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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.
2 | R4D.org
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
4 | R4D.org
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
8 | R4D.org
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
20
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
22 | R4D.org
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
23 | R4D.org
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
25
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
26 | R4D.org
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
27 | R4D.org