Understanding the magnitude and flow of financial resources is an important factor in making informed decisions about the equitable and efficient allocation of resources. Data from State Level Health Accounts (SLHA) can provide such information and can be particularly valuable in countries such as India where the health system is largely decentralized and most key health policy and financing decisions occur at the state level.

USAID is working in partnership with six priority states in India to provide targeted technical assistance in the area of health financing. The state of Haryana ranks among the highest in out-of-pocket expenditures on health in the country. If utilized effectively, results from SLHA, combined with service utilization information, can help stakeholders gauge the effectiveness of health financing policies that aim to reduce out-of-pocket expenditures and support the equitable provision of priority health services.

To track the flow of resources in the Haryana’s health sector and thereby strengthen informed policy making processes, the Health Finance and Governance (HFG) project is working in partnership with the National Health Mission to launch SLHA in Haryana.

Dr. Carlos Avila (HFG) leads a discussion about the importance of tracking health spending with members of the SLHA Steering Committee in Haryana, India.
Photo: National Health Mission, Haryana.

As part of this process, HFG helped the state develop a roadmap for the institutionalization of SLHA and, in July 2014, facilitated the inaugural meeting of the multi-stakeholder Steering Committee in Haryana. The meeting was chaired by Mrs. Navraj Sandhu, Additional Chief Secretary of Heath for Haryana, and was attended by several prominent government and ministry officials, including those from the National Health Mission and the National Health Systems Resource Center.

At the meeting, the HFG team presented international experiences and lessons learned from Health Accounts conducted in the Southeast Asia region, and health experts from Haryana shared their views and discussed policy applications of the results. Committee members agreed that SLHA in Haryana would be led by the Haryana State Health Resource Center (HSHRC), a think tank within the department of health, with technical support from HFG. Establishing a roadmap for institutionalization and utilizing the HSHRC will ensure that results are relevant to the state and that the SLHA methodology and analysis can be replicated in the future.

During the event’s closing remarks, Mrs. Sandhu noted that initiating and implementing health accounts is critical to the successful public health financial management in Haryana. The event drew media attention from the Amar Ujala, a local newspaper that published a brief summary of the steering committee deliberations.