Abt Associates Inc.

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)

Sample DRM for Health Dossier: Jasmania

Marty Makinen & Kirstin Krusell September 2, 2016

Purpose of Sample Dossier

This sample dossier demonstrates how countries might utilize

available data to hold more productive discussions concerning

domestic resource mobilization for health.

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Purpose of Sample Dossier

Which types of information each Ministry desires from the other

Where there are gaps in available information

How to present data in a way that is easily understood by both

Ministry and speaks to each other’s goals

In adapting this sample dossier, countries should keep in mind:

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Sample Dossier Contents

National Policies and Strategies

Macroeconomic Indicators

Health Expenditure Data

External Assistance for Health

Health Indicators

Issues Concerning MOH-MOF Relationship

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National Policies and Strategies

5

Jasmania’s National Policies and Strategies

National Strategic Development Plan (2015 – 2025)

Strategy emphasizes investment in economic infrastructure and improving the social sectors to achieve SDGs

National Health Sector Strategy (2015-2020)

Main objectives

Advancing UHC

Reaching underserved populations

Decreasing MMR and IMR

Improving information systems

Main approaches

Increase investment in facilities

Increase hiring of health workers (particularly midwives)

Use resources more efficiently

Mobilize additional resources

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Macroeconomic Indicators

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Macroeconomic Indicators

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2011 2012 2013 2014 2015 2016 2017 2018

Income

group

LIC LMIC LMIC

LMIC

LMIC

LMIC LMIC LMIC

GDP per

capita

$1013

$1045

$1083

$1118

$1156

Economic

growth rate

5.7% 5.5% 5.9% 5.7% 5.7%

Taxes as %

GDP

11.1% 11.3% 11.4% 12.4% 12.4%

*All monetary amounts presented in current $USD, unless otherwise noted

Health Expenditure Data

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Total Health Expenditure (THE)

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2011 2012 2013 2014 2015

THE (USD millions) $977 $997 $1,040 $1,043 $1,064

THE per capita (USD) 50 51 52 51 52

THE as % of GDP

5.0% 4.9% 4.8% 4.6% 4.4%

*All monetary amounts presented in current $USD, unless otherwise noted

Comparison to peers

0.0%

1.0%

2.0%

3.0%

4.0%

5.0%

6.0%

7.0%

2011 2012 2013 2014 2015

THE as a % of GNI

Oliviana THE % GNI Jasmania THE % GNI LMICs THE % GNI11 | R4D.org

0

10

20

30

40

50

60

70

2011 2012 2013 2014 2015

THE per capita

Oliviana THE per capita Jasmania THE per capita

LMIC THE per capita

0.0%

1.0%

2.0%

3.0%

4.0%

5.0%

6.0%

7.0%

2011 2012 2013 2014 2015

GNI growth rates

Oliviana GNI growth Jasmania GNI growth

LMIC GNI growth

Government Health Expenditure (GHE)

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*All monetary amounts presented in current $USD, unless otherwise noted

2011 2012 2013 2014 2015

GHE (USD millions)

$332 $332 $360 $368 $389 GHE per capita

(USD) $17 $17 $18 $18 $19

GHE as % THE

34% 33% 35% 35% 37% GHE as % GGE

12% 12% 12% 12% 12% GHE as % of GDP 1.7% 1.6% 1.7% 1.6% 1.6%

Government Health

Expenditure (GHE)

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$-

$5

$10

$15

$20

$25

$30

$35

GHE per capita

GHE per capita

Jasmania

Oliviana

LMICs

0%

10%

20%

30%

40%

50%

60%

GHE as % THE

GHE as % of THE

Jasmania Oliviana LMICs

0%

2%

4%

6%

8%

10%

12%

14%

16%

Jasmania Oliviana LMICs

GHE as % of GGE

Out-of-Pocket Expenditure (OOP)

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2011 2012 2013 2014 2015

OOP as % THE 60% 61% 60% 59% 58%

OOP per capita

$30 $31 $31 $30 $30

*All monetary amounts presented in current $USD, unless otherwise noted

Out-of-Pocket Expenditure (OOP)

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0%

10%

20%

30%

40%

50%

60%

70%

OOP % THE

OOP as a % of THE 2015

Oliviana LMICs Jasmania

$-

$5

$10

$15

$20

$25

$30

$35

OOP per capita

OOP per capita 2015

Jasmania Oliviana LMICs

Budget Execution

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2011 2012 2013 2014 2015

GHE as % of budgeted

amounts

82% 88% 92% 90% 89%

*All monetary amounts presented in current $USD, unless otherwise noted

External Assistance for Health

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External Assistance for Health

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2011 2012 2013 2014 2015

External resources

as % THE

4% 4% 3% 3% 3%

Grants 62% 45% 40% 45% 49%

Loans 38% 55% 60% 55% 51%

External resources per

capita $ 2.20 $1.94 $1.77 $1.73 $1.72

External assistance (USD

millions) $43 $38 $35 $35 $35

Gavi status Graduating Graduating Graduating Graduating Graduating

Global Fund status Graduating Graduating Graduating Ended Ended

PEPFAR status Graduating Graduating Graduating Graduating

Ended

World Bank IDA lending Eligible Eligible

Not eligible Not eligible Not eligible

External Assistance for Health

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*All monetary amounts presented in current $USD, unless otherwise noted

$2.20 $1.94

$1.77 $1.73 $1.72

$-

$0.50

$1.00

$1.50

$2.00

$2.50

2011 2012 2013 2014 2015

External assistance per capita, Jasmania 2011-15

External per capita

Health Indicators

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Jasmania Health Indicators 2011-15

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2011 2012 2013 2014 2015

IMR 54 52 50 47 45

MMR 175 168 157 160 158

U5M 120 118 117 114 110

Pentavalent Coverage 88% 85% 83% 87% 85%

Jasmania Health Indicators by Wealth Quintile 2015

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Q1 (poorest) Q2 Q3 Q4

Q5 (wealthiest)

IMR 83 55 39 31 15

MMR 305 220 148 81 38

U5M 197 157 98 55 45

Pentavalent

Coverage (%)

62 84 94 93 93

Jasmania Health Indicators 2015 by Wealth Quintile

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0

10

20

30

40

50

60

70

80

90

Q1 (poorest) Q2 Q3 Q4 Q5 (wealthiest)

IMR by wealth quintile 2015

0

10

20

30

40

50

60

70

80

90

100

Q1 (poorest) Q2 Q3 Q4 Q5 (wealthiest)

Pentavalent Coverage by Wealth Quintile 2015

Jasmania Health Indicators, 2015 Compared to Peers

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0

10

20

30

40

50

60

Jasmania Oliviana Region of Econ DevCoop

IMR 2105, Jasmania, Oliviana, REDC

0

20

40

60

80

100

120

140

160

180

Jasmania Oliviana Region of Econ DevCoop

MMR 2015, Jasmania, Oliviana, REDC

Issues Concerning MOH-MOF Relationship

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Issues concerning MOH-MOF relationship

The MOH has difficulty demonstrating the efficiency of its spending

(i.e., linking expenditure to health outcomes)

The MOF is hesitant to allocate additional resources to health, given

the health sector’s challenges spending its past allocations

Dispersal of funds from MOF to MOH is often delayed

MOH feels it is underfunded given comparisons to neighboring

countries and others in its region

MOH feels like its contribution to poverty reduction and overall well

being of the Jasmania population is under-appreciated

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Dossier

Macro economic data

Policy priorities

Health financing data

Population health indicators

Comparisons to peers

Equity breakouts

Issues of misunderstanding or misalignment between MOF and

MOH

Provides evidence base for MOF-MOH interaction

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