Data for HD PERs Mattias Lundberg March, 2005

What data do you need?What data do you need? –Population status, outcomes –System: ‘real’ resources and management Supply side Demand side –Finance Sources Uses Data for HD PERs

Where can you find it?Where can you find it? –Population status, outcomes Health information systems / vital registries Sector assessments (ministries, NGOs, WB, WHO, etc) Poverty assessments Household surveys (eg LSMS) DHS / MICS Data for HD PERs

Where can you find it?Where can you find it? –System (supply side) Ministries (eg finance, health, social security) International agencies –WB/IMF (GFS, CEM, MTEF, PRSP/PRGF, HIPC, project/loan documents…) –WHO, PAHO, OECD Survey data (eg QSDS/PETS) National Health Accounts Data for HD PERs

Where can you find it?Where can you find it? –System (demand side) Ministries (eg finance, health, social security) International agencies Household survey data (eg LSMS) DHS / MICS Firm surveys Provider reports and surveys Data for HD PERs

Where can you find it?Where can you find it? –Finance National Health Accounts National Accounts Consolidated government budget documents Line ministries International agencies (IMF GFS, etc) Surveys (QSDS/PETS) Firm surveys – training and health spending Facilities surveys (schools and health facilities) Data for HD PERs

Where can you find it?Where can you find it? –Finance (out-of-pocket) Published sources (eg sector reports, poverty assessments) DHS – maybe Household surveys – spending on health and education services Data for HD PERs

Data problems (1): Unknown population (on the demand side)Data problems (1): Unknown population (on the demand side) Data for HD PERs

Data problems (1): Unknown population (on the supply side)Data problems (1): Unknown population (on the supply side) Data for HD PERs

Data problems (2): Budgets neither comprehensive nor unifiedData problems (2): Budgets neither comprehensive nor unified –Different parts of the central government Various line ministries, military and veterans’ care, social security system, ministry of finance –Different parts of the general government National, provincial, municipal –Debt, arrears, etc. often excluded Data for HD PERs

Financial flows in Turkey’s health sectorFinancial flows in Turkey’s health sector Data for HD PERs Private Public SourcesFinancing AgentsHealth Providers Taxes Public Payments Public Institutions Social Security Funds Liabilities Public Private Credits Private Sector / Private Insurance Enterprices Employers Private Household Out-of Pocket Loans Loans Aids Out-of-Pocket Expenditures Employers

Financial flows in Turkey’s health sectorFinancial flows in Turkey’s health sector Data for HD PERs

Financial flows in Turkey’s health sector – data sourcesFinancial flows in Turkey’s health sector – data sources Associations (3704) Foundations (256) Private hospitals Private health insurance companies Private businesses State-owned economic enterprises Privatization Administration Social Security units Municipalities (3200) Provincial administrations (81) Households (10,675) Data for HD PERs

Social protection in GuatemalaSocial protection in Guatemala –According to GFS, spending on SP is 1% of GDP But cull through ministries and agencies looking for programs you might expect to find and be labeled SP –spending on SP is actually 1.8% of GDP Data for HD PERs

Social protection in UkraineSocial protection in Ukraine Data for HD PERs

Health in MozambiqueHealth in Mozambique Data for HD PERs

Health in VietnamHealth in Vietnam Data for HD PERs

Data problems (3): Domestic off-budget revenue and expensesData problems (3): Domestic off-budget revenue and expenses –10 to 15% of GDP China in 1998 (70-120% of public budget) –Off-budget borrowing by gov’t agencies in the Czech Republic equal to 13% of GDP in 1998 –In Turkey in 1999: 3,000 off-budget agencies in health and education social security institutions “outside budget coverage” Data for HD PERs

Data problems (4): Donors and NGOsData problems (4): Donors and NGOs –Donors can provide half of health expenditure (Mozambique, Tanzania, Uganda) –a large part of which is off-budget (more than half in Tanzania and Malawi) –Donors often provide majority of funds for certain activities (donor spending on HIV/AIDS equivalent to a 50% increase in the national health budget in Uganda). Data for HD PERs

Data problems (5): What to do with missing and conflicting dataData problems (5): What to do with missing and conflicting data –Be conservative. –Do sensitivity analysis. –If only some data is missing, the first choice is to do nothing. –Be explicit about how the numbers were made up. Data for HD PERs

Web addresses:Web addresses: –NHA –PETS/QSDS –Household surveys Data for HD PERs