National health accounts of the Republic of Botswana: 2000-2002

Abstract

The objective of this study was to estimate the total health expenditure by various health financing sources and make recommendations for national health accounts (NHA) institutionalization. Data was obtained from government ministries, National AIDS Coordinating Agency, private for-profit/not-for-profit health care providers, public and private health insurance schemes, employers/firms, non-governmental organizations, and donors. NHA questionnaires were sent to all the 225 employers/private companies, 58 private health facilities, 27 NGOs, 12 donors and 8 insurance companies with health expenditures. The data were entered into NHA dummy matrix tables and analyzed using Excel software. The matrices were built in accordance to the International Classification of NHA to facilitate international comparison, but customized to the local situation.

Total health expenditure (THE) was approximately P1172.3 million (US$218.6M) in year 2000; P1717.1 million (US$284.7M) in 2001; and P2139.3 million (US$342.9M) in 2002. That expenditure represented 6.43%, 9.27% and 10.54% of the Gross Domestic product (GDP) during the three years, respectively. NHA evidence is useful for health system governance and decision-making, design of comprehensive health financing policies and strategic plans, financial planning, monitoring and evaluation.