Data for development in health: a case study and monitoring framework from Kazakhstan

Abstract

Healthcare reforms are often not coupled with a relevant and appropriate monitoring framework, leaving policymakers and the public without evidence about the implications of such reforms.Kazakhstan has embarked on a large-scale reform of its healthcare system in order to achieve Universal Health Coverage. The health-related 2020 Strategic Development Goals reflect this political ambition. In a case-study approach and on the basis of published and unpublished evidence as well as personal involvement and experience (A) the indicators in the 2020 Strategic Development Goals were assessed and (B) a ‘data-mapping’ exercise was conducted, where the WHO health system framework was used to describe the data available at present in Kazakhstan and comment on the different indicators regarding their usefulness for monitoring the current health-related 2020 Strategic Development Goals in Kazakhstan.It was concluded that the country’s current monitoring framework needs further development to track the progress and outcomes of policy implementation. The application of a modified WHO/World Bank/Global Fund health system monitoring framework was suggested to examine the implications of recent health sector reforms. Lessons drawn from the Kazakhstan experience on tailoring the suggested framework, collecting the data, and using the generated intelligence in policy development and decision-making can serve as a useful example for other middle-income countries, potentially enabling them to fast-track developments in the health sector.

Using the World Health Organization health system building blocks through survey of healthcare professionals to determine the performance of public healthcare facilities

“…Unlike other health system strengthening strategies which are disease-specific [ 13 ] or narrow [ 14 – 16 ], the WHO’s health system framework intends to improve the overall health in a responsive, financially fair and most efficient way [ 11 ]. Evidences revealed that the framework helps to assess in-country healthcare performances [ 17 ], interactions between health reforms and country health systems [ 18 ], implications of health sector reforms [ 19 ], and the status of health facilities [ 20 ] and specific health problems [ 21 ].…”

Lower-Income Countries That Face The Most Rapid Shift In Noncommunicable Disease Burden Are Also The Least Prepared

“…Previous studies have also constructed indices reflecting the WHO building blocks, but we found none that specifically target noncommunicable diseases. 22,23 Indicators included in our index are hospital beds per 1,000 population and number of surgeries per 100,000 population (WHO building block: health service delivery), physicians per 1,000 population and the percentage of births with skilled attendants (WHO building block: health workforce), total health expenditure as a percentage of gross domestic product (WHO building block: health financing), and a variable identifying the degree to which each country has implemented tobacco control policies (WHO building block: leadership and governance). The remaining two building blocks (health information systems and access to essential medicines) were not included because externally validated data for a sufficient number of countries were not available.…”

Construcción de un marco de monitoreo para la salud universal

“…El monitoreo centrado en forma exclusiva en el seguimiento de tendencias, sin estar asociado a información contextual de los procesos de transformación del sistema de salud, no suele informar de manera apropiada sobre la efectividad de las políticas de gobierno (3). Por lo tanto, es necesario complementar el seguimiento con información cualitativa, recolectada mediante procesos sistemáticos, y que permita analizar las características y profundidad de los cambios introducidos en el sistema de salud (14).…”

“…Este enfoque renovado en la necesidad de transformar los sistemas de salud en la Región de las Américas resalta la necesidad de contar con un marco de referencia regional que permita medir los avances de las políticas orientadas al fortalecimiento de los sistemas de salud y el logro de la salud universal. Sin embargo, no existe un marco de monitoreo conceptual consensuado que ayude a los tomadores de decisiones a entender las implicaciones y efectos de las transformaciones del sistema de salud (3). La consistencia entre marcos conceptuales es importante porque facilita el trabajo colaborativo y el aprendizaje regional.…”