As health systems evolve to respond to changing demographics, disease patterns and complex financing mechanisms, governments are increasingly asked to provide transparent and accurate data on how much is being spent on health. WHO/Europe is now urging countries to make use of the international System of Health Accounts (SHA) developed jointly by WHO, the Organisation for Economic Co-operation and Development (OECD) and Eurostat to address this specific need.
When countries are able to track health spending data accurately, they can assess their health resources, the efficiency and effectiveness of resource allocation, and the equity of health-care delivery. It can also help monitor progress towards important goals, such as universal health coverage.
The SHA is a framework that helps countries improve their understanding of how health-related spending is used. For example, it can help identify who benefits from the spending, the purpose for which it is applied (which diseases or conditions), the type of care being provided (prevention, outpatient or inpatient care), and the sources of funds as well as the financing schemes.
In the past 6 years, interest has grown among the countries of eastern Europe, central Asia and the western Balkans in using the SHA to track health spending. WHO is addressing this demand by providing technical support to countries in developing and producing the evidence and utilizing it in policy-making.
Tracking health spending using the SHA
WHO/Europe recently held a joint workshop for health policy-makers and financing experts from 16 countries in eastern Europe, central Asia and the western Balkans, encouraging governments to move to a new phase of health spending tracking.
Held in Istanbul, the “5th Sub-regional European meeting on tracking health spending using the SHA” saw renewed commitment to better and more transparent data in health spending across this group of countries.
“The health accounts data offer a comprehensive and internationally comparable overview of health spending in countries in the WHO European Region, providing valuable insights for policy-makers to make informed decisions,” said Dr Tamás Evetovits, Head of the WHO Barcelona Office for Health Systems Financing, the WHO/Europe office leading in this area of work. The results produced by standardization of data reporting based on the SHA methodology are published in the widely used Global Health Expenditure Database (GHED), making them easily accessible for researchers, policy-makers and other stakeholders to use for evidence-informed policy-making and strategic planning.
One key factor related to the SHA methodology is the need to regularly present health accounts data and develop tailored reports that offer insights into a country’s health system. This in turn helps address public health priorities such as strengthening primary health care and mental health services, and illuminate out-of-pocket spending on medicines.
“To increase the relevance and usefulness of health accounts at country level, Member States are encouraged to focus their tracking of health spending reports on the most relevant policy questions in their specific country contexts. In addition to the tailored country support provided by WHO, countries benefit from the comparative analytical reports on the most pressing health system issues at regional level produced by our office using health accounts data,” added Baktygul Akkazieva, Technical Officer at the WHO Barcelona Office for Health Systems Financing.