Health statistics and information systems

Report: First Consultation of the High Level Advisory Panel on Health Statistics

Summary of Main Recommendations

Strengthen the WHO process for the production of estimates

  • The proposed WHO four-step process for the production of regional and global estimates at headquarters – accessible database, transparent methods, independent advisory group and overall consistency through EIP clearance – is endorsed by the Panel. This pertains to mortality, morbidity and health status, disability, coverage and risk factor estimates.
  • There is considerable demand for country specific estimates. WHO can release estimates of country health statistics if the following are in place:
    • clearance through the four-step process and accompanying grading of underlying evidence for the estimate;
    • country consultation; emphasis on and clear communication of the uncertainty associated with the estimates;
    • efforts to provide a clear understanding to countries of the methods used to obtain the estimates, preferably by enabling the countries to carry out the analyses themselves.

Focus on producing key health statistics, especially mortality and causes of death

  • WHO's priorities for health statistics include reporting on mortality, morbidity, health status, service coverage and risk factor prevalence.
  • WHO should aim to produce mortality statistics by age, sex and cause of death on a regular basis for all countries. The comparability and quality of the estimates should be ensured in close collaboration with countries. The data sets should be accessible to the wider public and the methods should be transparent and developed in consultation with an external reference group. The frequency of the estimates should be driven by the availability of empirical data, but as a minimum a 3-year interval is desirable.
  • The estimation of composite measures of health, such as DALY, is to be limited in frequency (e.g. every 5 to 10 years) not because they are intrinsically less important, but rather because they require more effort, and, more importantly, the mortality and especially morbidity data upon which they are based in many countries are weak. The required modelling may be done better by academic or other institutions outside WHO. WHO should collaborate with such institutions, contribute to the production of estimates, and require transparency and reproducibility of the estimates.

Strengthen country data collection and analysis

  • WHO should take a leadership role in developing strategies for country data collection, capacity building and coordination of such activities across different partners. This includes advocacy and technical work to promote:
    • (sample) vital registration systems as a source of mortality and cause of death data.
    • household surveys as a source of data on mortality and health levels and distribution, including morbidity, health status, health service coverage and risk factor prevalence. Biomarkers in surveys can greatly expand the role of household surveys in monitoring morbidity, health status and risk factor prevalence.
    • Tools to provide sub-national health statistics.
  • Country-level statistical and epidemiological capacity to adjust for biases, synthesize and analyse data is weak in most developing countries. WHO should work with to strengthen analytical capacity through closer collaboration with the statistical constituency in countries, investment in user-friendly tools at the country level for data analysis and enhancing use for decision-making.