The things they did not know

Pitfalls while preparing the global health report: credit: WHO

So you thought preparing the World Health Report means packaging a lot of information readily available to experts who know it all? Wrong.

David Evans, director of health systems financing at WHO, gave some idea about the pitfalls during the report preparation, in a talk on Tuesday evening.

But, first, a peek at what the report will contain: Country experiences and best options available; solutions for some fundamental health financing problems, such as financial barriers to access to services, and inefficiency and inequity in the use of resources; and suggestions on how the international community can help low-income countries improve their health financing systems and institutions.

So, what did the experts not know when they undertook the task? Cross-country data on coverage with health services; and long-term financial hardship or the effect of out-of-pocket spending on health on financial catastrophe and impoverishment, to name some.

Millions continue to suffer financial problems when they spend out of their pocket for a health service, and compromise on education or sanitation to balance out their limited resources. According to WHO data, an estimated 150 million suffer financial hardships every year and 100 million are pushed into poverty for paying out of their pocket.

There was also scant information on what proportion of global disbursements is actually being spent by countries and scattered information on transaction costs of donor disbursements at country level – for example, Rwanda has to report on 890 health indicators to various donors, almost 600 for HIV and TB alone; while Vietnam had 400 aid missions to review projects in 2009.

So why is this information lacking? Evans believes there could be several reasons: researchers may not be interested in these questions, or funders do not fund this type of research, or the potential users of this knowledge do not explicitly demand the data be available.

He is possibly spot-on.

T. V. Padma, South Asia Regional Coordinator, SciDev.Net

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