Has Improved Availability of Health Expenditure Data Contributed to Evidence-Based Policymaking? Country Experiences with National Health Accounts

2003

• Has Improved Availability of Health Expenditure Data Contributed to Evidence-Based Policymaking? Country Experiences with National Health Accounts

• • • • Figure 4: Household Out-of-Pocket Expenditures as a Share of Total Health Care Spending in Egypt ...17
      • Informing discussions to restructure primary health care in Egypt: The Egyptian Ministry of

Health and Population (MOHP) and collaborating international agencies (World Bank, USAID, and European Commission [EC]) used findings from NHA as well as nonfinancial data to initiate a policy dialogue that led to the design and ongoing implementation of a primary health care restructuring initiative. NHA results contributed to the promotion of this initiative by showing that Egypt spent nearly 4 percent of its gross domestic product (GDP) on health care, with household out-of-pocket expenditures amounting to almost 50 percent of total expenditures and the MOHP accounting for less than 20 percent of the total (see Figure 4). While the sum spent on primary care should be adequate to provide a set of basic services to all, most of these resources were not organized or allocated efficiently. The burden of expenditures was inequitably distributed, with the poor paying the largest share of their income for care. This form of financing also resulted in lower levels of access by the poor and those living in rural areas. Such findings provided the then Egyptian Minister of Health and Population with the needed information to convince the People’s Assembly, the public, and those working within the MOHP of the need to significantly restructure the way primary health care was organized and financed in Egypt. In addition, NHA provided valuable information to the World Bank, USAID, and EC to inform their own discussions with the government. Consequently, the Minister of Health and the international donors, through a series of discussions, were able to arrive at a mutually acceptable reform agenda as well as receive financing support.3