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Strengthening Capacity for Health Sector Governance Reforms in Laos

Summary

The goal of the Asian Development Bank (ADB) Strengthening Capacity for Health Sector Governance Reforms project is to strengthen governance and accountability for health financing by providing support in budget reform, provincial planning and budgeting, financial management, human resources for health planning and management, and health information systems. ThinkWell provides technical support and capacity building to the Ministry of Health (MOH) in the production of National Health Accounts (NHA), a standardized and internationally recognized methodology to measure health expenditure. ThinkWell also supports the development of a process to produce NHA in Laos on an annual basis and works with the MOH, the Ministry of Finance, World Health Organization, the World Bank, and other partners to strengthen the use of NHA results to inform resource mobilization, policy development, planning, and resource allocation.

Breaking New Ground

Health accounts have been produced in Laos since 2010, but findings have not been fully integrated into existing processes of policy development and implementation. A central component of the project approach is to identify and implement innovative ways of ensuring that health accounts are produced and disseminated to maximize policy use. ThinkWell conducts key informant interviews, workshops, and policy dialogues to build an understanding of the policy relevance and limitations of health accounts. In addition, we will apply innovative tools such as data visualization to maximize the impact of the results of health accounts.

Challenges

The Ministry of Health (MOH) technical team responsible for health accounts production faces challenges including data availability and quality. The focus on data collection has limited the time available for analysis, presentation, and dissemination of findings. The project therefore works on establishing innovative processes to collect data and strengthen the capacity of provinces to prepare, provide, and use health account data for policy and planning.

Approach

ThinkWell applies a mix of technical support and capacity building to the Department of Finance within MOH to strengthen capacity to systematically collect, analyze, and present data, and provides advice on how to increase the use of health account data for advocacy and policy use by the government and its development partners.

Lao National Health Accounts Report 2013-2016

The report presents findings of the National Health Accounts (NHA) 2013-2016 in Lao PDR. The preparation of the NHA is led by the Health Financing Policy Division, Department of Finance, MOH, with support from ADB, ThinkWell and the World Health Organization. ThinkWell provided technical guidance and support during the development of this report. MOH intends to conduct NHA on an annual basis starting in 2018 and have full ownership over the production of NHA. The report also includes selected results of the NHA 2011-2012 to increase the number of data points for the trend analysis. Key findings of NHA show that (i) total health expenditure more than doubled between 2011-2016, (ii) subnational health spending increased compared to central government reflecting the government’s decentralization approach, (iii) out-of-pocket expenditure is still the largest source of health spending etc. The report also includes recommendations highlighting that efforts are needed to (i) achieve the expected result of the first phase of the Health Sector Reform, (ii) reduce household out-of-pocket expenditure and reach the national target, (ii) strengthen allocation of funding at provincial level and (iv) strengthen the collection process of financial information.

Read the Lao NHA 2013-2016 report.

Read the Lao NHA brief.

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