National Health Accounts Bosnia Herzegovina

Presented by:Stephen BattsSenior 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?

Money2009 - 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 information1. Health Policy2. Health Budgeting and

Financing3. Tracking resources4. Equity /Access5. Efficiency of health spending6. Public health issues

Who?

Key institutions necessary to participate in NHA Level of BiH:

• Ministry of Civil Affairs BiH (lead institution)

• Agency for statistics BiHFederation of BiH:

• Institute of Statistics Federation BiH

• Ministry of Health Federation BiH• Health insurance fund Federation

BiH• Public Health Institute Federation

BiH• Ministry of Finances Federation

BiHRepublic of Srpska:

• Institute of Statistics RS• Ministry of Health AND Social

Welfare RS• Health insurance fund RS• Public Health Institute RS• Ministry of Finances RSBrcko District:• Statistical Office of Brcko district• Health Insurance Fund BD• Department of Health Brcko District

Private Sector and BusinessOther ministries – Defense,

Labor and Social Affairs, Education, etc

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....

BiHHealth 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

1. Create demand on the part of policymakers for institutionalization;

 

2. Determine a location where NHA is housed;

5 Main Steps..........3. 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;

 5. Developing a health/welfare policy and

planning unit is essential.

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

Thank YOU