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A global commitment to improve health data

Dr Ties Boerma, Director of the Department of Health Statistics and Information Systems

Commentary
9 June 2015

For several years now, leaders from United Nations agencies and global health partnerships have been making increasingly loud calls for more and better health data.

They have been right to do so. Accurate and complete data are essential for good decision-making on health spending, for responding to countries' specific health needs and measuring progress and impact of health programmes.

Dr Ties Boerma, Director of the Department of Health Statistics and Information Systems.
WHO

International partners and donors, as well as domestic ministries of finance, are demanding stronger evidence that investments in health are producing results.

Health is a central component in the new set of global Sustainable Development Goals that will be finalized later this year. More than ever, this ambitious agenda will require countries to be able to show where and how they are making progress in health.

This means that every country needs to have robust and reliable health information systems. They need to be able to generate their own data to monitor health programmes and report on progress.

Right now, the world is not yet ready to do this. Here are some of the problems:

"More than two-thirds of the world's population lives in countries that do not produce reliable statistics on mortality by age, sex and cause of death."

Dr Ties Boerma, Director of the Department of Health Statistics and Information Systems

Virtually all of the 80 low- and lower-middle income countries have major gaps in skills, tools and resources to build quality health information systems.

More than two-thirds of the world's population lives in countries that do not produce reliable statistics on mortality by age, sex and cause of death – one of the most important health indicators for understanding a country's health priorities.

Low-quality data is being used to inform decisions on allocation of limited health resources – undermining the quality of those decisions.

There is a lack of a coordinated global approach between countries and development partners on what information countries should collect to measure progress in health.

Currently there are at least 600 health indicators that countries could be required to report upon through various global agreements, resolutions and programmes under United Nations agencies, partners and donors.

Donor programmes often collect data only for specific diseases and systems are fragmented and duplicative.

Countries and development partners have not invested wisely to build sustainable information systems that gather and make real-time health data available to all who need it. With the recent huge growth in digital technology, there are major opportunities to radically improve health information.

A turning point for health information systems

But that can all change. The Measurement and Accountability for Results in Health Summit, 9-11 June, heralds a new approach. WHO’s Director-General, who has been championing information and accountability among global health leaders, will set the stage and call for better information and accountability.

WHO, together with the World Bank and USAID, is leading an international collaboration to improve measurement and accountability for global public health over the next 15 years. Our goal is to support countries to have strong health information systems.

Global health leaders will endorse a Roadmap for Health Measurement and Accountability as well as a 5-point Call to Action. The Roadmap outlines a shared approach that countries and development partners can use to improve local capacity to plan, manage and measure their health programmes. The Call to Action proposes priority actions on investments, capacity strengthening, data sources, digital revolution and accountability, and presents measurable targets to guide this work.

Targets include countries having electronic systems in at least 80% of health facilities for real-time reporting of health statistics by 2025. They should also be able to collect and use comprehensive disaggregated quality data to review progress against national plans and report on progress against health-related goals.

By 2030, all births worldwide should be recorded in a civil registration system, and all hospitals should use the WHO standard ICD (International Classification of Disease) to report the cause of every death in their facility.

After the Summit, major global partners and country leaders will continue to work on establishing a global collaborative for measurement and accountability. The partnership aims to facilitate alignment, and accelerate country systems strengthening and monitoring of progress towards the targets.

Data revolution is key to improving health information

Recent rapid growth in digital technology in low- and middle-income countries provides major opportunities for improving data on health, but many of these remain untapped without the resources, skills and political will to set up sustainable systems.

The global agreements made this week place a strong emphasis on supporting countries to maximize the use of information technology, based on open standards, to improve information systems and empower decision-makers at all levels with real-time access to information.

100 core health indicators

This week, to coincide with the Summit, WHO is launching the Global Reference List of 100 Core Health Indicators.

"This set of 100 core indicators... provides concise information on the health situation and trends at the national and global level."

Dr Ties Boerma, Director of the Department of Health Statistics and Information Systems

Developed by a multi-agency working group chaired by WHO's Director-General over the past 2 years, this list is an example of work already underway to align and improve health information and measurement across development partners.

This set of 100 core indicators agreed by the global community provides concise information on the health situation and trends at the national and global level.

It covers the full spectrum of health priorities including maternal and child health, infectious diseases and emerging priorities such as noncommunicable diseases and universal health coverage.

All indicators were selected because they are scientifically robust and have a track record of being used for measurement in countries. The list will be a living document to be updated periodically as new priorities emerge and interventions change.

The aim of the Global Reference List is to reduce excessive and duplicative reporting requirements that currently burden countries and improve harmonization. It will serve as a global standard for health data collection in countries and align global health partners – exactly what is needed to enhance efficiency and availability of data and thereby improve transparency and accountability.