dissemination meeting - uwi...

Dissemination Meeting

Guyana Health Accounts 2016

August 3, 2018

Objectives

Discuss methodology of Health Accounts study in Guyana

Disseminate Guyana’s 2016 Health Accounts results

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GUYANA’S 2016 HEALTH ACCOUNTS PROCESS/

METHODOLOGY

Health Accounts in Guyana First exercise

Health Accounts for

calendar year 2016

Led by the MOPH

Supported by USAID’s

HFG project, PEPFAR

and PAHO/WHO

© 2014 Lorine Ghabranious/MSH, Courtesy of Photoshare 4

Governance Health Accounts Technical Team: Responsible for

data collection, analysis, and validation Health Accounts Steering Committee:

Responsible for strategic guidance and support

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Timeline

Launch(June 5, 2017)

SHA 2011 Training(June 5-9, 2017)

Steering Committee

Engagement(First meeting June 9, 2017 & subsequent

meetings throughout)

Data collectors trained(July 2017)

Primary data collection

(July – Sept. 2017)

Secondary data collection & validation

(October 2017-Feb 2018)

Analysis workshop (Feb 2018)

Analysis continued &

refined(Feb – July 2018)

Data validation(July 2018)

Dissemination(August 2018)

Data collection

Data analysis

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Data Collection Primary data source –

surveys collected from all major: Donors NGOs Employers Insurance companies

(including NIS) Secondary data sources Government MOPH (including GPHC) Regions

Households© 2013 Stacy Bauer, Courtesy of Photoshare 7

Methodology -Household Expenditure Estimation (2016)

Household Budgetary Survey (2006): Sections on health services and contributions to insurance

Used medical inflationand population growth to adjust the data to 2016

© 2006 Helen Hawkings, Courtesy of Photoshare8

Handling Double Counting

Reviewed and handled double counting for the following: Employer // Insurance

Household // Insurance

NGO // Government

NGO // Donor

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Distribution Keys

Distribution keys used to unpack the non-earmarked spending by function and disease

Data source for distribution key: Health services utilization: 2009 Statistical Bulletin,

2009 DHS, and 2009 data from the Guyana AIDS Response Report

Unit cost data: St. Lucia costing study of the main referral hospital and public facility (April 2010 –March 2011)

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RESULTS

2016 Guyana Health Accounts: Summary Results

Indicator Data (2016)

Total Health Expenditure (THE, GYD) 28,595,303,655

Current Health Expenditure (GYD) 28,422,162,398

Capital Expenditure on Health (GYD) 173,141,256

Health-Related Spending (GYD) 28,772,368

Health-Related Capital Spending (GYD) 580,768,205

THE per capita (GYD) 38,207.28

THE as a % of GDP 3.93%

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Source of Total Health Expenditure

Government81%

Households9%

Donors6%

Coporations4%

NGO<1%

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Regional Comparison of Source of Total Health Expenditure

81%72%

62%56%

37%

9%14% 34%

38%

55%

10% 15%4% 7% 8%

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

Guyana(2016)

St. Vincent &Grendadines

(2012)

Dominica(2010-11)

Barbados(2012-13)

St. Kitts & Nevis(2011)

Government Households Other

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Managers of Total Health Expenditure

Central Government

58%

Regional Government

24%

Households8%

Donors3%

NIS2%

Insurance Companies

2%

Corporations2%NGOs

1% 15

Total Health Spending by Type of Provider

40%32%

9% 7% 5% 3% 2% 3%0%5%

10%15%20%25%30%35%40%45%

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Total Health Spending by Function

Curative Care64%

Preventive Care19%

Administration8%

Pharmaceuticals5%

Laboratory and Diagnostic Services

2%

Other<1%

Capital<1%

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34%

8%

22%

13%

12%

12%

Non-communicable Diseases

HIV/AIDS and Other STDs

Other Infectious Diseases

Injuries

Reproductive Health

Other

0% 5% 10% 15% 20% 25% 30% 35% 40%

Share

Total Health Spending by Disease

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Household Out-of-Pocket Spending by Function

Pharmaceuticals59%

Outpatient Curative Care

22%

Inpatient Curative Care

15%

Preventive Care4%

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HIV Current Health Spending by Source

Donors35%

Government62%

Other3%

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HIV Spending by Type of Service

Administration25%

Curative Care21%

Preventive Care52%

Capital Spending1%

Other1%

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POLICY IMPLICATIONS

Policy Implications

Increase spending on NCD prevention Improve the balance of spending tertiary and

primary facilities to improve accessibility of services

Assess options for improving allocative efficiency in government HIV spending

Better understand the impact of HIV prevention spending

Increase spending on treatment to implement Treat All and prevent transmission

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Thank youwww.HFGproject.org

The HFG project is funded by the United States Agency for International Development (USAID) under cooperative agreement No. OAA-A-12-00080. The author's views expressed in this presentation do not necessarily reflect the

views of USAID or the United States government.

Abt Associates In collaboration with: Avenir Health | Broad Branch Associates | Development Alternatives Inc. (DAI) | Johns Hopkins Bloomberg School of Public Health (JHSPH) | Results for Development Institute (R4D)| RTI International | Training Resources Group, Inc. (TRG)