2. National Health Accounts Bosnia Herzegovina

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

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

5. 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.

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

8. Why?

9. Money
% 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

11. 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.

12. 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

15. Who?

16. 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:

17. Other Countries?

18. NHA Institutionalisation Progress

19. 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

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

21. 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

22. Next steps?

23. 5 Main Steps for Successful Implementation of SHA
Create demand on the part of policymakers for institutionalization;
Determine a location where NHA is housed;

24. 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.

25. Working Group 4
Representatives

26. Thank YOU