session 10: measurement & accountability for progress on...

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

[email protected]

World Health Organization South-East Asia Regional Office

mailto:[email protected]


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.


Moving from MDGs to SDGs…

More flexible, comprehensive, integrated monitoring

Driven by national not global targets

Emphasis on stratifying indicators by equity dimensions


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


Health and the Sustainable Development

Goals (SDGs)

Total: 17 goals, 169 targets, 200+ indicators

Health: 1 goal, 13 targets, 25+ indicators


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


13 Targets under SDG 3: “Ensure healthy lives and promote well-being for all at all ages”


26 Indicators under Health SDG 3 (Blue = Tier 1 or 2; Red = Tier 3)


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


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)


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)


Good data availability for the indicators of

the UHC service coverage index


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


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


UHC Monitoring Dashboard for SEAR

Country and

Regional views of

UHC progress

Financial risk

protection

Health service

coverage

Inequalities

Overall health

impacts


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


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


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


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


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.


Thank You

Mark Landry [email protected]

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