Technical support to produce and institutionalize the System of Health Accounts (2011) in former Soviet Union countries and the Balkans

The objective of the project was to continue to support the World Health Organisation (WHO) Barcelona Office in:

  • Providing technical support to the selected countries in the WHO European Region to institutionalize the System of Health Accounts (SHA) in  their routine  information systems and to  produce  health accounts (HA) on  a   routine base including disease expenditure estimates; and
  • Validating and updating the WHO Global Health Expenditure Database (GHED).

The assignment covered phase I of the project from  May 20 to August 31, 2020.

The CGC HA team was responsible for carrying out the  following tasks to accomplish both objectives:

 Objective 1.     Provide technical support to produce full HA study for 2018, including disease expenditures and to institutionalize HA:

  • Production of full HA studies in six countries:
    • Check and review collected 2018 health expenditure data from different sources by the country HA teams based on relevant international experience;
    • Check and review mapped health expenditure data of 2018 (by the country HA teams) according to the SHA 2011 framework (financial sources, financing schemes, factors of provision, functions, providers, disease, and age);
    • Review and check the quality of produced HA studies’ results including disease expenditure, in particular, the HA matrixes/tables;
    • Contribute to the finalization of the HA studies (matrixes/tables and methodology) by sharing relevant international experience and providing the technical guidance;
    • Ensure that the country HA teams submit the latest and correct HA studies to WHO;
  • Ensure completion of HA studies for 2016, 2017 and 2018 for three countries – Georgia, Kyrgyzstan and Republic of Moldova (conditional upon political turmoil or the epidemic situation);
  • Guide the efforts to finalize the institutionalization process to collect health expenditure data on a routine base in three countries – Georgia, North Macedonia, Kyrgyzstan;
  • Guide the efforts of in-country actors to start data collection for HA production in Montenegro;
  • Guide the local HA team to prepare a country-specific methodology to produce HA on a routine base and make sure it is very well documented in Georgia.

Objective 2:   Support and validate the health expenditure data for 2018 to be consistent with the previous time-series 2000-2017 within the framework of Global Health Expenditure Database/GHED) for Belarus, Georgia, Kyrgyzstan, North Macedonia, Republic of Moldova and Tajikistan.

  • Support the preparation of and review/check of 2018 data for the GHED in order to have a consistent time series 2000-2018, if needed to adjust the previous data and explain any changes in data collection methodology, health reforms/landscape;
  • Review the HA questionnaires 2020 and country metadata and notes (provided by the countries), as needed;
  • Conduct data quality checks, resolve all errors and provide explanations where needed;
  • Research a country’s health system and their financing mechanisms to ensure reforms and historical changes are reflected in time series if needed and produce a “financing schemes” and “revenues” table with the flow of funds under the guidance of WHO;
  • Provide methodological support (with GHED data) for the Regional report on tracking health expenditures in the European region.

The team succeeded in:

  • the development of the country-tailored HA production methodology (based on the SHA 2011 framework) and HA production in the HAPT in Georiga and Montenegro, and revision of the HA production methodology in Belarus.
  • Transferring of the HA production process into national statistics services in North Macedonia and Kyrgyzstan, although the latter was not able to produce HA in HAPT due to the lack of data.