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National Health Accounts (NHA) is tool specifically designed for policy
makers and managers of the health care sector. It is designed to help them in
their efforts to improve health systems performance and make evidence-based
policy making by providing useful information about the use of financial
resources.
NHA can demonstrate how a country's health resources
are spent, on what services, and who pays for them. They are a set of
accounts that describe all expenditure flows within the health sector, both
governmental and non-governmental. In short, they describe; where does the
money come from? (sources of funding) and where does
the money go? (uses of funds). If undertaken
regularly, NHA reveals trends in health expenditure over time, an essential
element in health system monitoring and evaluation. NHA methodology can be
used to make financial projections of a country’s health system requirements
and compare their own experiences with those of other countries.
The National Health Policy 2002 had emphasized the
need to establish a National Health Accounts (NHA) system in India by the
year 2005. Against this backdrop, the NHA Cell has been setup in the Ministry
of Health and Family Welfare, Government of India in the end of July 2003.
This is one of the activities that MOHFW has taken up under the GOI-WHO
2002-2003 biennium. A Steering Committee has been constituted by the Ministry
of Health and Family Welfare to guide the NHA Cell in taking decisions on
various issues, which would emanate as a result of taking this initiative
forward in the Indian context.
The NHA cell has compiled and analyzed health
expenditure data in the country for the year 2001-02. Studies were
commissioned to fill in the data gaps. The report titled – National Health
Accounts India 2001-2002, is one of the first of its kind. The report was
released in June 2006 in a dissemination workshop. The findings of the report
are being currently being disseminated at a wider level.
The Cell is also responsible for capacity building
on NHA in the country. As part of this, a workshop titled ‘In-Country
Capacity Building Workshop on NHA’ was organized from 8-12, September 2003
for developing in house capacities both at the national and state level
across individuals and institutions to conduct this exercise. This workshop
was attended by participants from Central Government, selected state
governments, academic institutions and non-governmental research
organizations. The workshop provided valuable inputs for in house capacity
building on NHA in the country.
Thereafter, the cell organized a second workshop
titled “State Level Capacity Building Workshop on Health Accounts” from 29th
– 30th January, 2004 at India International Centre, New Delhi. With the additional knowledge
gained through preparation of health expenditure estimates for the country,
the NHA Cell proposes to conduct similar capacity building workshops in the
future on a routine basis.
Under the 2006-2007 WHO – GOI biennium, efforts are
underway to develop estimates for the year 2004-05 and initiate state health
accounts work in 6 states on a pilot basis. Towards this, a five-day Training
Programme on National Health Accounts for officials
from States of Bihar, Gujarat, Himachal
Pradesh, Madhya Pradesh, Mizoram and Tamil Nadu was organised
in September 2006. A training manual for National Health Accounts is also
currently under preparation. The manual is being developed to assist NHA and
SHA teams as well as academic researchers by imparting comprehensive
theoretical knowledge as well as practical classroom experience regarding
health accounts system in India.
Along side the process of computerization of
National Health Accounts System is underway to facilitate development of user-friendly
data entry modules as well as query based report generation.
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