How can we tell how much funding is devoted to global health programmes? How can planning and policymaking in the health sector be improved? This paper from the Center for Global Development’s Global Health Resource Tracking Working Group argues that more timely, complete, and detailed data are required in order to mobilise the necessary resources to achieve the Millennium Development Goals (MDGs). More attention needs to be given to improving the management of public-sector expenditures in developing countries, strengthening and institutionalising national health accounts work, and improving the timeliness and comprehensiveness of reporting of external support from bilateral, multilateral, and private sources.
In many developing countries, neither government agencies nor development agencies have routine access to useful information about spending on health inputs and services. At the global level, the lack of credible estimates of donor commitments and actual funds available to global health programmes greatly impedes planning, decision making, and advocacy efforts. Data systems and access to information lag behind the rhetoric of greater transparency and accountability in international agencies. As a result, for many health areas, both funders and observers find it impossible to know whether the development community is living up to its commitments to provide greater and more effective transfers and timely flows of development assistance.
- Few countries have integrated the collection and use of data on expenditures into policymaking and programme implementation. They are hampered by lack of resources, and weak co-ordination among donors.
- Detailed information about how much donors are committing and spending on priority health programmes in specific countries is available mainly retrospectively and is cumbersome to obtain.
- The Creditor Reporting System cannot respond to increasing demands for more timely and detailed information about donors’ spending by type of health programme.
- Efforts to generate information about financial flows in global health have been undertaken in an unco-ordinated manner with limited attention to the quality of the primary data sources.
- At the country level, much of the primary data from the public financial management system is of inadequate quality.
Progress toward a coherent, effective resource tracking system requires a long term view based on the needs of in-country decision makers and making the best use of modern information management technology. Therefore, the international community should:
- support improvements in the ability of developing country governments to develop sound budgets and report on their execution
- support the integration and institutionalisation of national health accounts into policymaking in developing countries
- improve data on private spending – including households, non governmental organisations (NGOs), and firms, as well as donations by private entities
- support and refine global-level information systems – including a long-term movement toward a system that takes advantage of technological advances to collect more accurate data.
