Measurable outputs are a key element of the World Health Organization transformation and its “triple billion” target. Last week, WHO Executive Board discussed the Impact Framework, a key measurement system. Board members asked clarifications on indicators and underlined the challenge of data collection in many countries. A consultation with country experts is expected to be held before the May World Health Assembly.

The framework, which seeks to implement the United Nations Sustainable Development Goals, is a measurement system including targets and indicators to measure progress in healthy life expectancy, universal health coverage, health emergencies and healthier populations, according to the Board document [pdf].

The Board took the action of noting the meeting document last week at the 144^th session of the Executive Board meeting taking place from 24 January to 1 February. Before doing so, a number of Board members asked for clarification on the framework and its indicators, such as Zambia for the Africa region, which asked how each index refers to each billion target, and how each region contributes. The Zambian delegate also questioned the comparability of indexes across countries.

The so-called “Triple Billion” are three WHO strategic priorities or targets over the coming five years: 1 billion more people benefiting from universal health coverage; 1 billion more people better protected from health emergencies; and 1 billion more people enjoying better health and well-being.

Data collection was another issue that was brought to attention by Board members, and Finland for the Nordic and Baltic countries suggested a Geneva-based consultation before the annual World Health Assembly (WHA) in May to discuss indicators. The United States also stressed the challenge of data collection in many countries, and asked how WHO will help countries prioritise indicators and asked for more details on accountability.

Data requirement as described in the framework is challenging, Sri Lanka remarked, and asked for a discussion to prioritise core indicators to help member states to adapt the framework to national needs. Brazil added that many indicators are complex in terms of concept, novelty, and assessment, and that different countries measure health-related issues differently, and might not measure outputs the way that is suggested in the framework. Some of the criteria also are subjective, such as what better living conditions means, the Brazilian delegate added.

Non-Board members such as Bangladesh also underlined the challenge of data gathering in particular in resource-constrained settings, and the need for support from the international community.

WHO Director General Tedros Adhanom Ghebreyesus agreed on a Geneva-based consultation so the framework can be refined before the May WHA. Following the UN process, he said, no indicators can be used without the approval of member states. He agreed to the need of capacity building and said he welcomes recommendations in building health information system in order to have better capacity at national level, which is key.

Soumya Swaminathan, WHO deputy director-general for programmes, said comments showed the need to work along with member states experts both statistical experts and from ministries of health in developing indexes further.

[Note: this article first ran in our sister publication, Intellectual Property Watch.]

Image Credits: Rikolto (Vredeseilanden).