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Banner Epidemiological Bulletin

Article No.4 - Vol.28, No.3 - September 2009

Regional Plan for Strengthening Vital and Health Statistics (PSVS)

Current Status of Design and Implementation

   At the meeting held in September 2003, the Regional Advisory Committee on Health Statistics (CRAES), PAHO advisory body, recommended developing a sustainable mechanism which will help the countries develop plans for strengthening their vital and health statistics.

   Within this context, PAHO developed a set of activities which ended in 2008 with the approval of a resolution by the Governing Bodies of the Organization, through the DD/AIS (Health Analysis and Information Systems) office. The most significant milestones which merit highlighting along this path are: the development of a situation analysis guideline on vital and health statistics between 2004 and 2005 ; the elaboration of country reports , and a regional report between 2006 and 2007; the alliance with other initiatives such as the Health Metrics Network (HMN), USAID, MEASURE-Evaluation, to mention but a few.

   The Regional Plan for Strengthening Vital and Health Statistics (PSVS), approved at the 48th Meeting of PAHO Directing Council (Resolution CD48/6, October 2008) constitutes the operationality of the Strategy for Strengthening Vital and Health Statistics (SSVHS) approved by the 27th Pan American Sanitary Conference in October 2007 (Resolution CSP27.R12), based on the document of the same name (CSP27/13) which outlines a diagnosis of the situation in the countries .

   In order to facilitate the coordination and harmonization of the SIS, the PSVS adopted the goal, objectives and principles of the HMN, a global alliance which encourages standards for the development and improvement of the performance of health information systems and of the World Health Organization (WHO) in the field of the strengthening the Health Information Systems.

   Likewise, PAHO and WHO technical areas and a group of international organisms have discussed and consolidated the conceptual and operative aspect regarding the PSVS of the countries in three dimensions: a) evaluation of the process of information generation, characterized by the presence of contextual, technological, procedural and human factors, among others, which may affect the quality of data; b) identification of problems and needs for the establishment of the areas requiring more attention for the improvement of data coverage, quality and timeliness), and c) the definition of intervention levels, to guide the application of the best solutions and good practices identified in problematic areas, be they geographic, populational, thematic or sectorial settings .

   On the other hand, and within the ambit of the agreement established in the year 2005 between PAHO and the Economic Commission for Latin America and the Caribbean (CEPAL), and the joint activity with the Latin America and the Caribbean Demographic Center (CELADE), a plan of activities was developed and its different variants were presented in the ambit of the United Nations Statistics Commission and the Statistical Conference of the Americas (SCA).

   Also, the PSVS aligns with PAHO 2008-2013 Strategic Plan, through its Strategic Objective 11 ("To strengthen leadership, governance and scientific evidence of the health systems"), which considers "the improvement of national health systems and the generation of quality data, information and knowledge to be of major concern for planning and decision-making" .

   The PSVS is based on the AD/HSD/HA project, where other relevant activities aimed at the production, use, analysis and dissemination of health statistics are also carried out, through the Regional Core Data Initiative (which develops a database for the circulation of health indicators of the Region), the development of methodologies and software for the analysis and dissemination of data and the analysis of the health situation in the countries. The PSVS coordination is located at PAHO Representation in Chile (PWR-CHI).

   This document outlines the general characteristics of the PSVS and the situation status of its design and implementation.

INTERVENTION LEVELS OF THE PSVS

   The intervention levels of the PSVS may be summarized in four components: country, inter-country or group of countries, corporative and global.

   The first one (country) refers to specific problems identified in each country and includes actions and solutions defined in an individual strategic plan, designed with the highest consensus between the main actors of the civil society and the State (users and producers of statistical information).

   The inter-country (or group of countries) component includes shared activities for a group or group of countries, sub-regions and the region itself, with shared problems (coverage, quality, opportunity) and shared solutions (regional courses, use of homologous computer programs, dissemination of good practices, transference of technology, etc.).

   The third component (corporate), is co-adjuvant to the provision of PAHO technical cooperation, through the standardization of methodologies and the development of complementary and joint actions which can contribute to the strengthening of the statistics used in the work of the Organization.

   Finally, the global component considers sharing coordination mechanisms with other international agencies in order to approach common needs regarding validity and reliability of health statistics and the harmonization of technical cooperation projects and programs and funding in issues directly or indirectly related to the strengthening of the SIS.

   The PSVS foresees the existence of different coordination mechanisms, including: 1) a joint PAHO/CELADE Unit; 2) a Coordinating Group (GC) comprising the coordination of the PSVS in PWR-CHI, HMN-Technical Support Partnership (TSP) and Measure/USAID; 3) a Consulting Group (CONS), formed by the HSD/HA members, two members of other areas of PAHO/WHO, two members of the PWR and two members of country Statistical Offices; and 4) the Country Group (CG) which will participate in the design, implementation, monitoring and evaluation of the activities included in their Plan of Action, consisting of HSD/HA Focal Points in the PWRs, National Statistical Offices (NSO), Health Statistical Offices (HSO), and Inter-institutional Committees of the countries.

GENERAL AND SPECIFIC OBJECTIVES ACCORDING TO INTERVENTION LEVELS

   The following Table shows the general and specific objectives of the PSVS, disaggregated by component.

Table 1. General and specific objectivs of the PEVS. Disaggregated by component.

 

General objective

 

Specific

objectives

 Coordination Group

1

Developing coordination activities of the PSVS.

Harmonizing and integrating approaches and work groups responsible for the PSVS.

 Country component

2

Supporting the countries in the development and implementation of development plans for strengthening the structure and performance of the national information systems for the improvement of vital and health statistics.

 

Defining and sustaining an inter-institutional coordination mechanism of the National Plan of Action for the Strengthening of the Vital and Health Statistics (NPA).

Developing a diagnosis of the situation of vital and health statistics and drawing up a report of the situation of the vital and health statistics.

Elaborating and implementing the NPA for the strengthening of the vital and health statistics.

Defining the mechanisms for monitoring and evaluating the NPA.

Disseminating, promoting and supporting the implementation of standards, methodologies and tools for the analysis of the vital and health statistics.

Promoting the elaboration of evidence, analysis and summary reports on vital and health statistics.

Organizing workshops for the development of capacities for the analysis of vital and health statistics.

 Inter-country or group of countries component

3

Identifying and disseminating the good practices for the improvement of the vital and health statistics in the countries

Proposing harmonized actions according to shared needs between the countries, groups of countries and sub-regions.

Organizing expert groups which support the development of harmonized lines of actions, identification, harmonization and promotion of good practices.

Defining the contents of the component.

Establishing horizontal cooperation mechanisms between the countries, sub-regions and the Region.

Carrying out technical visits between the countries.

Organizing meetings and workshops for the exchange of experiences, good practices and lessons learned.

 Corporate Component

4

Developing or promoting recommendations, standards, methodologies and tools for strengthening the vital and health statistics of the countries.

 

Articulating with the Secretariat entities in order to attain indicators related to health information defined in the ambit of the Strategic Plan 2008-2013 (ST).

Developing common projects for the fulfillment of the ST objectives.

Developing the standards, methodologies and tools for strengthening the vital and health statistics.

Publishing standards, methodologies and tools for strengthening the vital and health statistics.

Global Component

5

Harmonizing projects and programs for technical cooperation and funding with other agencies for strengthening the vital statistics and mortality indicators.

 

Strengthening the Work Group (WG) established with the Latin American Demographic Center (CELADE), Population Division of the Economic Commission for Latin America (CEPAL), in the ambit of the agreement between PAHO and CEPAL.

Establishing alliances with other agencies of the United Nations system, at regional and national levels, with a view to harmonizing projects and programs for technical cooperation and funding.

IMPLEMENTATION OF THE PSVS

   As mentioned above, in the context of the PSVS country component, 25 country reports and 1 Regional Report were drawn up based on the Guideline elaborated by PAHO. Nevertheless, most countries, which include those with significant information problems and are considered top priority by PAHO, have broadened their country reports with SIS evaluation and monitoring tools of HMN and PRISM , whether with funds coming from the Organization, of the HMN itself, or from the joint project PAHO/USAID.

   Among the countries, Honduras, Mexico, Nicaragua, Panama and Paraguay, already have a Strategic Plan in motion, with the support of PAHO, HMN, and the Global Fund for Tuberculosis, HIV-AIDS and Malaria, USAID and MEASURE-Evaluation. The Canadian cooperation agency (CIDA) is considering the financial support to Honduras and the Organization itself. Peru and the Dominican Republic are concluding the design of their Strategic Plans. Other countries are either currently performing the analysis of their SIS (Belize, El Salvador), or commencing it (Bolivia, Costa Rica, Ecuador and Guatemala). The following figure shows the current status of the situation of interventions carried out with the countries through this component.

Figure 1.Countries diagnosed by PAHO which have applied analytical tools from RMN and PRISM

 

   Regarding the inter-country component of the PSVS, the preliminary tasks for establishing a Network of countries are being carried out, which will enable the horizontal exchange of good practices and the development of activities shared among the countries, group of countries, sub-regions or the region itself, for the resolution of shared problems. Some of the activities expected to be implemented in the short term regarding the inter-country component are: a regional mechanism for education and training of human resources, a regional map of good practices and the harmonization of information developments between the countries for the assisted coding using PAHO international family of classifications.

   A joint project with the Gender and Ethnicity Project (AD/GE), the Latin American Demographics Center (CELADE, Population Division of CEPAL) and the United Nations Fund for the Funding of Population Activities (UNFPA) is being developed since 2007, under the corporate and global components, for the inclusion of the ethnical approach in the sources of health data. Moreover, action strategies are being formulated with the countries and sub-regions for the sensitization of producers and users in the gender approach for the production, use, analysis and dissemination of health information. With CELADE itself and the Area of Sustainable Development and Environmental Health of PAHO, an Atlas of Vulnerability was completed at municipal level, which allows analyzing the relationship between social determinants and the health status of the population. Owing to this work, PAHO counts with a database with over fifty census indicators at municipal level for most of the region of Latin America and the Caribbean . In conjunction with UNICEF, the World Bank and other international organisms, actions for the development of a project on Identity and Vital Statistics are also being coordinated as well as the development of strategic plans with the countries of the region.

   Finally, together with the HMN and the PAHO/USAID project, a Network for the exchange of experiences and practices between the countries of the Region is being defined. In July 2009, a meeting was held in Mexico at which experiences in the application of diagnosis tools and the preparation of strategic plans were shared, and a second meeting will be held soon to define sub-regional lines of action.

For further information: Mr. Alejandro Giusti, Regional Advisor ond Vital and Health Statistics.

Source: Health Surveillance and Disease Prevention and Control (HSD); Health Information and Analysis (HSD/HA). PAHO.

Note: This paper was presented and aproved at the meeting of the Regional Advisory Committee on Health Statistics (CRAES) held in Washington, DC, from 11 to 13 of August, 2009.

REFERENCES

  1. Pan American Health Organization / World Health Organization (OPS/OMS).48th Directing Council. 60th Session of the Regional Committee. Item 4.5 of the provisional agenda. Resolution CD48/9: Regional Plan of Action for Strengthening Vital and Health Statistics. Washington, D.C., USA, 7 August 2008. Available at: www.paho.org/english/gov/cd/cd48-09-e.pdf
  2. OPS/OMS. 27° Conferencia Sanitaria Panamericana. 59° Sesión del Comité Regional. Resolución CSP27.R12: Estrategia para el Fortalecimiento de las Estadísticas Vitales y de Salud de los Países de las Américas. Washington, D.C., USA, 5 October 2007. Available at: http://www.paho.org/spanish/gov/csp/csp27.r12-s.pdf
  3. OPS/OMS. 27° Conferencia Sanitaria Panamericana. 59° Sesión del Comité Regional.Documento CSP27/13: Estrategia para el Fortalecimiento de las Estadísticas Vitales y de Salud de los Países de las Américas. Washington, D.C., USA, 5 October 2007. Available at: http://www.paho.org/spanish/gov/csp/csp27-13-s.pdf
  4. OPS/OMS. 140° Sesión del Comité Ejecutivo. Documento: CE140/15: Estrategia para el Fortalecimiento de las Estadísticas Vitales y de Salud de los Países de las Américas. Washington, D.C, USA, 29 May 2007. Available at:http://www.paho.org/spanish/gov/ce/ce140-15-s.pdf
  5. OPS/OMS (2004). Guideline for the analysis of vital, morbidity and health resources statistics – General Document -Guía para el análisis de las estadísticas vitales, de morbilidad y recursos de salud. Documento general. Washington DC.
  6. OPS/OMS (2007). Situación de las estadísticas vitales, de morbilidad y de recursos y servicios en salud de los países de las Américas. Síntesis del informe regional. Santiago, Chile.
  7. World Health Organization (WHO). (2006). "A Framework and Standards for Country Health Information System Development. Health Metrics Network (HMN). Geneva.
  8. OPS/OMS (2006). Plan de fortalecimiento de las estadísticas vitales y de salud de los países de las Américas (PFEVS). Aspectos conceptuales de su diseño. Santiago, Chile.
  9. OPS/OMS (2007). Propuesta del Plan Estratégico 2008 – 2012. Documento Oficial No. 328. Available at: http://www.paho.org/Spanish/GOV/CSP/od328-full-s.pdf

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