Terms of Reference

1
Terms of Reference
Primary Health care in Azerbaijan

• monitoring the budget and developing mechanisms
  of efficient allocations

2
Background

• Only one-fifth of total healthcare expenditure in
  Azerbaijan is directed to PHC services. AZN 27.9
  million (US 31 million) has been allocated to
  PHC from the State Budget-2006 and its share in
  total healthcare expenditure is 18.5. That means
  the annual amount of public healthcare costs is
  3 per capita. (WHO standards are 15-20)

3
The overall goal of the project

• Project aims at improving transparency of budget
  processes through developing a model, which
  allows assessing effectiveness of budget
  expenditure in primary health care.
• In the long-term perspective, this will
  contribute to improving the quality of primary
  health care in Azerbaijan.

4
The focus point

• The expenditures at all levels of distribution
• Sources MoF
• Agents MoH, Finance department at district
  levels Central hospital Rural executive bodies
• Providers clinics and hospitals

Source ? agent ? provider
5
Study aim and objectives

• To identify efficiency of budget expenditure in
  two pilot districts on primary health care in
  2005.
• To develop the model and mechanisms for effective
  and efficient use of budget expenditure in PHC.
• The fiscal and calendar year are the same in
  Azerbaijan.

6
Rationale source of data

• The research will track officially reported
  actual expenditures of MoH on PHC in 2005. The
  research might slightly touch other sources of
  funding (for ex., out-of-pocket expenditures of
  the patients)
• In order to receive the information a budget
  documentation will be obtained. The project group
  will officially request all appropriate
  organizations/institutions to provide an
  additional information. The personal
  contacts/relations will be used. The project will
  conduct survey among health care workers in PHC
  clinics/hospitals. The second survey will be
  conducted among population.

7

• The funds allocated in the budget will be
  measured with the actual expenditures stated in
  the documentation of service providers (i.e.
  clinics and hospitals). The indicators to be
  used PHC per capita expenditures according to
  the official information from MoH and those
  stated in the clinics/hospitals.
• The analysis will include analysis of the
  beneficiary groups and object of expenditures.
• During the research the functional cost analysis
  will be performed

8
Advocacy

• The results of the study i.e. quantitative and
  description reports will be submitted to Working
  group on health reforms, MoH and MoF officials,
  parliament and to international organizations
  such as WHO, WB, WMF
• The results of the research will be submitted to
  the officials and international organizations in
  the form of the official report. The meetings
  will be conducted with all the listed
  organizations. The results will also be discussed
  on round tables with representatives of civil
  society, experts and the mass media.
• The specific detailed reports will be submitted
  to NGOs and the mass media.

9

• The project will use the capacities of
• National Budget Group (which includes 9 strongest
  NGOs)
• NGOs working in health sector
• Mass media, both publishing and TV
• Representatives of Social Economic Committees
  of the Parliament

10

• Our messengers
• Head of Committees in the Parliament
• NGO alliances
• Initiative groups

11

• There are several health reform projects are
  being performed by WHO, WB and USAID in
  Azerbaijan. The project group will conduct
  meetings with the representatives and provide the
  research results and the projects suggestions to
  these organizations
• There will be organized a forum with
  participation of regional and international
  experts on organization of health care.
• The project intends to conduct TV debates and
  talk shows develop PSAs.

12
Expected results

• To improve the budget mechanisms in healthcare
  system
• To make the PHC more efficient and accessible for
  vulnerable groups

13

• Thank you!