Available measurement tools and methods
Current efforts, priorities
Country Planning and Review Process
Year 0
Year 1
Annual
reviews
Year 2
Year 3
Annual operational plans
Annual
reviews
Midterm
reviews
Year 4
Year 5
Annual
reviews
Final
reviews
Annual health sector progress and performance assessment
Routine
facility reports
&
administrative
DQA &
analysis
DQA &
analysis
DQA &
analysis
DQA &
analysis
DQA &
analysis
Finance
HRH
Infrastructure
Finance
HRH
Infrastructure
Finance
HRH
Infrastructure
Finance
HRH
Infrastructure
Finance
HRH
Infrastructure
HMIS
HMIS
HMIS
HMIS
HMIS
data
Facility
assessments
Availability
& Readiness
Availability
& Readiness
Availability
& Readiness
Availability
& Readiness
Availability
& Readiness
Research
Quality of
care
Quality of
care
Quality of
care
Quality of
care
Quality of
care
Household
Surveys
Household
Survey
Vital event
monitoring
CRVS SRS
Household
Survey
CRVS SRS
CRVS SRS
Household
Survey
CRVS SRS
CRVS SRS
What do we need to improve the measurement of PHC?
MORE 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!!!
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
 Standard set of facility survey
instruments (indicators, modules,
data collection instruments, analyses)
 Builds upon routine facility
reporting system
 Development work on some
indicators & methods (pregnancy,
post partum, newborn, child
treatment etc.)
 Verification of data quality in
routine data system
 New information of state of
service delivery
 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