Health Budget Tracking System, Egypt, BTS Phase II: Final Report
Development of a Budget Tracking System (BTS) was one of several major activities in Egypt undertaken by the Data for Decision Making (DDM) project. The object of the BTS is to provide routine accurate information on the allocation of government health care expenditures by function. Functions were defined in collaboration with the Ministry of Health and Population (MOHP), Arab Republic of Egypt (ARE). USAID/Cairo asked the DDM project to determine whether such a system was practical and if so, to develop the methodology necessary for the MOHP to operate and maintain the system. The DDM project was also asked to develop or help develop the necessary supporting information technology. BTS activities were separated into two phases. Phase I concentrated on defining function categories, methods for classifying expenditures into these categories, and testing the methodology in three governorates: Alexandria, Beni Suef, and Suez. Phase II expanded testing to eight governorates: Alexandria, Aswan, Beni Suef, Dakahlia, North Sinai, Port Said, South Sinai, and Suez. The original three governorates were included so that results from two successive years could be compared. Phase II also funded development and testing of three automated management systems: drug inventory control, general accounting, and personnel/payroll. These three systems were designed to provide data required by the BTS and to eliminate most manual data collection. Phase II collected complete BTS results for eight governorates. These results, including comparisons among governorates and between years for three governorates, are included in Annex C. Collecting and classifying this data manually requires considerable effort. It is not practical to repeat this regularly on a national scale without automation. Three automated management modules were developed and tested by a software contractor under DDM supervision. Testing was done in Alexandria governorate over the span of several months. Drug inventory control and general accounting systems are complete and operational. The personnel/payroll system still contains serious flaws. Despite some problems, it is difficult to see how the MOHP could possibly develop and maintain these kind of software systems over the long term. It should be possible for the private sector to meet the needs of this large potential market competitively. DDM developed a flexible bilingual Executive Information System (EIS) using Microsoft Excel and ODBC database drivers for database access. The Partnerships in Health Reform (PHR) project plans to transfer the EIS to the MOHP for further development and deployment. Development of a fully automated national BTS will take time. With PHR assistance, the MOHP is trying to develop the internal capacity to operate and maintain this kind of system. In the mean time, a vastly simplified formula is being used to provide the basic indicators required for USAID health sector reform program assistance.