Healthy Lifestyle

Towards Better Health Spending Transparency: The Role of SHA

As health systems become more complex and diverse, it has become increasingly important for governments to provide accurate and transparent data on healthcare spending. The World Health Organization’s (WHO) regional office for Europe is calling on countries to use the System of Health Accounts (SHA) to address this need. The SHA is a framework developed by the WHO, the Organisation for Economic Co-operation and Development (OECD), and Eurostat, which helps countries understand how health-related spending is used.

Accurate tracking of health spending data allows countries to assess their health resources, the efficiency and effectiveness of resource allocation, and the equity of healthcare delivery. It can also help monitor progress towards important goals, such as universal health coverage. The SHA can identify who benefits from the spending, the purpose for which it is applied (which diseases or conditions), the type of care being provided (prevention, outpatient or inpatient care), and the sources of funds as well as the financing schemes.

In the past six years, interest has grown among the countries of eastern Europe, central Asia and the western Balkans in using the SHA to track health spending. The WHO is addressing this demand by providing technical support to countries in developing and producing the evidence and utilizing it in policy-making.

WHO/Europe recently held a joint workshop for health policy-makers and financing experts from 16 countries in eastern Europe, central Asia and the western Balkans, encouraging governments to move to a new phase of health spending tracking. The workshop, titled “5th Sub-regional European meeting on tracking health spending using the SHA,” was held in Istanbul and saw renewed commitment to better and more transparent data in health spending across this group of countries.

“The health accounts data offer a comprehensive and internationally comparable overview of health spending in countries in the WHO European Region, providing valuable insights for policy-makers to make informed decisions,” said Dr Tamás Evetovits, Head of the WHO Barcelona Office for Health Systems Financing, the WHO/Europe office leading in this area of work.

The results produced by standardization of data reporting based on the SHA methodology are published in the widely used Global Health Expenditure Database (GHED), making them easily accessible for researchers, policy-makers, and other stakeholders to use for evidence-informed policy-making and strategic planning.

One key factor related to the SHA methodology is the need to regularly present health accounts data and develop tailored reports that offer insights into a country’s health system. This in turn helps address public health priorities such as strengthening primary health care and mental health services, and illuminating out-of-pocket spending on medicines.

“To increase the relevance and usefulness of health accounts at country level, Member States are encouraged to focus their tracking of health spending reports on the most relevant policy questions in their specific country contexts. In addition to the tailored country support provided by WHO, countries benefit from the comparative analytical reports on the most pressing health system issues at regional level produced by our office using health accounts data,” added Baktygul Akkazieva, Technical Officer at the WHO Barcelona Office for Health Systems Financing.

Governments in the eastern European, central Asian and western Balkan countries are now taking more steps to use SHA to track their health spending. The SHA framework allows them to develop better policies by understanding how the funds are spent and where they are needed the most. The WHO is also helping these countries in utilizing the evidence from the SHA in policy-making by providing them with technical support.

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