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WHO is continuing to work to improve methods and country health informat= ion systems for measuring population health, health system functioning, ine= quities in health, core health-related indicators including health-related = millennium development goals, as well as key inputs into the health system = such as national health expenditures.=20
WHO's Global Health Observato= ry=20
WHO is developing a Global Health Observatory (GHO) that aims to enhance=
access to ¬-- and analyses of - WHO's data and statistics on health si=
tuation and trends. The Global Health Observatory is an Organization-wide a=
ctivity with strong links to the regional and country offices. The goal is =
to enhance the quality, efficiency and effectiveness of all of WHO's work i=
n the area of health statistics. The main target audiences are the general =
public, policymakers and public health professionals (in practice, research=
and education) in Member States and international organizations. The Globa=
l Health Observatory disseminates information in three ways:
=E2=80= =A2 a web portal providing one entry-point to WHO's health statistics and a= nalyses, including theme pages and data views;
=E2=80=A2 a data repos= itory that includes easy links to all major data bases;
=E2=80=A2 ana= lytical reports on specific and cross-cutting topics.
In 2009, as par= t of the GHO, WHO issued a global report on women and health bringing toget= her and analysing data on health-issues relevant to women across the life-c= ourse and around the world. WHO also produces the annual World Health Stati= stics publication.
WHO methodological work continues to focus on better measurement of fata= l and non-fatal health outcomes in a comparable manner and on the developme= nt of improved estimation techniques for summary measures of population hea= lth and the measurement of inequality. Specific activities include:=20
The WHO Department of Health= Statistics and Informatics is continuing to support countries strengthen t= heir routine health information and civil registration systems. WHO has dev= eloped a strategic guidance tool to support countries to identify gaps and = weaknesses in their vital statistics and find feasible ways of addressing t= hem.
WHO continues to invest greater effort to improve the coverage a= nd timeliness of causes of death statistics by working with countries to: =E2=80=A2 obtain and update civil registration information for Member = States with complete civil registration, with a delay of no more than two c= alendar years;
=E2=80=A2 establish and implement mechanisms to obtain= , validate and update vital statistics for countries with partial registrat= ion data, e.g., where data are limited to cities or to sample registration = areas;
=E2=80=A2 establish and implement mechanisms to obtain, valida= te and update data for countries with limited registration capacity, using = data from small scale/sample registration and surveillance systems;
= =E2=80=A2 WHO has produced, in collaboration with other international partn= ers, a standard verbal autopsy tool to collect data on cause of death data = in household surveys in settings where vital registration is non-existent o= r incomplete.
Improving Measurement of Morbidity and Risk factors
Self reported health data on levels of health, chronic diseases and risk= factors are known to be subject to a host of reporting biases. In order to= provide comparable measurement of these factors, innovative methods of dat= a collection are proposed for low- and middle-income countries with poor he= alth information:
=E2=80=A2 Health examination survey: collection of = biological and clinical data, behavioural/risk factor data and background c= haracteristics;
=E2=80=A2 Global risks to health: 2004 update: WHO ha= s updated its analyses of the relative contribution of major risk factors t= o population ill-health and produced a report detailing the burden of morta= lity, injuries and disease caused by 24 risk factors globally and in a rang= e of regional groupings.
Summary measures of population health
WHO will co= ntinue to work with international partners in the updating of information o= n burden of disease using up-to-date epidemiological data as well as improv= ed estimation techniques:
=E2=80=A2 Child mortality estimates are upd= ated annually, working in coordination with the Inter-agency Group for Chil= d Mortality Estimation (IGME), which includes Unicef, United Nations Popula= tion Division, the World Bank, WHO. The latest child mortality estimates up= to 2009 were published in 2010.
=E2=80=A2 Neonatal mortality estimat= es by country are updated and published periodically by WHO. The latest est= imates were for the year 2008 were released in 2010. For 2011, for the firs= t time, it is planned to publish a time series from 1990 to 2009 for neonat= al deaths for all the countries of the Member States. WHO compiled an exten= sive database and improved modeling methods from previous estimates.
= =E2=80=A2 Maternal mortality estimates 1990 to 2008 released in 2010 were d= eveloped in close collaboration with an international expert group and used= all available country data on maternal mortality, as well as improved meth= ods of estimation. The intensive country consultation carried out as part o= f the development of these estimates has been instrumental in identifying i= ncreased data collection efforts in recent years including the special syst= ems to capture data on maternal deaths. There are however major gaps in the= availability and quality of data for many countries where maternal mortali= ty levels are high, and only through statistical modeling is it possible to= obtain an understanding of the trend. WHO and partner agencies will contin= ue to strengthen the systems for data collection and analysis as well as th= e global database for improving the future estimates.
=E2=80=A2 Life = tables estimates are also updated annually for all Member States. They prov= ide consistent indicators across countries, period and ages for life expect= ancy at birth, child mortality and adult mortality. For child mortality, es= timates from IGME is taken into account, furthermore, they provide the esti= mated total number of deaths which constitute the "envelope" that= should not be exceeded when all cause-specific number of deaths are summed= .
=E2=80=A2 WHO is an active partner in the update to the Global Burd= en of Disease for 2005. WHO's contribution includes:
o Advancing meth= ods for using multiple-cause-of-death statistics to generate correction alg= orithms for incorrectly certified deaths.
o Developing estimates of t= he total (all-cause) incidence and prevalence of selected disabilities whic= h are sequelae of multiple diseases, including hearing loss, vision loss, i= nfertility, low IQ, incontinence, and anemia.
o Updating disability w= eights using new primary data from a multi-country community study, in coll= aboration with Harvard University.
Monitoring health system performance
In 2010, a h= andbook of indicators and measurement strategies for monitoring health syst= ems building blocks was published, with a wide range of collaborators, incl= uding country experts and donor agencies. Additionally, guidance towards mo= nitoring and evaluation of national health strategies has been developed. T= his guidance outlines the key elements and characteristics of a platform th= at requires regular assessment of country progress and performance and uses= the results to enhance the implementation and evidence base of the nationa= l health strategy.
During 2009-2010, WHO continued to work with countries and partners to s=
trengthen health systems, under the Country Health Systems Surveillance (CH=
eSS) framework. The goals are to improve the availability, quality and use =
of health system data to inform country health sector reviews and planning =
processes and strengthen assessments of health systems performance. Several=
regional workshops have been conducted in the African Region involving 20 =
countries and more will take place in 2011. These workshops aim to enhance =
the analytical capacity of countries to conduct comprehensive health progre=
ss and performance reviews in the context of national health plans and rela=
ted global health goals. Outputs of the workshops include: i) Increased cap=
acity for analysis and synthesis among participants from country institutio=
ns; ii) Sharing of tools and methods among country participants and facilit=
ators; and iii) Selected outputs of country analyses that can feed into the=
ir health sector reviews.
The WHO Health Statistics and Informatics d= epartment continues to work with the Health Metrics Network (HMN) partnersh= ip in strengthening country capacity to collect and report high quality hea= lth data. HMN is working closely with partners in countries to strengthen t= he infrastructure for a health information system that combines information= from multiple sources.
Global Observatory for eHea= lth (GOe)=20
The Global Observatory for eHealth (GOe) (www.who.int/goe) provides Member States wi= th strategic information and guidance on the use of information and communi= cation technologies (ICT) for health. The World Health Assembly endorsed th= e establishment of the GOe in 2005.=20
=E2=80=A2 Dedicated to monitoring the impact of ICT on health and to imp= roving the understanding of developments, opportunities and challenges to t= he implementation of eHealth worldwide.=20
=E2=80=A2 First global survey conducted in 2005/6: development of eHealt= h country profiles, identification of eHealth challenges and presentation o= f recommendations for action.=20
=E2=80=A2 Second global survey conducted in 2009/10: builds upon the fir= st survey and expands its scope to address relevant eHealth areas that have= evolved since the first survey.=20
=E2=80=A2 Publishing a series of reports on telehealth, atlas of partici= pating country profiles, mobile health, management of patient information a= nd legal and ethical frameworks for eHealth during 2011.
=E2=80=A2 WHO has completed the first round of data collection from SAGE=
=E2=80=A2 Data sets from these studies are now available upon reque= st. A public release data set with all metadata will be made available by m= id 2011.
=E2=80=A2 The pilot testing has been completed in the three = European SAGE-like surveys. The main field work will be completed in 2011.<= /p>=20
Other survey related activities=20
=E2=80=A2 WHO will work closely with the International Household Survey =
Network (IHSN) and international experts to develop a standard set of modul=
es for use in health interview surveys for priority health outcomes. A meet=
ing has been held to start the process with the module on health expenditur=
es but resource constraints may considerably delay this project.
=E2= =80=A2 A set of health examination surveys in the Gulf Cooperation Council = countries, building on the World Health Survey, have been completed in five= countries. The last survey will be completed in 2011.4.3.5 Other administrative and non-survey sources (= WHO (Headquarters))