Available measurement tools and methods Current efforts, priorities Available measurement tools and methods Current efforts, priorities
Country Planning and Review Process Year 0Year 1Year 2Year 3Year 4 Annual operational plans Year 5 Annual reviews Annual reviews Midterm reviews Annual reviews Final reviews Facility assessments Research Routine facility reports & administrative data Household Surveys Vital event monitoring Annual health sector progress and performance assessment DQA & analysis CRVS SRS Availability & Readiness Quality of care Household Survey Household Survey Household Survey Finance HRH Infrastructure HMIS CRVS SRS Availability & Readiness Quality of care Finance HRH Infrastructure HMIS Finance HRH Infrastructure HMIS Finance HRH Infrastructure HMIS Finance HRH Infrastructure HMIS Quality of care
What do we need to improve the measurement of PHC? MORE INDICATORS!!! BETTER INDICATORS
Current situation Global 100 health indicators –Coverage: 27 indicators (+25 in additional 100) –Effective coverage: 5 (+ 5) –Service access & quality : 16 (+ 25 additional) OECD Quality of Care indicators –Very instructive experience –How far can one go with comparable data on quality of care? –Need for other methods beyond indicators for local action
What do we need to improve the measurement of PHC? MORE DATA COLLECTION!!! BETTER DATA COLLECTION
Current measurement efforts Routine facility health information systems –Coverage of intervention –Tracer drug availability Health facility surveys –SARA, SDI, SPA, and program specific surveys –Work towards standardized facility survey modules –Different levels: availability / readiness; knowledge provider; provider-client observation; "mystery" clients; exit interviews; Household surveys –Standardized health survey modules – PHC / UHC (e.g. diabetes) Research –Health services, implementation, operational, action …. –Patient Reported Outcome Measures (PROMS), Patient Reported Experience Measures (PREMS)
What do we need to improve the measurement of PHC? BETTER FACILITY DATA !!!!
Routine HMIS Major challenges/gaps & priorities Data quality inadequate - but improving Private sector often not captured Mushrooming of indicators; too many forms- Heavy burden on health workers Inadequate analytical capacity and use: local and national Package of data standards and tools for facility/ community data Core indicators, data quality metrics, analytical methods outputs, dashboards, template forms, ICD mortality module Integrated/interoperable systems – strengthen governance Joint strategy for DHIS 2.0 investment (development, scale up, capacity, maintenance)
Health facility surveys What are the major challenges & priorities? Regular harmonized system of monitoring of availability, readiness and quality of services Builds upon routine facility reporting system Verification of data quality in routine data system New information of state of service delivery Standard set of facility survey instruments (indicators, modules, data collection instruments, analyses) Development work on some indicators & methods (pregnancy, post partum, newborn, child treatment etc.) Aligned partner support for one country system of health facility surveys Local monitoring and research to measure and improve quality of care and performance
WORKING GROUPS Deliverables