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Creating Evidence for Better Health Financing Decisions
data-producing agencies to the NSCB. The Association of Health Maintenance Organizations is a regular participant in the IAC-HNS, although other private sector or academic agencies are not involved at present (Racelis 2008).6 Still, room remains for additional capacity building, because the NSCB lacks the statistical staff to conduct the NHA. For example, the NSCB has been scaled down from 10 to 4 members, with one serving as lead coordinator. This reduction is due, in part, to the high attrition of staff members who may opt for higher-paying jobs in the private sector. The staff shortage can also be attributed to a government hiring freeze put in place because of budget constraints.7 A move under way to conduct NHA analyses at the local (regional and provincial) level would use local health accounts to produce a deeper, decentralized view of health spending levels and trends, as well as local financing sources. The goal is to move closer to universal health care coverage and to improve fiscal space, as discussed later.8 NSCB staff members are being used to train local health accountants to that end.9 Finally, an important point is that NHA are only one of many inputs that can be used to inform health sector decision making. They are fully optimized when used with other data instruments, for example, the Public Expenditure Review (PER) and the MediumTerm Expenditure Framework (MTEF). As highlighted below, the Philippines serves as a unique example in which NHA data are triangulated and used with other sources to inform policy and illustrate the connections between financial decisions. The Philippines illustrates how the utility of inputs such as NHA data are further enhanced when they can be translated in ways that reach policy makers. As the Philippines continues with NHA production and analysis, it will be interesting to observe how these key areas develop to better inform decision making.
Using Insights from NHA to Inform Policy Sustained health resource tracking efforts have added value to the health sector in the Philippines by increasing government accountability to ensure financial risk protection for its population, by shifting central government resources to local public health priority programs, and by calling for further inquiry as to the limitations in fiscal space at both national and local levels.