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 results NHA findings impact on health policies Future Plans

Classification of NHA Institutionalization process in Georgia

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 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)

Total health expenditure as % of GDP

2001 2002 2003 2004 2005 2006 2007 20080

200

400

600

800

1,000

1,200

1,400

1,600

1,800

07%

08%

09%

522 651 725 836998

1,1601,387

1,6607.8%

8.7%8.5% 8.5%

8.6%8.4% 8.2%

8.7%

Total Health Expenditure (Mill GEL) % of GDP

NHA

Public Health Expenditure

2001 2002 2003 2004 2005 2006 2007 20080

50

100

150

200

250

300

350

400

0%

1%

2%

3%

4%

5%

6%

7%

8%

75 88109

130196

255256

343

1.1% 1.2% 1.3% 1.3%1.7% 1.8%

1.5%1.8%

6.1% 6.3%6.7%

5.4%6.0% 5.7%

4.2%

4.9%

Public Health Expenditure (Mill GEL) % of GDP

% of Government Expenditure

NHA

Total health Expenditure strucuture by financial sources (%)

2001 2002 2003 2004 2005 2006 2007 2008

14% 14% 15% 16% 20% 22% 18% 21%

77% 74% 78% 78% 78% 73% 72% 69%

9% 12% 7% 6% 3% 5% 9% 11%

Public Expenditure Private Expenditure International Aid

NHA

Per capita Total health expenditure (GEL)

2001 2002 2003 2004 2005 2006 2007 20080

50

100

150

200

250

300

350

400

84 106 130 152 178 193230 261

2124

2530

4557

5878

1018

1312

614

29

40

International Aid Public Private

NHA

NHA findings impact on health policies (1)

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.

Results are included into WHO NHA data base 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. Medium Term Expenditure Framework 2006-2010

Program budgeting process oriented on the results of 2011-2014 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 2002-2007 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.

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.

World Health statistics report 2008-2010 (WHO). 2001-2008 NHA Data were used in World Health statistics report 2008-2010

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.

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.

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.

Preparation of 2009 NHA will be finished until the end of 2010.

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.

Thank you for your Attention!