HEALTH SYSTEM INDICATORS PROFESSIONAL

The global health indicators used in developing countries for the most part address morbidity, mortality and important precursors of both. It is beyond the scope of this overview to address all potential indicators, and the glossary therefore focuses on direct measures of health, population and nutrition (or services related to these areas). On the basis of population statistics describing levels of education attained and access to safe water and sanitation, it is possible to categorize a country fairly accurately as having a population with high, medium or low burden of disease. Global health indicators can be divided into those that directly measure health phenomena (e.g., diseases, deaths, use of services) and indirect measures (e.g., social development, education and poverty indicators) these are also referred to as proximal and distal indicators respectively. However, many others are not well understood and tend to bewilder readers or create “statistical overload” rather than accomplishing the intended purpose of improving understanding. Several global health indicators, such as infant mortality rate, are well known to health professionals working in both developed and developing countries.

HEALTH SYSTEM INDICATORS PROFESSIONAL

This overview and the accompanying glossary of global health indicators (see the online appendix at are intended to assist readers in understanding and interpreting summaries of global health statistics reported in professional journals and multinational publications, such as UNICEF's annual report, The State of the World's Children 4 (see text box). However, we also need indicators that are relevant to contemporary patterns of disease and their determinants. 3 Global monitoring of changes in the health of various populations requires the use of “tried and true” global health indicators. The most obvious example of such change relates to HIV/AIDS, but others include the re-emergence of tuberculosis as a global health problem, the emergence of new infectious diseases, the increase in violence and the occurrence of chronic diseases formerly thought to be of concern only in developed countries, such as coronary artery disease and cerebrovascular accidents. 2 At the same time, disease patterns and causes of death in less developed countries have changed markedly. 1 Unfortunately, in most of sub-Saharan Africa and some parts of South Asia, these reductions in mortality have stagnated or even reversed over the past decade. For example, the total number of deaths annually among children less than 5 years of age has been halved over the past 40 years. These comparative data inform researchers and policymakers internationally when designing health performance frameworks and indicator sets.Įpidemiology/public health health performance international comparison performance frameworks performance indicators quality of care.The health of people living in developing countries around the world has improved considerably over the past 2 decades. Cardiovascular, surgery and mental health were the most frequently reported disease groups. Of these, 45 indicators are reported in more than one country. The search found 401 indicators that fulfilled the 'nationally consistent and locally relevant' criteria. The most commonly used domains in performance frameworks were safety, effectiveness and access. Two dimensions of indicators - that they are nationally consistent (used across the country rather than just regionally) and locally relevant (measured and reported publicly at a local level, for example, a health service) - were deemed important. Identification of comparable international indicators and analyses of their characteristics and of their broader national frameworks and contexts were undertaken. Countries involved are Australia, Canada, Denmark, England, the Netherlands, New Zealand, Scotland and the United States. This study identifies and compares frameworks and performance indicators used in selected Organisation for Economic Co-operation and Development health systems to measure and report on the performance of healthcare organisations and local health systems. Few studies make comparative assessments of different countries' performance indicator frameworks. Performance indicators are a popular mechanism for measuring the quality of healthcare to facilitate both quality improvement and systems management.

Health system indicators