National Health Accounts

It’s helpful to look at real-life examples of national health accounts and reports to understand how they can be used. A good starting place is A System of Health Accounts which lays out a standard used in OECD countries. As an example of the way in which the SHA are presented, take a look at ‘Table 1. Current expenditure on health by function of care, provider and source of funding’ on page 26, which categorises current health expenditure by function of care, provider and source of funding according to the ICHA classifications.

In general, the SHA tables appear as two-dimensional spreadsheets with function, provider, and source on the horizontal axis, and health services of different types on the vertical axis.

The WHO guide to producing national health accounts also has some good examples and guidelines, if you want to explore this further.

The NHA detail the flow of funds from the sources of financing, through the agents that allocate the funding, to the many different providers who deliver health care to the population. National Health Accounts can also be produced also for different sectors within the health system. Like the general NHA, NHA sub-analysis for reproductive health (for example) captures and organises information on health expenditures in the standard table format, from financing sources to end uses, but does so only for reproductive health.

To see an illustration of this process, have a look at the USAID and PHR Plus case study.