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1. PURPOSES AND PRINCIPLES OF THE SHA
There are different health systems in the countries which need one common standard framework to describe and capture all the flow of funds in health systems. This challenge involves an initial effort to delimit health systems and the diversity of their structures. A standard framework which consolidates previous work on health accounts such as SHA1.0, NHA Producers Guide, Satellite accounts, SNA is required for collating data to meet the national requirements and international reporting needs. A framework for health accounts is proposed which would provide data for research and analytical use.
Principles and analytical use
Principles
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Health expenditure definition to be reviewed in view of the current accounting practices (SNA, SHA/PG), health system definitions and analytical dimensions
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The boundaries for health accounts will have to be set based on the health functions covered by the health systems,
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The classification schemes for health expenditure
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To be aligned with the current existing accounting system to ease the migration for countries already producing NHA.
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To follow the principles of statistical systems such as consistency, comprehensiveness, completeness, etc.
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To contain mutually exclusive and exhaustive categories regarding financing, Production and consumption of health services and 6 classifications: financing sources, financing schemes/agents, providers, factors of production, functions and recipients/beneficiaries.
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To address the analytical issues relevant to most health systems and also allow for basic international reporting and country specific reporting.
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Requires comprehensiveness to facilitate the passage from any distinct national institutional and information system to a common reporting system. Some experts recommend that the classifications follow international classification systems (ISIC/NACE, COFOG, COICOP etc.) to make them more consistent with National Accounting methods. (These would need to be briefly reviewed and discussed). This is important for presenting the health sector within the national economy.
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Requires coherence across the dimensions and classifications of SHA 2.0.
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To consider feasibility of measurements
Analytical relevance
- Need a framework to address analytical issues to support decision making such as
- planning the health resource requirements,
- monitoring and evaluation,
- future projections,
- measuring technical and allocative efficiency,
- measuring if the resources are allocated according to the priorities in the country - e.g. according to the burden of disease, or for the population groups needing most, or for the geographical areas poorly financed.
- There is need for
- improving comparability of health expenditure to provide information for analysis of international trends and comparison across countries
- adequately tracking how the resources are generated and used in a health system
- better contributing to the evaluation of health systems performance at national level
- better presentation of the importance of health sector within the national economy
- advocacy for donors and governments.- to support the appropriate funding requirement of health services
- evidence for policy makers to improve leadership and governance in health through increased accountability.
- Discuss applications of NHA that will assist health care administrators, policy makers, academe and researchers and advocates to strengthen national health systems
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