Monitoring, tracking and evaluation
Countries need to be able to assess both their status and momentum whether they are in the phase of planning, engaged in the transition or already at a certain endpoint of a larger reform. They need to know whether the country is moving closer to or further away from the goals associated with universal coverage.
Monitoring policy and reforms
Monitoring progress towards universal coverage and the health financing reforms undertaken needs to focus on changes to the extent to which people have access to needed, good quality health services and to financial risk protection.
Countries also need to monitor their progress regarding some of the key health financing indicators. Information provided by the National Health Accounts (NHA) is the key source for this information. Countries can also use other information and indicators that are relevant to their context and policy aims. Ideally, this requires a comprehensive health information system that integrates all the needed health system indicators and information collection and tracking mechanisms. It also requires having people with the necessary policy analytic skills and mandate, both to analyze the data for tracking indicators, and to develop and implement an evaluation framework tailored to their country’s specific challenges and financing reform agenda.
Some of the information needed to effectively monitor changes in out-of-pocket spending and financial risk protection comes from household surveys. There is often a need for better analytical use of household surveys, especially for access to services and financial risk protection.
To assess how reforms are influencing these and other objectives, such as aspects of efficiency for which contextualized country-specific measures would need to be developed, specific research methodologies need to be applied depending on the way that reforms are implemented (e.g. pilots, phasing, etc.). This assessment will often relying on a combination of household surveys, administrative data, and qualitative research.