Download logoThe African Center of Statistics (ACS) at the UN Economic Commission for Africa (ECA) this week opened a five-day workshop for delegates from Botswana, Ethiopia, Sierra Leone, and Togo, aimed at giving health ministries and statistical offices the tools to show, in economic terms, that health spending is an investment, not a cost.
The workshop is the first country level activity under ECA's broader Transforming Health Financing in Africa initiative, with the five countries as first movers. This week's session covers one part of it: building health focused Social Accounting Matrices (SAMs), economy wide accounts linking health services, financing, households, government, firms, and the rest of the world. Policymakers often know how much is spent on health but struggle to see the bigger picture: where the money comes from, who benefits, how much employment it generates, and how households are affected. The SAM connects data already spread across national accounts, health accounts, household surveys, and other sources into one coherent picture.
William Muhwava, representing the Director of ACS, said a central aim of the week is to "bring these different sources together within a coherent statistical framework" using each country's own national data, adding: "We are particularly pleased that this exercise is based on country data, not international data, and national ownership."
Delegates from ministries of health and national statistical offices in the four countries are participating, alongside resource persons from ECA and the World Health Organization (WHO).
Opening the workshop, Aboubakari Diaw, Chief of Staff at ECA, said the initiative responds to a mandate set by African Ministers of Finance in Tangier last April, where ministers agreed that health "cannot be considered, or continue to be considered, as a social expenditure, because it's an economic investment."
"Ministers of Finance cannot finance slowdowns. They need pipelines. They need projects. They need something that is structured. And they need to see, when we say that health is an investment, how health is an investment," Aboubakari Diaw said, noting that fiscal space across the continent is under exceptional strain, with debt servicing absorbing a growing share of government revenue and an estimated 150 million people pushed into poverty by health expenditures.
WHO Ethiopia's Kinsley Addai Frimpong also addressed participants, describing health financing as one of WHO's core health system "building blocks" and noting that integrating national health accounts into the SAM is, in his words, "a rich way of putting together the health data into the national system of accounts."
By Friday, each country team is expected to have an initial health disaggregated SAM with documented assumptions, data gaps, and balancing choices, a starting point rather than a finished product, with validation continuing under the wider project through 2028. Data availability remains the main practical challenge teams expect to face. Organizers also emphasized peer learning, with the ambition that participants leave as a network that keeps solving shared problems together.
Distributed by APO Group on behalf of United Nations Economic Commission for Africa (ECA).
