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The World Health Survey Health System Metrics Glion, 28-29 September 2006

The World Health Survey Health System Metrics Glion, 28-29 September 2006. Q uestions raised by policy makers. How well is our health system doing? How do we know if we are making progress? How well are we doing given the resources? Where are the main problems? What can and should be fixed?

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The World Health Survey Health System Metrics Glion, 28-29 September 2006

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  1. The World Health SurveyHealth System MetricsGlion, 28-29 September 2006

  2. Questions raised by policy makers • How well is our health system doing? • How do we know if we are making progress? • How well are we doing given the resources? • Where are the main problems? • What can and should be fixed? • What will it cost? • What is the best use of limited (additional) resources?

  3. Goals of Health Systems Performance Assessment • Provide national decision-makers and the public with sound evidence: • to inform strategic decisions on health sector reform and health system organization e.g. financing arrangements, regulation of private providers • to inform implementation of programmes by local, regional and national managers • to monitor progress towards national targets for health and health systems

  4. Stewardship (oversight) Responsiveness (to people’s non medical expectations) Creating resources (investment and training) Delivering services (provision) Health Financing (collecting, pooling and purchasing) Fair financial contribution The WHO health system framework GOALS / OUTCOMES OF THE SYSTEM FUNCTIONS THE SYSTEM PERFORMS I N P U T S Coverage Provider Performance

  5. develop a low cost means of providing data that is valid, relevant, reliable and comparable on outcomes, functions & inputs to health systems to supplement the information provided by HIS The World Health SurveyObjectives

  6. build the evidence base necessary for policy-makers to routinely monitor if health systems are achieving the desired goals and in some countries, to assess if the increase in health resources is having the desired effect The World Health Survey Objectives

  7. 71 SURVEYS in 71 countries Household - long : 53 Household - short: 14 CATI : 4 The boundaries and names shown and the designations used on this map do not imply the expression of any opinion whatsoever on the part of the World Health Organization concerning the legal status of any country, territory, city or area or of its authorities, or concerning the delimitation of its frontiers or boundaries. Dotted lines on maps represent approximate border lines for which there may not yet be full agreement. © WHO 2002. All rights reserved World Health Survey

  8. World Health SurveyContent • Health Expenditure and Economic status • Measurement of Health States • Risk Factors • Mortality • Coverage • Responsiveness • Health System Goals

  9. World Health SurveyHousehold Health Expenditure • Information on health care spending • Provides reliable figures for health care fraction of household expenditure • Provides an alternative way of estimating or validating permanent income data

  10. World Health SurveyHealth Insurance • protection from catastrophic health expenditure • access to health services • reduction of financial burden of paying for health services

  11. World Health SurveyHealth State Description • Baseline data on national healthy life expectancies and inequalities in healthy life expectancies in absolute terms and by income groups • Health is a multidimensional experience • Difficulty in 8 domains of functioning based on an international framework • Valuation of health states to combine measurement across domains

  12. World Health Survey Coverage Do those with health care needs get the necessary health interventions? • DETERMINANTS: What determines the coverage ? • BARRIERS: What are the barriers preventing coverage ?

  13. Catastrophic expenditure and impoverishment

  14. Out of pocket payment

  15. Coverage

  16. Coverage

  17. Responsivenessproblems communicating

  18. World Health SurveyFuture steps • Strengthen Health Information Systems by • Supplementing vital registration systems • Combining census, surveys and service data • Incorporating private sector and public sector data • Improving survey methods by including measurements and biomarkers • Improving methods for small area assessment

  19. Acknowledgement • Xu Ke • Paul Kowal • Saba Moussavi • Nirmala Naidoo • Amit Prasad • Emese Verdes

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