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Measuring Health Systems Performance




Often the biggest challenge facing developing countries is not a lack of information. More frequently, the challenge is bringing together the many disparate sources and types of data that are being produced. Developing countries are often overwhelmed with the distinct and competing requirements for data tied to external program investments, with the greatest burden falling on the lowest levels of the health system.

In addition, routinely collected data (such as facility-based data) is often not associated with the intermittently collected data (such as surveys and census data), leaving large gaps in measuring health systems performance.These challenges often keep policymakers from modifying health planning and resource allocation based on accurate, timely and relevant health systems data.


The Health Systems 20/20 strategy for measuring and monitoring health systems is to provide and maximize the use of a set of established, innovative tools creating a standardized measurement. A key starting point for countries is to identify the relative strengths and weaknesses of the health system, priority issues, and potential recommendations by conducting a health systems assessment.

After an initial assessment, health information systems tools can be implemented to improve linkages between health care entities at the local, regional, and central levels to increase the flow of accurate, complete data in a timely manner. HIS strengthening includes leveraging key analytical tools, such as Geographic Information System technology, to identify trends that inform program planning and decision making and to correlate service delivery with health outcomes.

At higher levels, the web-based Health Systems Database allows users to easily compile and analyze country data from multiple sources to quickly assess the performance of a country’s health system, benchmark performance against other countries on key indicators, and monitor progress toward system strengthening goals.

Health Systems 20/20 and Measuring & Monitoring Health Systems Performance brief

Measuring and Monitoring Country Progress towards Universal Health Coverage

Health Systems 20/20 Project Brief

Oct 2011 | Health Systems 20/20  | Brief 

Using HIS/GIS Data & Tools to Improve Resource Allocation: The Yemen Experience

Abdulkader Nueman
Nov 2008 | Health Systems 20/20  | Presentation 

Health Systems 20/20 Offers Assistance in Operations

Health Systems 20/20
Aug 2008 | Health Systems 20/20  | Brief 

Health Systems Operations Survey Report

Health Systems 20/20
Aug 2007 | Health Systems 20/20  | Report 

Yemen Health Sector Analyzer: Users Manual

Yemen Partners for Health Reform
Jun 2007 | Tool 

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Workforce Planning Tool in Use by MOH

Jun 7 2010

The past year marked significant efforts by the Health Systems 20/20’s Workforce Planning activity team to finalize the Workforce Planning Tool (WPT). The WPT is an Access-based application developed to assist Egypt’s Ministry of Health (MOH) to estimate health facilities’ staffing gaps.


Health Systems 20/20 Releases Year 2 Annual Report

Dec 31 2008

Read about project activities in Year 2 to increase the use of priority population, health, and nutrition services, especially by the disadvantaged through improvements in health financing, governance, operations, and capacity building.


Health Operations Survey Results

Aug 16 2007
Health Systems 20/20 recently conducted a web-based survey to learn more about the experiences and perspectives of country and international actors on health systems operations. More...

Demystifying Health Systems: The Health Systems Assessment Approach

Apr 25 2007
April 25, 2007
1:00 - 3:00 pm
National Press Club

USAID asked its three major health system strengthening projects (PHRplus/Health Systems 20/20; RPM Plus; and the Quality Assurance Project) to develop a rapid but comprehensive approach to assessing health systems by drawing from their experiences working on different, but complementary components of health systems. The result of this effort is an indicator-based, modular assessment tool—Health Systems Assessment Approach: A How-to Manual. This seminar covered the contents of the manual, the circuitous path to its development, and a range of applications in Angola, Azerbaijan, Benin, Ghana, Malawi, Pakistan, and Yemen.


Health Systems Assessment Approach: A How-To Manual

Apr 1 2007

USAID’s Office of Health, Infectious Diseases and Nutrition (HIDN) requested the development of a Health Systems Assessment Approach as part of its global Mainstreaming Health Systems Strengthening Initiative. The Health Systems Assessment Approach: A How-To Manual was developed by Health Systems 20/20, Partners for Health Reformplus (PHRplus), Rational Pharmaceutical Management Plus (RPM Plus), and the Quality Assurance Project (QAP).It is designed to provide a rapid yet comprehensive assessment of a country's health system.


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