Monitoring health systems Health system metrics

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Monitoring health systemsHealth system metrics

• Health Metrics Network
• 1st Steering Committee Meeting
• March 21 2006

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Overall goal

• Develop a common strategy to monitor health
  systems in countries that
• Guides and advocates for investment in a data
  generation strategy that provides accurate
  statistics for health system indicators
• Includes a core set of health system indicators,
  if possible with baselines and targets or
  thresholds
• Promotes the incorporation of health system
  monitoring in planning cycles (e.g. PRSP, annual
  health sector reviews, strategic plans etc.)
• Contributes to effectively communicating about
  health systems

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Demand Side

• Communication Make health systems tangible by
  focusing on actionable (measurable) items
• Global Health Partnerships enhance
  accountability of investments in health systems,
  directly related to core mandate of the
  respective partnerships
• Performance-based disbursement systems
  performance using relatively simple reliable set
  of statistics that can be reported on frequently
  (e.g. EC)
• Composite measures of health system performance
  (effective coverage, responsiveness)
• Demand for human resources statistics
• Health Metrics Network in coordination role

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Supply Side

• WHO World Health Statistics 2005 (9 indicators)
  and World Health Report annexes (financing)
• OECD, developed countries indicators extensive
  lists of indicators of clinical services for
  reporting
• Global Health Partnerships (GAVI, GFATM), WHO
  departments, HR developing shortlist of
  indicators for (suggested) reporting
• Co-coverage of interventions of child health
  (equity, Countdown)

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WHO / World Bank meeting in 2004 First step
towards defining a set of core health system
metrics(health system inputs, outputs)

• Financing
• Total health expenditure per capita
• Total health expenditure as of GDP
• General government expenditure on health as of
  total government expenditure
• Human resources
• Health workers per 1,000 population (physicians,
  assistance doctors, nurses, midwives)
• Nurse physician ratio (skills mix) Annual output
  of health workers by training institutions per
  1,000 population
• Information
• of estimated deaths that are 'counted'
• Service delivery
• Hospital (in-patient) beds
• Policy / governance
• CPIA
• Additional (OECD list)
• Under development

Health system Inputs Outputs
Outcomes Policy Financing Human resources
Information Service delivery
Service coverage Utilization
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Human resource data availability end 2004
percent distribution of countries by year and
WHO region, World Health Statistics 2005
Quality concerns!
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GAVI