Better health statistics are possible

Abstract

After decades of debate about the need to improve the quality of basic health statistics in developing countries, there is at last substantial progress on the horizon. The recently created Health Metrics Network and the Ellison Institute for World Health offer the potential for strengthened health information systems to inform better policy development.1 , 2 , 3 Both initiatives are backed by new funding. Both will lead to new secretariats and partnerships between academics, governments, and intergovernmental agencies. That is the promise. The magnitude of the need has been well documented. Many countries are still unable to count their dead, let alone produce accurate statistics for cause of death or disease. Most countries do not have the capacity to regularly assess the performance of their health systems and few use reliable information for decision-making. In recent years, some progress has been made in addressing the need for improved global and regional health data. For specific diseases, such as HIV, a solid empirical database has been established. However, most summary statistics of general mortality have relied heavily on complex modelling approaches to fill gaps in basic country-specific data. The new initiatives should focus on strengthening empirical knowledge at country level, thus enhancing the quality of global and regional estimates. Over the years, interest in improving the quality of basic health statistics has waxed and waned—no serious sustained effort has been made to get the basics in place. Now, for several reasons, the demand for high-quality data has accelerated. The reporting requirements of the Millennium Development Goals (MDGs) and the monitoring and evaluation measures required by the performance-based disbursement schemes of new global initiatives, such as the Global Alliance for Vaccine and Immunization and the Global Fund to Fight AIDS, Tuberculosis and Malaria, have highlighted the substantial gaps and needs in countries. Measurement systems are urgently needed to enable monitoring and evaluation of health-system interventions, to demonstrate accountability, and to sustain funding. Substantial resources coming through these global health initiatives can and should be used to build better health-information systems, and more investments are expected.