session 10: measurement & accountability for progress on...
TRANSCRIPT
1 | Health, the SDGs and the role of UHC consultation | 30 March – 1 April 2016, New Delhi, India
Session 10: Measurement & Accountability for
Progress on UHC and the Health SDG
Mark Landry
Regional Advisor Health Situation and Trend Assessment
World Health Organization South-East Asia Regional Office
2 | Health, the SDGs and the role of UHC consultation | 30 March – 1 April 2016, New Delhi, India
Key Messages
Minimize data collection and reporting burden, maximize data quality, analysis and use for policy, planning, and better services. Information is care.
Align the new SDG and UHC monitoring frameworks, processes, indicators with national M&E framework and core indicators. National priorities come first. UHC is central to the health-related SDGs.
Implement strategic approach to support effective health measurement and accountability. Operationalizing the 5-point Call to Action at country level.
3 | Health, the SDGs and the role of UHC consultation | 30 March – 1 April 2016, New Delhi, India
Moving from MDGs to SDGs…
More flexible, comprehensive, integrated monitoring
Driven by national not global targets
Emphasis on stratifying indicators by equity dimensions
4 | Health, the SDGs and the role of UHC consultation | 30 March – 1 April 2016, New Delhi, India
Importance of Equity—who is left behind?
0
20
40
60
80
100
Contraceptive Met
Needs
ANC - 4visits
SBA
PNC(within 2 days)
DTP3coverage
AntibioticTreatment - Under
5
ImprovedSource ofDrinkingWater
Coverage in Q5 Coverage in Q1
0
20
40
60
80
100
Contraceptive MetNeeds
ANC - 4visits
SBA
PNC(with in2 days)
DTP3coverage
AntibioticTreatment -
Under 5
ImprovedSource ofDrinkingWater
Urban Rural
0
20
40
60
80
100
Contraceptive MetNeeds
ANC - 4visits
SBA
PNC(with in2 days)
DTP3coverage
AntibioticTreatment -
Under 5
Higher Secondary No Education
No data
By income Urban v Rural By education level
5 | Health, the SDGs and the role of UHC consultation | 30 March – 1 April 2016, New Delhi, India
Health and the Sustainable Development
Goals (SDGs)
Total: 17 goals, 169 targets, 200+ indicators
Health: 1 goal, 13 targets, 25+ indicators
6 | Health, the SDGs and the role of UHC consultation | 30 March – 1 April 2016, New Delhi, India
Health in other SDGs
Target 1.3:
Implement social
protection systems
for all
Target 6.1: achieve
universal and
equitable access to
safe and affordable
drinking water
Target 2.2: End
malnutrition,
achieve targets for
reductions child
stunting and
wasting
Target 16.1: reduce
all forms of violence
and related death
rates everywhere
Target 5.2: End all
forms of violence
against all women
and girls ….
Target 4.2: ensure
access to early
childhood
development, care
and pre-primary
education
7 | Health, the SDGs and the role of UHC consultation | 30 March – 1 April 2016, New Delhi, India
13 Targets under SDG 3: “Ensure healthy lives and promote well-being for all at all ages”
8 | Health, the SDGs and the role of UHC consultation | 30 March – 1 April 2016, New Delhi, India
26 Indicators under Health SDG 3 (Blue = Tier 1 or 2; Red = Tier 3)
9 | Health, the SDGs and the role of UHC consultation | 30 March – 1 April 2016, New Delhi, India
Health SDG 3: Target 3.8
Indicator 3.8.1: coverage of essential health services (index)
Indicator 3.8.2: financial protection when using health services
Achieve universal health coverage, including financial risk protection, access to quality essential health-care services and access to safe, effective, quality and affordable essential medicines and vaccines for all
10 | Health, the SDGs and the role of UHC consultation | 30 March – 1 April 2016, New Delhi, India
Based on global
UHC monitoring framework
2013-2014: Development of framework
– WHO & World Bank, 13 country-led case studies, web consultation
– Scientific publication with country studies
2015-2016: Implementation of framework
– 2015 1st Global report tracking UHC (WHO & World Bank)
– 2016 1st Monitoring the health-related SDG
– 2016: 2nd Global tracking UHC report (WHO & World Bank)
11 | Health, the SDGs and the role of UHC consultation | 30 March – 1 April 2016, New Delhi, India
Indicator 3.8.1
Coverage of essential health services
Definition: Average coverage of essential services based on 4 tracer
indicators in each of 4 categories:
– service capacity and access
– noncommunicable diseases
– infectious diseases
– reproductive, maternal, newborn and child health
Index = average national coverage for tracer indicators across the
four categories, adjusted for coverage among the most
disadvantaged population
Data sources for the 16 tracer interventions:
– Household surveys (10); Facility surveys (2)
– Administrative records (2) and a combination of all these sources (2)
12 | Health, the SDGs and the role of UHC consultation | 30 March – 1 April 2016, New Delhi, India
Good data availability for the indicators of
the UHC service coverage index
13 | Health, the SDGs and the role of UHC consultation | 30 March – 1 April 2016, New Delhi, India
Indicator 3.8.2:
Financial Protection
Current indicator: Number of people covered by health
insurance or a public health system per 1,000
population
– Problematic formulation as it reflects affiliation or an entitlement.
“Public health system coverage” is too vague. People may be
insured or covered, but still face high payments.
Proposed alternative indicator: Proportion of the
population with large household expenditure on
health as a share of total household expenditure or
income (e.g. 25%)
– Still being debated now at the Inter-Agency and Expert Group
(IAEG) for the SDGs meeting in Mexico City, 30 Mar – 1 April
14 | Health, the SDGs and the role of UHC consultation | 30 March – 1 April 2016, New Delhi, India
Regional Updates on Health Indicators
Launch of new Regional Health Information Platform
(HIP) for SEAR May/June 2016
– Powered by District Health Information Software 2.0 (DHIS2),
which is in use in 9 of 11 SEAR countries already
– Better access to nationally reported health indicators and global
health estimates, query and analytics, health theme
dashboards
Consolidated and single annual data call from countries
for new SEAR Core Health Indicators (CHI) based on:
– Includes Global Reference List of 100 Core Health Indicators
(Health SDG indicators inclusive)
– Plus 32 regional priority indicators
15 | Health, the SDGs and the role of UHC consultation | 30 March – 1 April 2016, New Delhi, India
UHC Monitoring Dashboard for SEAR
Country and
Regional views of
UHC progress
Financial risk
protection
Health service
coverage
Inequalities
Overall health
impacts
16 | Health, the SDGs and the role of UHC consultation | 30 March – 1 April 2016, New Delhi, India
Measurement and Accountability for
Results in Health (MA4Health)
Convened Summit by World
Bank, WHO, USAID (June 2015)
Renewing commitments,
increasing attention, and creating
pathways for coordinated
strengthening of M&E, HIS,
CRVS, eHealth in post-MDG era
SEAR moving ahead with
partners
17 | Health, the SDGs and the role of UHC consultation | 30 March – 1 April 2016, New Delhi, India
MA4Health: 5-Point Call to Action
1) Increase the level and efficiency of investment by governments and development
partners to strengthen the country HIS in line with international standards and
commitments
2) Strengthen country institutional capacity to collect, compile, share, disaggregate,
analyze, disseminate and use data at all levels of the health system
3) Ensure that countries have well-functioning sources for generating population health
data, including civil registration and vital statistics systems, censuses, and health
surveys tailored to country needs, in line with international standards
4) Maximize effective use of the data revolution, based on open standards, to improve
health facility and community information systems including disease and risk
surveillance and financial and health workforce accounts, empowering decisions makers
at all levels with real-time access to information
5) Promote country and global governance with citizens’ and community’s participation for
accountability through monitoring and regular, inclusive transparent reviews of progress
and performance at the facility, subnational, national, regional, and global levels, linked
to the health-related SDGs
18 | Health, the SDGs and the role of UHC consultation | 30 March – 1 April 2016, New Delhi, India
MA4Health: 5-Point Call to Action
1) Increase the level and efficiency of investment by governments and development
partners to strengthen the country HIS in line with international standards and
commitments
2) Strengthen country institutional capacity to collect, compile, share,
disaggregate, analyze, disseminate and use data at all levels of the health system
3) Ensure that countries have well-functioning sources for generating
population health data, including civil registration and vital statistics systems, censuses,
and health surveys tailored to country needs, in line with international standards
4) Maximize effective use of the data revolution, based on open standards, to
improve health facility and community information systems including disease and risk
surveillance and financial and health workforce accounts, empowering decisions makers
at all levels with real-time access to information
5) Promote country and global governance with citizens’ and community’s
participation for accountability through monitoring and regular, inclusive
transparent reviews of progress and performance at the facility, subnational, national,
regional, and global levels, linked to the health-related SDGs
19 | Health, the SDGs and the role of UHC consultation | 30 March – 1 April 2016, New Delhi, India
The Country Roadmap for Health
Measurement and Accountability
Goal
By 2030, all low and middle income
countries have the necessary
information to improve health and health
services and achieve national and
global health-related Sustainable
Development Goals
20 | Health, the SDGs and the role of UHC consultation | 30 March – 1 April 2016, New Delhi, India
Key Messages
Minimize data collection and reporting burden, maximize data quality, analysis and use for policy, planning, and better services. Information is care.
Align the new SDG and UHC monitoring frameworks, processes, indicators with national M&E framework and core indicators. National priorities come first. UHC is central to the health-related SDGs.
Implement strategic approach to support effective health measurement and accountability. Operationalizing the 5-point Call to Action at country level.
21 | Health, the SDGs and the role of UHC consultation | 30 March – 1 April 2016, New Delhi, India
Thank You
Mark Landry [email protected]