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Building the Knowledge and Use of National Health Accounts Among Civil Society Stakeholders in Liberia


Financing mechanisms for public health care are one of the indispensable pillars of a strong health system. In many developing countries, however, an understanding of the important role to be played by civil society in advocating for health financing is weak. In particular, there is little knowledge of National Health Accounts (NHA) and how NHA data can be used to influence government policies. NHAs are a globally-recognized tool for helping governments track and organize healthcare expenditures in order to more effectively analyze and plan for health systems in the long term. As part of the USAID-funded Health Systems 20/20 project, Deloitte Consulting LLP collaborated with the Ministry of Health and Social Welfare (MoHSW) in Liberia and local and international non-governmental organizations (NGOs) to increase the knowledge and use of NHA data by a wider variety of actors with a view toward impacting the quality of healthcare delivered.

The Challenge

Liberian organizations engaged at the national level often struggle to access specific data around health spending that could be used for advocacy, policy, and planning purposes. This challenge is exacerbated by an already weak clinical data collection system which renders difficult evidence-based healthcare planning. Of particular note is NGOs' lack of knowledge of the purpose, use, and findings of NHAs. By addressing this gap, NHA data can serve as an important tool for national decision-makers and civil society advocating to expand health financing.

How We Helped

Deloitte and its collaborators on the HS 20/20 project worked with the Department of Planning, Research, and Development of the MoHSW to organize and execute an NHA Subaccount Workshop for local and international NGOs as well as other civil society stakeholders. Held in Monrovia, the activity focused on the following objectives:

  • Increase participants' knowledge, use and understanding of NHA and subaccount findings to inform, advocate for, and evaluate health policies and funding allocations;
  • Generate local interest and engagement around NHA subaccounts, with the goal of promoting their long-term use;
  • Learn how NHA findings could be relevant to local organizations and programs when planning health activities; and
  • Solicit input from civil society to improve and facilitate the NHA process for future estimations.

NHA knowledge sharing specifically emphasized subaccounts for reproductive health, child health, and malaria in order to discuss and seek solutions for the persistent financing challenges presented by these health issues in Liberia.


By engaging for the first time key civil society stakeholders in Liberia about NHAs, the Health Systems 20/20 project is helping to expand the knowledge and the usefulness and of the NHA tool and encourage a more rigorous use of NHA data. In doing so, Liberian health organizations can play a more active role in supporting the development and implementation of critical evidence-based health policies.

Deloitte's work in Liberia under Health Systems 20/20 is carried out under a subcontract with Abt Associates Inc., prime contractor for the Health Systems 20/20 cooperative agreement. Health Systems 20/20 is funded through the generous support of the American people through the U.S. Agency for International Development (USAID). The project helps USAID-supported countries address health system barriers to the use of life-saving priority health services. In the process, the project works to strengthen health systems through integrated approaches to improving financing, governance, and operations, and building sustainable capacity of local institutions.

As used in this document, `Deloitte' means Deloitte Consulting LLP, a subsidiary of Deloitte LLP. Please see for a detailed description of the legal structure of Deloitte LLP and its subsidiaries. Certain services may not be available to attest clients under the rules and regulations of public accounting.

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