presentation: monitoring universal health coverage in the western pacific region - framework,...

7/26/2019 PRESENTATION: Monitoring Universal Health Coverage in the Western Pacific Region - Framework, Indicators and Dashboard

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Monitoring Universal Health Coverage

in the Western Pacific Region

Framework, Indicators and Dashboard

Rosebelle May Azcuna MScMonitoring and Evaluation Consultant

Disclaimer: The views expressed in this paper/presentation are the views of

the author and do not necessarily reflect the views or policies of the Asian

Development Bank (ADB), or its Board of Governors, or the governments

they represent. ADB does not guarantee the accuracy of the data included in

this paper and accepts no responsibility for any consequence of their use.

Terminology used may not necessarily be consistent with ADB official terms.


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Introduction

Universal health coverage (UHC)

overarching health theme of the post-2015Sustainable Development Goals (SDGs)

UHC monitoring framework

Guide to monitor progress toward UHC within thebroader health system performance framework

Developed through a comprehensive health systems-

focused approach

UHC dimensions: service access, financial risk protection, equity

Equally important: health system performance including serviceavailability and readiness, quality of care, efficiency, people-

centeredness

Requires national commitment to robust M&E systems


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The UHC Monitoring Framework

Developed through series of consultations from July 2014

UHC Technical Advisory Group

(WHO-WPRO health system teams + ADB)

WHO-WPRO regional technical teams and

country health system teams

WHO-WPRO UHC technical consultation in June 2015

An expansion of the IHP+ framework for health systems

performance

Considers other global and national health system

monitoring frameworks:Social determinants of health; OECD; national frameworks


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Health System Performance Framework to Achieve the

Health-related Sustainable Development Goals and

Universal Health Coverage in the Western Pacific Region

OUTPUTS

HEALTH FINANCING

Out-of-pocket spending

Government investment in health

HEALTH SERVICE DELIVERY

HEALTH-RELATED INTERVENTIONS

AND SOCIAL DETERMINANTS

IMPACTS OUTCOMES

HOUSEHOLD

HEALTH-RELATED

EXPENDITURE

Catastrophic expenditure

HEALTH SERVICE

COVERAGE

Promotive

Preventive

Curative

LIFESTYLE FACTORS

AND PRACTICES

Health literacy

Substance use

Nutrition

HEALTH SECTOR

Governance

Health financing

Health workforce

Service delivery

OTHER SECTORS

Governance and policies

Financing

Infrastructure andtechnologies

Medicines and technologies

Health information and

surveillance systems

Rehabilitative

Palliative

INPUTS and PROCESSES

Effectiveness and safety

HOUSEHOLD

AND SOCIETAL IMPACT

Poverty impact

Health security

POPULATION

HEALTH

Life expectancy

Mortality

Morbidity

Disability

HEALTH

SYSTEM

Quality

Efficiency

Equity

Accountability

Resilience

Education Food and nutrition

Infrastructural and

environmental interventionsIndividuals

and families

Employment

System efficiency

Physical activity

Safe practices

Availability and readiness

Accessibility

Housing

Well-being

People-centredness


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UHC Monitoring Framework

Sets the monitoringrequirements for

tracking progress

across the dimensions

of UHC but considers

broader health system

performance

Captures critical system inputs, process and outputs tobring about the desired levels of financial protection and

service coverage to attain targeted levels of population

health and financial security


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UHC Monitoring Framework

Developed to beadaptable for country

use

Considering a countrys

demographic,economic, and

epidemiological

conditions,

framework can be used as a guide to consider key systeminputs, processes, and outputs to consider in relation to

desired levels of financial risk protection and service

coverage


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Core Indicator Set

Tracer indicators to operationalize monitoring of the

framework and to provide strategic level information on

Essential health systems resources and outputs

(health facility readiness, availability and accessibility of

essential services and commodities)

Health-related initiatives from other sectors (education,

water and sanitation), social determinants of health

Coverage of priority health services and interventions

Mechanisms and levels of financial risk protection

Different dimensions of population health


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Core Universal Health Coverage Indicators for the Western Pacific

based on the Health-related Sustainable Development Goals

Household health related

financial security

Impoverishinghealth

expenditure1,2

Reach and outcomes ImpactsOutputsInputs & processes

1 Included in the Global Reference List of 100 Core Health Indicators (25)2 Indicators where stratified equity analysis is recommended (partial list)

Health related interventions

and social determinants

Populationusingimproved

drinkingwatersources1,2

Populationusingimproved

sanitationfacilities1,2

Meanurbanairpollutionofparticulatematter 1

SDG Goal 3 indicators (16)

WHO-WB tracer indicators for service and financial risk protection coverage (11)

Health-related SDG indicators (5)

Household health related expenditure

Catastrophichealthexpenditure1,2

Lifestyle factors and practices

Children


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Universal Health Coverage Indicators for the Western Pacific:

Health-related Sustainable Development Goals and Health System Performance


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Indicator rationalization: criteria


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Framework views and indicator use

The framework and indicators allow flexibility of use andreporting to serve different purposes and priorities

Life-course view

emphasis to monitoring of priority health interventions across

different life stages.

Health system development view

Indicators may be bundled into core, expanded, and optimal

sets to highlight monitoring different packages of health

system services and interventions at each level of health

system maturity


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UHC M&E view

through the life-course


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Framework views and indicator use

The framework and indicators allow flexibility of use andreporting to serve different purposes and priorities

Life-course view

emphasis to monitoring of priority health interventions across

different life stages.

Health system development view

Indicators may be bundled into core, expanded, and optimal

sets to highlight monitoring different packages of health

system services and interventions at each level of health

system maturity


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Monitoring equity

A core requirement in monitoring health system

performance and progress towards UHC and the

SDGs

Requires data disaggregated by

demographic groups (age, sex and place of residence)

socioeconomic (education and wealth) groups

Highly reliant on surveys

eg Multiple Indicator Cluster Surveys (MICS) andDemographic and Health Surveys (DHS)

that mainly cover maternal and child health


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UHC Dashboard

A visualization tool of key UHC indicators to

provide regional-level intelligence of country-

specific UHC situations

Multiple data sources: national health information

systems, surveys and global databases


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UHC Dashboard

Country-level view of indicators for UHC-relatedthemes including health financing, health service

coverage, inequities in service coverage, and

trends in health outcomes

Regional-level view of key UHC indicators to allow

comparison of countries in the region

Customizable: allows user-defined selection ofcountries, indicators, equity stratifiers, charts, and

performance metrics


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UHC Dashboard: COUNTRY VIEW


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UHC Dashboard: REGIONAL VIEW


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UHC Dashboard: REGIONAL VIEW


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Dashboard access:

://hiip.wpro.who.int/hiipchttpusing Google Chrome
http://hiip.wpro.who.int/hiipchttp://hiip.wpro.who.int/hiipchttp://hiip.wpro.who.int/hiipchttp://hiip.wpro.who.int/hiipc


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Figure 1 Health System Performance Framework to Achieve the Health-Related


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Figure 1. Health System Performance Framework to Achieve the Health-Related

Sustainable Development Goals and Universal Health Coverage in the Western Pacific

Figure 2 UHC M&E through the life course


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Figure 2. UHC M&E through the life course


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General guidance for standard indicators and definitions

Guide monitoring of health results nationally and globally

and the selection of priority indicators

Contribute to reduced reporting requirements and to

greater alignment and smarter investment in country data

and M&E systems

Reflects indicators relevant for country,

regional and global reporting of globalhealth priorities

MDGs, NCDs & other new priorities,

UHC, SDGs

Alignment with global M&E references


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Alignment with SDG M&E references

presentation: monitoring universal health coverage in the western pacific region - framework,...

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