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Understanding Health Accounts: A Primer for Policymakers

Heather Cogswell, Tesfaye Dereje


June 16, 2015
As a country’s economy and population grows, so will its spending on health. Policymakers can affect public and private health spending to improve efficiency, quality, equity, and ultimately save lives; to do this it is critical to have the necessary evidence around the health financing landscape. Health Accounts is among one of the key tools to generate evidence to inform health financing policy and later track whether those policies are working as intended.  It encompasses total health spending in a country – including public, private, household, and donor expenditures. Health Accounts carefully track the amount and flow of funds from one health care actor to another, such as the distribution of funds from the Ministry of Health to each government health provider and health service. In short, Health Accounts measures the “financial pulse” of national health systems.

This primer is an update of the earlier brief developed in 2003 and provides an introduction of Health Accounts and what its framework (System of Health Accounts 2011) entails, outlines the key steps involved in conducting Health Accounts exercises using SHA 2011 with particular emphasis on how policymakers can get involved to facilitate the process.  Included in this are descriptions of country experiences that show how Health Accounts data can be used for policy purposes, with specific attention to the importance of institutionalizing Health Accounts so that it may serve as an ongoing resource to policymakers.  The document is intended to provide insight on how Health Accounts can support health systems policymakers and managers in their work to improve health system performance and management.