National health accounts

National health accounts in policy formulation

In order to enhance health system performance in a changing environment, policy-makers need reliable national and sub-national information on health expenditures.
National Health Accounts (NHA) are a tool specifically designed to inform the health policy process, including policy design and implementation, policy dialogue, monitoring and evaluation of health care interventions. They provide evidence to help all levels of policy-makers, non-governmental stakeholders and managers to make better decisions in their efforts to improve health system performance.

Country experience shows that NHA information is used to answer questions such as:

  • How are resources mobilized and managed for the health system?
  • Who pays and how much is paid for health care?
  • Who provides goods/services and what resources do they use?
  • How are health care funds distributed across different services/interventions/activities produced by the health system?
  • Who benefits from health care expenditure?

To answer many policy questions, NHA information must be combined with non-financial data from sources such as epidemiological studies, population surveys, and the like. The accounts themselves do not assess the effectiveness of expenditures and requires linkages to non-financial data such as health outcomes.
NHA can track health expenditure trends, an essential element in health care monitoring and evaluation. NHA methodology can also be used to make financial projections of a country’s health system requirements. They offer the possibility of comparing one country’s health system expenditures with those of other countries when setting bench marks.