Institutionalisation elements | Indicators | Units | |
---|---|---|---|
National Health Accounts Unit (NHAU) | Program for Fighting Non-Communicable Diseases (PFNCD) | ||
1. Existence of an institutional framework (the unit’s mandate from government) | 1.1. Law/regulation providing a mandate for the unit | ➢ There is an inter-ministerial decree signed by the ministers of health and economy and finance; this identifies the stakeholders and their role in the production of health accounts ➢ An integrated organisation chart is aligned with the organisation chart for the overarching directorate | ➢ There is an institutional framework that allows the implementation of the program ➢ There is an integrated organisation chart aligned with the organisation chart of the service for the fight against non-communicable diseases |
1.2. Institutional home identified for the policy units | ➢ There is a dedicated working space for this unit but it is insufficient for all staff | ➢ There is working space available in an office, but shared with four other policy units | |
1.3. Protocols/public norms set out for data or information production | ➢ WHO’s system of health accounts framework (currently SHA-2011) is the main guideline for health accounts | ➢ There are protocols for medical care amongst those with these diseases | |
2. Consistent production of data and preparation of reports | 2.1. Explicit process designed for data gathering, compilation and transmission for decision-making | ➢ There is no system for routine gathering of health expenditure in the health information system ➢ The service uses a database of health expenditure developed in 2008 and integrated into the health system ➢ A survey is carried out each year, funded by donors, to provide additional data | ➢ There is no data collection system, unlike other policy units for other diseases, although the unit has a data collection guideline ➢ No routine data are collected and no indicator from the unit is included in the statistical yearbook, the reference for data gathering and use in policymaking |
2.2. Policy unit activities are regular and ongoing | ➢ Ten sets of health accounts, including sub-accounts, have been produced since 2005 ➢ Health accounts are poorly used in decision-making processes | ➢ No policy unit activity was documented | |
2.3. Protocol exists for validating reports | ➢ Data collection is not integrated into routine data collection processes, but the policy unit uses a standard health expenditure database | ➢ There is a lack of coordination among stakeholders, which hinders data production ➢ There is a lack of involvement of stakeholders (NGOs, municipalities, social services) in caring for patients with these diseases | |
2.4. Minimum set of globally agreed data is produced | ➢ Health system expenditure data are available every year ➢ Data are processed using the health accounts production tool and the health account analysis tool provided by the WHO and US Agency for International Development | ➢ No administrative reports, evaluation reports or other publications have been developed and published | |
3. Adequate financial and human resources, and infrastructure capacity to routinely produce and make use of data in policymaking | 3.1. The policy unit has an annual action plan | ➢ There is an action plan for the health information and statistics department which includes the NHAU’s activities | ➢ There is an action plan for the overarching Ministry of Health department, which should include PFNCD activities, but little is planned |
3.2. Government budget is earmarked for the policy unit’s activities | ➢ There is no budget line from the Ministry of Health ➢ The state budget contribution is mainly for salaries ➢ The unit’s activities are typically funded by donors; there is usually no difficulty obtaining the money but there may be delays in releasing funds | ➢ There is a state budget line covering four health programs; the portion allocated to the policy unit is insufficient ➢ There are no donor funds available; the last such support was in 2006 | |
3.3. Sufficient material and human resources are available for the policy unit’s activities | ➢ The policy unit obtained computer equipment in 2010; it uses hardware from the health information and statistics unit ➢ There are sufficient multidisciplinary resources from several departments; however, staff must be regularly trained and financially motivated to retain them | ➢ The PFNCD does not have enough equipment; it lacks computers and office furniture ➢ The PFNCD has just one member of staff, the policy unit coordinator, who is rarely available and mostly absent during planning, which hinders the mobilisation of resources | |
3.4. The policy unit’s annual action plan is at least half funded | ➢ The history of the policy unit’s annual action plan shows that, since 2009, at least more than 90% of the activities were funded | ➢ The records of the policy unit action plans from 2005 to 2012 shows that the unit activities funding rate are between 10% and 16% |