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Development assistance in health - how much, where does it go and what more do health planners need to know? (WP21)

Development assistance in health - how much, where does it go and what more do health planners need to know? (WP21)

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What role does development assistance for health play in setting public health agendas?
What role does development assistance for health play in setting public health agendas?

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Published by: Nossal Institute for Global Health on Mar 08, 2013
Copyright:Attribution Non-commercial


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Development assistance in health–how much, where does it go, and whatmore do health planners need to know? A case study of Fiji’s national healthaccounts
Joel Negin
University of Sydney
Wayne Irava,
Centre for Health Information, Policy andSystems Research
Chris Morgan
Nossal Institute for Global Health and theBurnet Institute
Development assistance in health–how much,where does it go, and what more do healthplanners need to know? A case study of Fiji’snational health accounts
First draft – October 2012
Corresponding author:
Joel NeginSydney School of Public Health and Menzies Centre for Health PolicyUniversity of Sydney joel.negin@sydney.edu.au This Working Paper represents the views of its author/sand does not represent any ofcial position of theUniversity of Melbourne, AusAID or the AustralianGovernment.
 This Working Paper is produced by the Nossal Institutefor Global Health at the University of Melbourne, Australia. The Australian Agency for International Development(AusAID) has established four Knowledge Hubs for Health, each addressing different dimensions of thehealth system: Health Policy and Health Finance;Health Information Systems; Human Resources for Health; and Women’s and Children’s Health.Based at the Nossal Institute for Global Health, theHealth Policy and Health Finance Knowledge Hub aimsto support regional, national and international partnersto develop effective evidence-informed policy making,particularly in the eld of health nance and healthsystems. The Working Paper series is not a peer-reviewed journal; papers in this series are works-in-progress. Theaim is to stimulate discussion and comment amongpolicy makers and researchers. The Nossal Institute invites and encourages feedback.We would like to hear both where corrections areneeded to published papers and where additional work would be useful. We also would like to hear suggestionsfor new papers or the investigation of any topics thathealth planners or policy makers would nd helpful. Toprovide comment or obtain further information aboutthe Working Paper series please contact; ni-info@unimelb.edu.au with “Working Papers” as the subject.For updated Working Papers, the title page includesthe date of the latest revision.
Health Policy and Health Finance Knowledge Hub
WORKING PAPER 21Development assistance in health–how much, where does it go, and what more do health planners need to know? A case study of Fiji’s national health accounts
However, the data on the total and precise distributionof development assistance for health is incompleteand possibly underestimated. It remains difcultto differentiate development assistance for healthexpenditure by technical area or health system function. A review of publications from other countries suggeststhese problems are likely to occur elsewhere in thePacic. This paper calls for development partners to improveexpenditure reporting to national governments,to support national health accounts and providedisaggregation in categories that align with local healthsystem functions.If government health planners rene expenditurereporting of development assistance for health, a moredetailed understanding of donor spending for specicdisease priorities and types of health service deliverywill emerge.Furthermore, this paper highlights the importance of increasing the use of national health accounts in policyanalysis so policy-making is evidence based.
 This paper analyses publicly available healthexpenditure data to assess the contribution of externaldevelopment assistance for health (DAH) in Fiji.Development assistance is a signicant and increasingcontributor to the health sector in Fiji, representingnearly 9 per cent of total health expenditure.Further analysis revealed that prevention and publichealth services are reliant on donors with more than30 per cent of nancing from development assistance,together with a recent increase in assistance for healthadministration. The potential for development assistance to inuencehealth priorities is a concern. As such, the reporting of allocations needs standardisation and greater detail tobetter inform the national health accounts (NHA).Fiji’s national health accounts now comply withinternational standards and could increasingly be usedto provide valuable information for policy analysis,with more detail now available to review developmentassistance for health contributions.

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