Creating a Common Set of Indicators for Universal Health Coverage
Jul 20 2012
As countries declare their commitment to achieving universal health coverage (UHC), there is a need to establish guidelines and develop indicators to measure and monitor progress. On July 20, Health Systems 20/20 co-sponsored a meeting with the World Health Organization (WHO), USAID, Results for Development, UNAIDS, and the Rockefeller Foundation with the goal of moving toward consensus on ways to measure progress towards UHC.
Approximately 40 global health experts convened in Washington for the Measuring and Monitoring Country Progress towards UHC Concepts, Indicators, and Experiences event.
Carlos Avila, Financial Risk Protection Strategy Lead, and Marianne El-Khoury, Health Economist, from Health Systems 20/20 presented at the meeting along with Ariel Pablos-Méndez, USAID Assistant Administrator for Global Health, David Evans, Director of the Department of Health Systems Financing, WHO, and others.
At the meeting, participants intended to:
- Agree on what indicators are readily available for measuring UHC,
- Assess current experiences on monitoring UHC within HIV field,
- Identify major areas where further work is required, and
- Begin to develop an agenda and priorities for the next six to nine months.
Efforts to achieve universal coverage for HIV prevention and treatment in developing countries are showing positive impacts on other heath areas. UNAIDS has been working on a set of indicators and tools, in close cooperation with country representatives, to monitor the progresses on the accomplishment of the commitments made through the 2001 UN Declaration of Commitment on HIV/AIDS, and re-affirmed by the 2006 and 2011 UN Political Declarations on HIV/AIDS at country levels.
The World Health Report 2010 outlined a conceptual framework that suggested three broad dimensions of UHC: population coverage, service coverage, and financial coverage. Although a persuasive conceptual tool, additional work is needed to operationalize measurable indicators for tracking a country’s level of coverage.
Given the varying dimensions of coverage, developing reasonably low-cost and accurate methods to measure and track country progress towards UHC poses both conceptual and practical challenges. However, the potential payoff from such an undertaking is substantial, as countries further commit to achieving UHC and as donors and policymakers demand accurate metrics to gauge progress towards stronger health systems.
The WHO is leading a process to develop measureable indicators of country progress towards UHC. Last year, WHO hosted a small technical meeting in Rotterdam to discuss a theoretical framework for an index of UHC developed by Peter Smith. The July 20 meeting built upon the Rotterdam meeting to advance consensus on how to measure progress towards UHC. During the meeting participants clarified next steps for working towards post-MDG global UHC targets.