The Health Finance and Governance (HFG) Project organized a multi-country workshop to support policymakers from public health and finance agencies in developing concrete action plans for mobilizing domestic resources for health. This presentation on a DRM for health dossier demonstrates how countries might utilize available data to hold more productive discussions concerning domestic resource mobilization for health.

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)
Sample DRM for Health Dossier: Jasmania
Marty Makinen & Kirstin Krusell
September 2, 2016

2. Purpose of Sample Dossier
This sample dossier demonstrates how countries might utilize
available data to hold more productive discussions concerning
domestic resource mobilization for health.
2 | R4D.org

3. Purpose of Sample Dossier
 Which types of information each Ministry desires from the other
 Where there are gaps in available information
 How to present data in a way that is easily understood by both
Ministry and speaks to each other’s goals
In adapting this sample dossier, countries should keep in mind:
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4. Sample Dossier Contents
 National Policies and Strategies
 Macroeconomic Indicators
 Health Expenditure Data
 External Assistance for Health
 Health Indicators
 Issues Concerning MOH-MOF Relationship
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5. National Policies and Strategies
5

6. Jasmania’s National Policies and Strategies
 National Strategic Development Plan (2015 – 2025)
 Strategy emphasizes investment in economic infrastructure and
improving the social sectors to achieve SDGs
 National Health Sector Strategy (2015-2020)
 Main objectives
 Advancing UHC
 Reaching underserved populations
 Decreasing MMR and IMR
 Improving information systems
 Main approaches
 Increase investment in facilities
 Increase hiring of health workers (particularly midwives)
 Use resources more efficiently
 Mobilize additional resources
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7. Macroeconomic Indicators
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8. Macroeconomic Indicators
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2011 2012 2013 2014 2015 2016 2017 2018
Income
group
LIC LMIC LMIC LMIC LMIC LMIC LMIC LMIC
GDP per
capita
$1013 $1045 $1083 $1118 $1156
Economic
growth rate
5.7% 5.5% 5.9% 5.7% 5.7%
Taxes as %
GDP
11.1% 11.3% 11.4% 12.4% 12.4%
*All monetary amounts presented in current $USD, unless otherwise noted

9. Health Expenditure Data
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10. Total Health Expenditure (THE)
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2011 2012 2013 2014 2015
THE (USD millions)
$977 $997 $1,040 $1,043 $1,064
THE per capita (USD)
50 51 52 51 52
THE as % of GDP
5.0% 4.9% 4.8% 4.6% 4.4%
*All monetary amounts presented in current $USD, unless otherwise noted

11. Comparison to peers
0.0%
1.0%
2.0%
3.0%
4.0%
5.0%
6.0%
7.0%
2011 2012 2013 2014 2015
THE as a % of GNI
Oliviana THE % GNI Jasmania THE % GNI LMICs THE % GNI
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0
10
20
30
40
50
60
70
2011 2012 2013 2014 2015
THE per capita
Oliviana THE per capita Jasmania THE per capita
LMIC THE per capita
0.0%
1.0%
2.0%
3.0%
4.0%
5.0%
6.0%
7.0%
2011 2012 2013 2014 2015
GNI growth rates
Oliviana GNI growth Jasmania GNI growth
LMIC GNI growth

12. Government Health Expenditure (GHE)
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*All monetary amounts presented in current $USD, unless otherwise noted
2011 2012 2013 2014 2015
GHE (USD millions)
$332 $332 $360 $368 $389
GHE per capita
(USD)
$17 $17 $18 $18 $19
GHE as % THE
34% 33% 35% 35% 37%
GHE as % GGE
12% 12% 12% 12% 12%
GHE as % of GDP 1.7% 1.6% 1.7% 1.6% 1.6%

13. Government Health
Expenditure (GHE)
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$-
$5
$10
$15
$20
$25
$30
$35
GHE per capita
GHE per capita
Jasmania
Oliviana
LMICs
0%
10%
20%
30%
40%
50%
60%
GHE as % THE
GHE as % of THE
Jasmania Oliviana LMICs
0%
2%
4%
6%
8%
10%
12%
14%
16%
Jasmania Oliviana LMICs
GHE as % of GGE

14. Out-of-Pocket Expenditure (OOP)
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2011 2012 2013 2014 2015
OOP as % THE 60% 61% 60% 59% 58%
OOP per capita $30 $31 $31 $30 $30
*All monetary amounts presented in current $USD, unless otherwise noted

15. Out-of-Pocket Expenditure (OOP)
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0%
10%
20%
30%
40%
50%
60%
70%
OOP % THE
OOP as a % of THE 2015
Oliviana LMICs Jasmania
$-
$5
$10
$15
$20
$25
$30
$35
OOP per capita
OOP per capita 2015
Jasmania Oliviana LMICs

16. Budget Execution
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2011 2012 2013 2014 2015
GHE as % of budgeted
amounts
82% 88% 92% 90% 89%
*All monetary amounts presented in current $USD, unless otherwise noted

17. External Assistance for Health
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18. External Assistance for Health
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2011 2012 2013 2014 2015
External resources
as % THE
4% 4% 3% 3% 3%
Grants 62% 45% 40% 45% 49%
Loans 38% 55% 60% 55% 51%
External resources per
capita $ 2.20 $1.94 $1.77 $1.73 $1.72
External assistance (USD
millions) $43 $38 $35 $35 $35
Gavi status Graduating Graduating Graduating Graduating Graduating
Global Fund status Graduating Graduating Graduating Ended Ended
PEPFAR status Graduating Graduating Graduating Graduating Ended
World Bank IDA lending Eligible Eligible Not eligible Not eligible Not eligible

19. External Assistance for Health
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*All monetary amounts presented in current $USD, unless otherwise noted
$2.20
$1.94
$1.77 $1.73 $1.72
$-
$0.50
$1.00
$1.50
$2.00
$2.50
2011 2012 2013 2014 2015
External assistance per capita, Jasmania
2011-15
External per capita

20. Health Indicators
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21. Jasmania Health Indicators 2011-15
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2011 2012 2013 2014 2015
IMR 54 52 50 47 45
MMR 175 168 157 160 158
U5M 120 118 117 114 110
Pentavalent Coverage 88% 85% 83% 87% 85%

22. Jasmania Health Indicators by Wealth Quintile 2015
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Q1
(poorest) Q2 Q3 Q4
Q5
(wealthiest)
IMR
83 55 39 31 15
MMR
305 220 148 81 38
U5M
197 157 98 55 45
Pentavalent
Coverage (%)
62 84 94 93 93

23. Jasmania Health Indicators 2015 by Wealth Quintile
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0
10
20
30
40
50
60
70
80
90
Q1 (poorest) Q2 Q3 Q4 Q5 (wealthiest)
IMR by wealth quintile 2015
0
10
20
30
40
50
60
70
80
90
100
Q1 (poorest) Q2 Q3 Q4 Q5 (wealthiest)
Pentavalent Coverage by Wealth
Quintile 2015

24. Jasmania Health Indicators, 2015 Compared to Peers
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0
10
20
30
40
50
60
Jasmania Oliviana Region of Econ Dev
Coop
IMR 2105, Jasmania, Oliviana, REDC
0
20
40
60
80
100
120
140
160
180
Jasmania Oliviana Region of Econ Dev
Coop
MMR 2015, Jasmania, Oliviana, REDC

25. Issues Concerning MOH-MOF Relationship
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26. Issues concerning MOH-MOF relationship
 The MOH has difficulty demonstrating the efficiency of its spending
(i.e., linking expenditure to health outcomes)
 The MOF is hesitant to allocate additional resources to health, given
the health sector’s challenges spending its past allocations
 Dispersal of funds from MOF to MOH is often delayed
 MOH feels it is underfunded given comparisons to neighboring
countries and others in its region
 MOH feels like its contribution to poverty reduction and overall well
being of the Jasmania population is under-appreciated
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27. Dossier
 Macro economic data
 Policy priorities
 Health financing data
 Population health indicators
 Comparisons to peers
 Equity breakouts
 Issues of misunderstanding or misalignment between MOF and
MOH
Provides evidence base for MOF-MOH interaction
27 | R4D.org