National Health Accounts Bosnia Herzegovina

Presented by: Stephen Batts Senior Health Finance Adviser This project is hosted by the European Union

Presentation What are NHA? Why do we need NHA? Who needs to be involved? Where are other countries with NHA? Concerns? Next steps?

What are NHA? NHA is a tool designed to assist policy-makers in their efforts to understand their health systems and to improve health system performance.

We want to track.......... Where do the resources come from? Where do the resources go?

Why?

Money 2009 - 10.9% of Gross Domestic Product was paid for financing the health care system. Curative and rehabilitation services are the most expensive with 70% of the expenses. The per capita expenses increased to 696 KM in the year 2009. Source: National Health Account, Ministry of Civil Affairs

Need for NHA? Governments are being asked by their population to provide more and better health care even though national health care budgets are limited. Need for better health care financing information that is relevant, accurate, complete, and timely financial data to the ultimate goal of providing high quality health care.

Six main classes of use of NHA information Health Policy Health Budgeting and Financing Tracking resources Equity /Access Efficiency of health spending Public health issues

Who?

Key institutions necessary to participate in NHA Level of BiH: • Institute of Statistics RS • Ministry of Civil Affairs BiH (lead institution) • Ministry of Health AND Social Welfare RS • Agency for statistics BiH • Health insurance fund RS Federation of BiH: • Public Health Institute RS • Institute of Statistics Federation BiH • Ministry of Finances RS Brcko District: • Ministry of Health Federation BiH • Statistical Office of Brcko district • Health insurance fund Federation BiH • Health Insurance Fund BD • Department of Health Brcko District • Public Health Institute Federation BiH Private Sector and Business Other ministries – Defense, Labor and Social Affairs, Education, etc • Ministry of Finances Federation BiH Republic of Srpska:

Other Countries?

NHA Institutionalisation Progress

What successful NHA countries do.. Mandate long-term commitment to produce and use NHA. Harmonize national public and private sector efforts. Ensure that professional human and financial resources are available. Fund routine production and use of NHA, not one-time exercises. Introduce long term planned incremental approach towards producing the data and continuous TRAINING

Country concerns – data integrity and getting it right....

BiH Health insurance wonders why it does not have money for Hepatitis B & C – 50 people claiming in one small area and only 3 reported..... Other examples .....multiplied

Next steps?

5 Main Steps for Successful Implementation of SHA Create demand on the part of policymakers for institutionalization;   Determine a location where NHA is housed;

5 Main Steps.......... Establish manuals, data definitions, health ID cards, IT systems and standards for data collection and analysis; training the trainers at local levels......and continuous training plan. 4. Institute data reporting requirements via legislation or other means;   Developing a health/welfare policy and planning unit is essential.

Working Group 4 Representatives........

Thank YOU