How to harmonize resource tracking for better health financing decision-making

Effectively tracking how resources are spent within a health system — and whether current spending is leading to desired outcomes — is critical for effective policymaking, resource allocation, and program planning. Because of this, many countries are prioritizing resource tracking as a key area of investment.

However, with multiple resource-tracking methodologies (e.g., the System of Health Accounts (SHA) and National AIDS Spending Assessment (NASA)) — some of which are required by donors — countries face challenges maintaining multiple systems, conducting regular assessments and decisions about which data to use. And where there is need for regular detailed data on both health and HIV spending, countries often face reduced support for such exercises and increased pressure to institutionalize the processes domestically.

One solution is to harmonize resource tracking by combining the SHA and the NASA methodologies into one system. This approach was piloted in Namibia and Botswana by the USAID-funded African Collaborative for Health Financing Solutions (ACS) program. Here, we offer resources to support other countries that face similar challenges.

Key resources and how they can be used:

Introductory resources for harmonizing resource tracking: This Guide for Planning Harmonized SHA/NASA Resource Tracking provides an introduction to resource tracking, and approaches for harmonizing SHA/NASA systems, including dos and don’ts.

Lessons learned from harmonizing resource tracking: This brief provides a short summary of lessons learned from Namibia and Botswana as they implemented a harmonized resource tracking approach, and recommendations for other countries that are interested in pursuing the same approach.

An advocacy tool: This brief can be used to promote broader buy-in for harmonized resource tracking.

Measuring systems change: In a complex system it can be hard to see the value of an intervention like harmonizing resource tracking. In cases like this, it’s advisable to use a combination of different strategies. In a study completed by the ACS program team, we used a set of evaluation methodologies in a hybrid, innovative approach to document the value, using Namibia as a case example. The report assesses what changes occurred, how and why did these changes occurred, and what these changes mean for the HIV/AIDS response and the overall functioning of the health system.

These resources and many more appear below in English and in French.

For further information or to share feedback, please contact one of ACS HRT experts through the addresses below:

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