| Code | SH.XPD.EXTR.ZS |
| Indicator Name | External resources for health (% of total expenditure on health) |
| Long definition | External resources for health are funds or services in kind that are provided by entities not part of the country in question. The resources may come from international organizations, other countries through bilateral arrangements, or foreign nongovernmental organizations. These resources are part of total health expenditure. |
| Source | World Health Organization Global Health Expenditure database (see http://apps.who.int/nha/database for the most recent updates). |
| Topic | Health: Health systems |
| Periodicity | Annual |
| Aggregation method | Weighted average |
| Statistical concept and methodology | Health expenditure data are broken down into public and private expenditures. In general, low-income economies have a higher share of private health expenditure than do middle- and high-income countries, and out-of-pocket expenditure (direct payments by households to providers) makes up the largest proportion of private expenditures. High out-of-pocket expenditures may discourage people from accessing preventive or curative care and can impoverish households that cannot afford necessary care. Health financing data are collected through national health accounts, which systematically, comprehensively, and consistently monitor health system resource flows. To establish a national health account, countries must define the boundaries of the health system and classify health expenditure information along several dimensions, including sources of financing, providers of health services, functional use of health expenditures, and beneficiaries of expenditures. The accounting system can then provide an accurate picture of resource envelopes and financial flows and allow analysis of the equity and efficiency of financing to inform policy. |
| Development relevance | Health systems - the combined arrangements of institutions and actions whose primary purpose is to promote, restore, or maintain health (World Health Organization, World Health Report 2000) - are increasingly being recognized as key to combating disease and improving the health status of populations. The World Bank's Healthy Development: Strategy for Health, Nutrition, and Population Results emphasizes the need to strengthen health systems, which are weak in many countries, in order to increase the effectiveness of programs aimed at reducing specific diseases and further reduce morbidity and mortality. To evaluate health systems, the World Health Organization (WHO) has recommended that key components - such as financing, service delivery, workforce, governance, and information - be monitored using several key indicators. The data are a subset of the key indicators. Monitoring health systems allows the effectiveness, efficiency, and equity of different health system models to be compared. Health system data also help identify weaknesses and strengths and areas that need investment, such as additional health facilities, better health information systems, or better trained human resources. |
| Limitations and exceptions | Country data may differ in terms of definitions, data collection methods, population coverage and estimation methods used.
In countries where the fiscal year spans two calendar years, expenditure data have been allocated to the later year (for example, 2010 data cover fiscal year 2009/10).
External resources for health are disbursements to recipient countries as reported by donors, lagged one year to account for the delay between disbursement and expenditure. Except where a reliable full national health account study has been done, most data are from the Organisation for Economic Co-operation and Development's Development Assistance Committee's Creditor Reporting System database, which compiles data from government expenditure accounts, government records on external assistance, routine surveys of external financing assistance, and special services. Because of the variety of sources, caution should be used in interpreting the data. |
| Notes from original source | In some cases, the sum of public and private expenditures on health may not add up to 100% because of rounding. All the health expenditure indicators refer to expenditures by financing agent except external resources which is a financing source. When the number is smaller than 0.05%, the percentage may appear as zero. In countries where the fiscal year begins in July, expenditure data have been allocated to the later calendar year (for example, 2010 data will cover the fiscal year 2009–10), unless otherwise stated for the country. |
| License URL | https://datacatalog.worldbank.org/public-licenses#cc-by |
| License Type | CC BY-4.0 |
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