Impact of NHA Findings on Health Policies in Georgia Sofia Lebanidze Ministry of Labour Health and Social Affairs of Georgia Helsinki, 2010

Overview NHA Institutionalization: A historical review NHA Institutionalization: A historical review NHA results NHA results NHA findings impact on health policies NHA findings impact on health policies Future Plans Future Plans

Classification of NHA Institutionalization process in Georgia Phase I. Familiarization - NHA familiarization process at the MoLHSA (2003) Phase I. Familiarization - NHA familiarization process at the MoLHSA (2003) Phase II. NHA development and production - Technical support from WB, USAID, Abt Associates & Curatio International Foundation (CIF) (2004 – 2005) Phase II. NHA development and production - Technical support from WB, USAID, Abt Associates & Curatio International Foundation (CIF) (2004 – 2005) Phase III. Institutionalization – Governmental Decree regarding NHA institutionalization in the country (2006) Phase III. Institutionalization – Governmental Decree regarding NHA institutionalization in the country (2006) Phase IV. Beyond institutionalization – MoLHSA responsibility for NHA production (from 2007 up to now) Phase IV. Beyond institutionalization – MoLHSA responsibility for NHA production (from 2007 up to now)

Total health expenditure as % of GDP NHA

Public Health Expenditure NHA

Total health Expenditure strucuture by financial sources (%) NHA

Per capita Total health expenditure (GEL) NHA

NHA findings impact on health policies (1) NHA results are used for international comparison NHA results are used for international comparison NHA is also used to compute policy-related indicators such as per capita health spending, health expenditures as a percentage of the gross domestic product (GDP) and different indicators. NHA is also used to compute policy-related indicators such as per capita health spending, health expenditures as a percentage of the gross domestic product (GDP) and different indicators. Results are included into WHO NHA data base Results are included into WHO NHA data base NHA results are used to examine health financing policy issues NHA results are used to examine health financing policy issues  Allocation of Government Health Care Funding to Priority Services and Populations – a simulation tool for defining the health benefit package in Georgia.

NHA findings impact on health policies (2) NHA results used in Health Care Budget Planning. NHA results used in Health Care Budget Planning.  Medium Term Expenditure Framework  Program budgeting process oriented on the results of uses 2008 NHA results as a basis for evaluation and monitoring of annual outcomes.  Technical documents of State Health Programs use NHA findings for describing existing situation and pricing the services.

NHA findings impact on health policies (3) Report on Distribution of Health Payments and Catastrophic Expenditures in Georgia uses NHA data Report on Distribution of Health Payments and Catastrophic Expenditures in Georgia uses NHA data In 2008 Georgia Health System Performance Assessment Report was prepared, where from selected 42 indicators 7 were developed on the basis of NHA Results. In 2008 Georgia Health System Performance Assessment Report was prepared, where from selected 42 indicators 7 were developed on the basis of NHA Results. NHA data was used by actuary organization in calculation of government state programs premiums estimations and NHA Findings; by insurance companies and actuary organizations for calculation of Insurance premiums. NHA data was used by actuary organization in calculation of government state programs premiums estimations and NHA Findings; by insurance companies and actuary organizations for calculation of Insurance premiums. During Hospitals privatization process, investors used NHA results for planning their hospital expenditures and revenues based on NHA data and different materials. During Hospitals privatization process, investors used NHA results for planning their hospital expenditures and revenues based on NHA data and different materials. World Health statistics report (WHO) NHA Data were used in World Health statistics report World Health statistics report (WHO) NHA Data were used in World Health statistics report

NHA findings impact on health policies (4) AIDS Spending Assessments report (NASA) - expenditure chapter of 2007 UNGASS report was prepared on the basis of NHA data. AIDS Spending Assessments report (NASA) - expenditure chapter of 2007 UNGASS report was prepared on the basis of NHA data. NHA Data on HIV/AIDS was also used to prepare HIV/AIDS country strategy. NHA Data on HIV/AIDS was also used to prepare HIV/AIDS country strategy. TB NHA Sub-Analysis results were used by MoLHSA and donor organizations in evaluation of National Strategy plan for TB. TB NHA Sub-Analysis results were used by MoLHSA and donor organizations in evaluation of National Strategy plan for TB. Based on the Reproductive NHA Sub-Analysis results of sub-analysis and RH survey (2000, 2005) Country RH Strategy was developed Based on the Reproductive NHA Sub-Analysis results of sub-analysis and RH survey (2000, 2005) Country RH Strategy was developed

Future Plans Soon the analytical document of the 2001 – 2009 NHA accounts will be finished; Standardized NHA analysis will be included in the MoLHSA annual National Health Report. Soon the analytical document of the 2001 – 2009 NHA accounts will be finished; Standardized NHA analysis will be included in the MoLHSA annual National Health Report. Preparation of 2009 NHA will be finished until the end of Preparation of 2009 NHA will be finished until the end of In 2010 carry out the second round of HH in-depth survey with the support and financing of GHSPIC to estimate private out of pocket health expenditures. In 2010 carry out the second round of HH in-depth survey with the support and financing of GHSPIC to estimate private out of pocket health expenditures.

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