This document discusses how the System of Health Accounts 2011 (SHA 2011) framework can be used to track family planning spending and inform family planning programming. SHA 2011 is an internationally recognized framework for systematically tracking all health spending by source, financing arrangements, provider, and interventions. The summary provides examples of how SHA 2011 data from various countries has been used to analyze family planning spending levels and sources; compare family planning spending to overall health spending and targets; assess spending efficiency; and evaluate the sustainability of family planning financing. While challenges remain in fully applying the SHA 2011 framework, it provides a standardized method for understanding how resources are being used to support family planning programs.

1. 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)
Karishmah Bhuwanee MSc
Health Finance & Governance project
Tracking Family Planning
Spending Using the System of Health
Accounts Framework
International Conference on Family Planning,
27 January 2016

2. Question
Do you know HOW MUCH was spent by the public and
private sector for family planning in your country?
Do you know WHAT family planning activities that money
was spent on?
Is this type of information being used to drive FP
interventions?
This is where tracking spending comes in → helps
countries to understand how money was used for family
planning programs and where money came from

3. What is the System of Health Accounts 2011
and how does it contribute to FP programming?
Benefits:
• Contributes to measurement of
country’s health system
performance
• Provides comparisons over time
and across countries
• Captures priority placed on FP
vs. other health
conditions/diseases
Internationally recognized
framework for
systematically tracking
health spending in a
country
• Tracks magnitude and flow
of all health spending
• Breaks down spending by
source, financing
arrangements, type of
provider, interventions

4. HOW CAN DATA FROM SHA 2011
INFORM FP PROGRAMMING?

5. Uses of SHA 2011 Data for FP
Programming
Aligning spending
with priorities
Negotiating for
increased FP
resources
Financial
sustainability
analysis
Assessing spending
decisions to achieve
FP targets
Realigning spending
to increase efficiency
of FP spending

6. Country Data Using SHA 2011:
FP Spending by Source of Financing
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
Namibia
2013
Cote
d'Ivoire
2013
Lao 2012 Benin
2013
Cambodia
2012
Burkina
Faso 2013
DRC 2013 Burundi
2013
Sierra
Leone
2013
Comoros
2011
FP spending by source of financing
Government Foreign sources Household Others e.g. private sector

7. Country Data Using SHA 2011: FP
Spending as % of Current Health Spending
6.3%
5.6%
1.3%
1.0% 0.9% 0.7% 0.7% 0.6%
0.4% 0.2%
0.0%
1.0%
2.0%
3.0%
4.0%
5.0%
6.0%
7.0%
Sierra
Leone
2013
Cambodia
2012
Burkina
Faso 2013
Namibia
2013
Burundi
2013
Benin 2013 Comores
2011
DRC 2013 Lao 2012 Cote
d'Ivoire
2013
FP spending as % of Current Health Expenditure

8. Using SHA 2011 Data to Highlight Potential
Efficiency Considerations
 Is spending helping to achieve targets? Can spending be reallocated to different
interventions to increase outputs?
 How are we performing against other countries with similar spending levels?
Sierra Leone 2013
Camobodia 2012
Burkina Faso 2013
Namibia 2013
Burundi 2013
Benin 2013
DRC 2013
Niger 2013
Liberia 2012
20
30
40
50
60
70
80
- 5.0 10.0 15.0 20.0 25.0
%FPneedsmet
FP spending per capita (woman of ages 15-49)
FP spending per capita vs. % FP needs met

9. Using SHA 2011 Data to Assess FP Financing
Landscape and Sustainability
Changing composition of financing to more domestic
sources, particularly household spending
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
2011 2012 2013
Niger - FP spending by source
Govnt Donors HH Others/ n.e.c

10. Challenges in Applying SHA 2011
Framework
Boundary clarifications
Accounting for shared costs e.g. central ministry
functions, health worker salaries, general
supplies
Lack of detailed data to disaggregate spending
Documenting country examples of policy
changes resulting from Health Accounts data

11. Conclusions
SHA 2011 provides comprehensive, standardized
framework for tracking FP spending
Inform key programming decisions such as:
 How much is being spent on FP?
 How should FP be funded over time?
 How are FP funds being spent?
 What are the most effective and efficient FP activities which
should be funded?
Initial challenges with applying framework but new tools
such as guidance on disease classification will make the
process easier

12. 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)
Thank you
For more information:
karishmah_bhuwanee@abtassoc.com
www.hfgproject.org