This amounts to a total expenditure of $28.8 USD per capita. Donors and households financed the majority of health expenditures accounting for 47% and 35% of total health spending respectively. On average, households spent $10 per year in out-of-pocket payments. Health expenditures comprised only 7.7% of total government expenditures in 2007/2008.

Health Systems 20/20, together with the Health Financing Secretariat of the MOHSW, conducted a one-day workshop in Monrovia on December 10, 2009 to expand the use and understanding of NHA data to inform, advocate for, and evaluate health policies and funding allocations.

Deputy Minister Varpilah of the Department of Planning, Research and Development (DPRD) of the MOHSW opened the workshop held by reiterating the importance of the NHA as a useful tool for understanding and informing health policy decisions and recognizing the critical role of civil society in strengthening Liberia’s health care system. The Government of Liberia, through the MOHSW’s DPRD, is in the process of developing a national health financing policy and strategic plan. To help inform the process, the Health Financing Secretariat coordinated and conducted, with support from Health Systems 20/20, the first National Health Account (NHA) study in Liberia which included three NHA subaccounts focused on child health, malaria, and reproductive health.

Sessions at the workshop focused on engaging civil society stakeholders and were facilitated by the MOHSW health financing team and Health Systems 20/20 advisors. A similar NHA dissemination workshop targeting civil society was held in Kenya in July 2009 and lessons learned from that event were applied in Liberia.

Program MOHSW representatives for child health, malaria, and reproductive health participated along with representatives from more than 15 local and international NGOs and civil society organizations. Participants learned what the NHA is and its context within Liberia; discussed practical uses for NHA data; learned of applications of NHA data in other countries; exchanged ideas on potential policy implications of the Liberian NHA data; and proposed methods to improve the dissemination of results and future data collection processes.

The workshop contributes to Health Systems 20/20’s ongoing work in Liberia to help the MOHSW engage civil society to share information as well as to provide capacity building on the use and understanding of NHA and subaccount data focused on child health, malaria, and reproductive health.