National AI DS Spending Assessment Conceptual Framework Overview - - PowerPoint PPT Presentation

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National AI DS Spending Assessment

Conceptual Framework Overview

Glion

November 26th, 2007 Carlos Avila

Resource Tracking and Projections Unit UNAI DS EXO/ EVA

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Acronyms: English: National AIDS spending Assessment (NASA) Spanish: Medición de Gasto en SIDA (MEGAS) French: Évaluation des Flux de Ressources et des Dépenses nationales contre le Sida (EF-REDES) Portuguese: Medição do Gasto em Aids (MEGAA)

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NASA is not:

A Software. Resource Needs. Economic impact.

National Aids Spending Assessment

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T

• de sc ribe the fina nc ia l flows for HIV a nd AIDS
• who pa ys (so urc e s)?
• who ma na g e s the funds (fina nc ing a g e nts)
• who pro vide s the se rvic e s (pro vide rs)?
• wha t wa s pro vide d (func tio ns: pre ve ntio n, c a re , T

x, so c ia l mitig a tio n, o the r se c to r a c tivitie s)?

• whic h a re the c o mpo ne nts (Ob je c ts o f e xpe nditure )?
• who b e ne fits (b e ne fic ia rie s)?

NASA: Com ponents

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National AI DS Spending Assessm ents

• Ba se d o n the Na tio na l He a lth Ac c o unts

fra me wo rk – Co nsiste nc y a c ro ss se ve ra l va ria b le s; NHA-HI V/ AI DS sub a c c o unts – Use o f fina nc ia l tra c king , a c c o unting a nd c o sting princ iple s – Bo unda rie s a nd func tio ns (he a lth/ no n- he a lth)

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NASA Boundaries

Social Education

“The functions are no longer limited to health expenditures, following the framework of the NHA, but emphasize the tracking of social mitigation, education, labour, justice and other sectors for an expanded response to HIV/AIDS”

HIV Health

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T account

All the re ve nue s in o ne side a nd a ll the e xpe nditure s o n the

• the r side , pro duc e a b a la nc e a nd re duc e e rro r

I nfo rma tio n syste ms a nd b o o k ke e ping o n e xpe nditure s Pro o f o f purc ha se , b ills, c ha rg e s, de b its, invo ic e s, sta te me nts

Revenues Expenditures

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Triangulation

Gathering, compiling and cross checking information from three sources

Provision Consumption Financing Citizen Pooling Purchaser Provider

Three party transactions

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The agents’ triangulation Financing Financing Provision Provision Consumption Consumption

= = = = = =

Financing Sources Financing Sources & Financing Agents & Financing Agents Providers & Providers & Production Factors Production Factors Aids Spending Categories & Beneficiary Populations Aids Spending Categories & Beneficiary Populations

Sources Purchasers Providers Factors of production Commodities Beneficiaries

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NASA: One of the most important characteristics of a

classification scheme is assuring that the categories are

mutually exclusive and exhaustive. Using standardized classifications for Resource

Tracking allows both international comparisons and comparisons at country level in time trends.

The classifications scheme must answer to politically relevant questions in order to help monitoring the

national strategic action plans.

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NASA: Comprehensive: An inventory of all resources

addressed to HIV/AIDS

I nternally consistent: Totals must add-up and be

congruent across different variable dimensions and tables.

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T

• de sc rib e the AI

DS he a lth a nd no n-he a lth fina nc ia l flo ws a nd e xpe nditure s a c c o rding to T HRE E Dime nsio ns a nd six ve c to rs:

F INANCING:

1) So urc e s; 2) Ag e nts

PROVISION:

3) Pro vide rs; 4) Pro duc tio n F a c to rs

USE:

5) F unc tio ns; 6) Be ne fic ia rie s

NASA

Dim ensions and vectors

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SOURCES Agents Financiers Prestataires Public Ministere de la Sante Hôpitaux Autres ministères CTA CNLS Des autres ministères ANCS Bilatéral ONG Internationales ONG/OCB Coopération bilatérale Multilatéral Cabinets médicaux Hôpitaux privés Laboratoire privée Privée Ménages Pharmacies Medicine Traditionnelle Flux de financement Système des Nations Unit et autres multilatéraux ONG Internation

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Transactions

• Sources (Public, Private, International)

– Financing Agents (to decide the use of the funds)

• Providers of services and goods

– (e.g. hospitals, ambulatory services, pharmacies, NAP, MoH, other Ministries, etc.)

• Functions: (Health, Health Related, Non-health)
• Target Groups (or beneficiaries; vulnerable and at-risk

epidemiologically defined populations): MSM, CSW, IDU; Accessible groups: military, school children; Recipients of treatment: PLWH, PLWA

• Object of Expenditure (budgetary items): salary of health

personnel, non-health personnel, material and equipment, administration, etc.)

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Transaction: the basic unit of the financial flow, that describes the transit of resources from a source to an agent, who purchases from a provider one or more ASC benefiting beneficiary populations, specified or not, and produced consuming production factor.

Tracking the Transaction Tracking the Transaction

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Transactions

Resource Tracking “Top down” & “Bottom up”

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Production Factors

Flow of resources from origin to users: reconstruction of transactions (“Top Down”)

Financing Agents

Providers of services Functions

(Health or non-Health)

Beneficiaries

• Specific Target

Groups

• Or unspecified

Sources

Financing Provision Use

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1. Pre ve ntio n 2. T re a tme nt a nd c a re 3. Orpha n a nd vulne ra b le c hildre n 4. Pro g ra mme ma na g e me nt 5. Huma n re so urc e s fo r AI DS 6. So c ia l pro te c tio n 7. E na b ling e nviro nme nt & c o mmunity de ve lo pme nt 8. Re se a rc h: AI DS re la te d

Categories of Spending

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Reconstruction of transactions (“Bottom Up”) to reconcile with flows from sources (ceiling)

Production Factors

Financing Agents Providers of services Functions

(Health or non-Health)

Beneficiaries Financial Sources

Financing Provision Use Use

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Results and cross-tabulation system

• This methodology is based on double

entry tables –matrices-

– Represent the origin and the destination of resources – Help to avoid doubling counting of expenditures.

• A NASA report typically includes

matrices, summary tables, auxiliary tables and synthetic indicators to facilitate the situation analysis and exposition to selected audiences.

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–

Sta nda rdiza tion of c onc e pts

• Ro b ust inte r-te mpo ra l c o mpa riso ns to tra c k

re so urc e a va ila b ility

• E

nsure va lid c o mpa riso ns a c ro ss c o untrie s

• Sta nda rd de finitio ns, b o unda rie s a nd

c la ssific a tio ns –

Sta nda rdiza tion on e stima tion me thods

• Co mpa ra b le me tho ds in e stima ting spe c ific

ite ms o f e xpe nditure

• Ho spita l tre a tme nt a nd ho use ho ld OOPS

re q uire so me a mo unt o f e stima tio n a nd imputa tio n in mo st c o nte xts

NASA

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Use of NASA results

• Support in-country policy and decision making

process, specifically for AIDS

• Provide indicators on the financing of AIDS

– Annual estimates of Financing Sources and Functions

• Comparison: resources available (PAST) and (FUTURE) resource needs

– Monitoring of Declaration of Commitment (e.g. UNGASS)

• International Comparability
• Utiliza tio n o f da ta fo r c o untry de fine d purpo se s b y

AI DS pro g ra m ma na g e rs/ po lic y a nd de c isio n ma ke rs