Meeting the Demand for Results and Accountability: A Call for Action on Health Data from Eight Global Health Agencies
Authors: Margaret Chan, Michel Kazatchkine, Julian Lob-Levyt, Thoraya Obaid, Julian Schweizer, Michel Sidibe, Ann Veneman, Tadataka Yamada
Journal: PLoS Medicine (2010)

Recent substantial increases in international attention to health have been accompanied by demands for statistics that accurately track health progress and performance, evaluate the impact of health programs and policies, and increase accountability at country and global levels. The use of results-based financing mechanisms by major global donors has created further demand for timely and reliable data for decision-making. In addition, there is increasing country demand for data in the context of health sector strategic plans, including in countries that have established International Health Partnership (IHP+) compacts [1]. In spite of recognized efforts by programs and countries, the ability to respond to this demand is constrained by limited data availability, quality, and use. Many developing countries have limitations that hamper the production of data of sufficient quality and timeliness to permit regular tracking of progress made in scaling up and strengthening health systems. Data gaps span across the range of input, output, outcome, and impact indicators. New ways of working and a more systematic approach by all partners are needed to better monitor and evaluate progress and performance. We believe that this global public good is a necessary foundation to improve health investments and programs and accelerate progress towards the Millennium Development Goals (MDGs) and other major international health goals.

Monitoring and evaluation (M&E) in health requires different types of data, including levels and distribution of health financing, health workforce, service access and quality, intervention coverage, risk factors, and health status, which are derived from multiple sources. Table 1 summarizes the current situation and required actions in developing countries for the main data sources: household surveys, birth and death registration, census, health facility reporting systems including surveillance systems, and administrative data. To improve data availability, quality, and use, each of these data sources need to be strengthened according to international principles and standards, including the Health Metrics Network framework for country health information systems [2],[3]. In this process, strengthening country capacity in collecting, processing, analyzing, and using health data is essential. There are many initiatives to support capacity building, but the current situation tends to be fragmented, often driven by the needs of single-disease programs. Long-term systematic efforts to build the capacities of country institutions are few and far between. Such an approach should promote quasi-autonomous or independent country institutions, which work very closely with ministries of health and national statistical offices. Adherence to the Fundamental Principles of Official Statistics is critical to increase accountability, transparency, and adherence to quality standards [4].



Table 1

Health data sources: Situation in countries and required actions.



The eight agencies working in global health (Box 1) agree that it is critical to strengthen the five key data sources (Table 1) and capacity for analysis, synthesis, validation, and use of health data in countries. This should enable countries to better monitor and evaluate their own progress and performance and, secondarily, allow them to respond to the increased emphasis on results and accountability [5]. The eight agencies propose four global actions to support these country goals.


Box 1. Eight Agencies Working in Global Health

Bill & Melinda Gates Foundation


GAVI


Global Fund to Fight AIDS, Tuberculosis & Malaria


UNAIDS


UNFPA


UNICEF


World Bank


World Health Organization