INTRODUCTION
The World Health Report 2000: Health Systems: Improving Performance, which compared the performance of the health systems of WHO´s 191 Member States, created an unprecedented level of interest and debate within countries, international organizations, and research institutions.
Such debate led to the adoption of Resolution CD42.R5, entitled The World Health Report 2000 by the 42nd Directing Council of the Pan American Health Organization (PAHO) on 26 September 2000. The resolution urged Member States to mobilize national intelligence, represented by their respective Ministers of Health, universities, research institutions, and similar organizations, to monitor and evaluate their own health systems.
Likewise, on 19 January 2001 the 107th Session of the Executive Board of the World Health Organization adopted Resolution EB107.R8, entitled «Health Systems Performance Assessment». The aforementioned resolution determined that to help Member States contribute to the WHO assessment of their health systems performance on a regular basis a technical consultation process be established bringing together personnel and perspectives from Member States in different WHO regions. The region of the Americas held the first of a series of regional technical consultations on health systems performance assessment.
The Regional Consultation of the Americas on Health Systems Performance Assessment was held on the dates of May 8 through May 10, 2001 at PAHO Headquarters in Washington, D.C. The objectives of the meeting were to:
- Discuss different conceptual and methodological approaches to assess the performance of the health systems;
- Take stock of different country and regional experiences in the Americas related to health systems performance assessment;
- Identify the critical issues for furthering the conceptual and methodological development of a framework for measuring the performance of health systems which could be applied by countries on a regular basis and informed to WHO periodically;
- Discuss the linkage between health systems performance assessment practices and health systems policy and managerial decision-making processes; and
- Come up with an agenda of international technical cooperation in support to countries´ efforts to measure the performance of health systems.
The Regional Consultation brought together 70 experts from 19 countries. Other participants included professionals from PAHO/WHO, WHO Headquarters, USAID, The World Bank, the Hipólito Unanue Accord, and from CARICOM. Representatives from the WHO regional offices in Europe and Western Pacific participated as observers. The Consultation produced a report which was transmitted to the WHO Headquarters to be incorporated into the recommendations made by other regions and into the final document that will be presented on this matter to the WHO Executive Committee in January 2002.
After the Regional Consultation took place a work group was organized that met in Ottawa, Canada on September 4-6, 2001 to undertake an in-depth analysis of the subject matter and expand the recommendations made in the Regional Consultation.
Finally, the outcome of both meetings was presented in a special session scheduled during the 43rd PAHO/WHO Directing Council Meeting in September 2001 in order to inform the delegations of the Member States and to organize a discussion forum on the topic. The results of this discussion were also transmitted to WHO Headquarters.
This publication contains the documents that were presented and produced in the aforementioned three meetings, as well as the list of participants to the first two meetings. It also includes a provisional summary of the discussions that took place in the Directive Council on Health Systems Performance Assessment.
We hope that such discussions will contribute to the improvement of performance assessment, and of the performance of the health systems in the Region of the Americas.
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