—from the Epidemiological Bulletin, Vol. 20 No. 1, March 1999—
News: Creation of the Special Program for Health Analysis (SHA)
As part of its restructuring, the Pan American Health Organization has established the Special Program for Health Analysis (SHA). The SHA program began operations on 1 March, 1999.
The new SHA Program is designed to strengthen the capacity of the Bureau and Member States to produce, analyze, utilize, and disseminate information that can be used to evaluate the health situation and trends, focusing on the identification of inequities in the area of health and the use of epidemiology in the formulation of public health policies and programs. This information will also provide the means to monitor changes in health status and living conditions and evaluate the impact of health-related interventions.
Areas of Work and Lines of Action
During the period 1999-2002, SHA initiatives will focus on supporting the processes of change in epidemiological practices in the countries in order to address current health problems and living conditions. Accordingly, PAHO technical cooperation will be geared toward strengthening: (i) health information systems, with emphasis on systems of vital statistics; and 2) the epidemiological capacity for the analysis of the health situation and its trends, with emphasis on the conceptualization, methodological development, quantification, analysis, and monitoring of inequities in health.
Brief descriptions of SHAs areas of work and lines of action are listed below.
1. Reorganization and Operation of Epidemiological Services and Health Statistics
The current health problems of the population and the demands of health sector reform require strengthening the epidemiological and analytical capacity of health services, based on information and scientific knowledge. The lines of action are as follows:
To support the strengthening of epidemiological practices in order to monitor the health situation. This information will be used to: prioritize health actions; define health policies and interventions; monitor changes in the health situation and living conditions; evaluate the impact of policies and extrasectoral actions on health services; and promote the use of available information for local management.
To support the development of health databases and statistical information systems in order to meet country needs in terms of defining basic data and utilizing knowledge generated in the planning, implementation, monitoring, and evaluation of health programs. The development of integrated networks and the dissemination of health information using the Internet will also be supported.
Preparation of the Spanish version of the International Classification of Diseases and Related Health Problems, Tenth Revision (ICD-10),was completed in 1995 and its implementation started thereafter. Efforts to consolidate national groups contributing to the implementation and revision of ICD-10 will also continue. An e-mail forum has been established for the discussion and review of methodology and the adequate use of information generated by ICD-10 for health programming.
To reactivate the PAHO Regional Advisory Committee on Health Statistics, which will advise PAHO on appropriate methods for evaluating the status of the Regions vital statistics, health situation, and population data.
To provide technical cooperation, in the area of Geographic Information Systems in Epidemiology (GIS-Epi), for training activities, the establishment of collaborating centers, and the development of operational applications.
2. Surveillance of the Health Situation in the Region
In coordination with the Secretariat, a network of PAHO databases will be created and maintained, containing reliable public health and epidemiological data for use at the regional and national levels. Support will be provided to conduct health studies in the Region, including estimates and projections. Support will also be provided for new studies to evaluate the impact of the renewed strategy of Health for All (HFA).
The Core Health Data and country health profiles within the current Technical Information System (TIS), contains up-to-date mortality and population information. Using the new technologies available, work will begin on preparing periodic country health profiles, which will include mechanisms to update, verify, maintain, and disseminate information in electronic format on the World Wide Web and other media.
With respect to monitoring strategies for HFA 21, SHA will collaborate with other programs in the review of monitoring activities associated with the renewal of the HFA strategy in the Region.
Work on Health in the Americas, 2002 edition, will begin in 1999. Compilation of the document will be approached through a ongoing modular process, based on the positive experiences gained during the publication of Health in the Americas 1998. The process is expected to result in better quality country health profiles and improved applications for the programming and evaluation of PAHO technical cooperation.
3. Production and Dissemination of Health Information
SHA will promote the rapid dissemination of pertinent epidemiological information to facilitate effective public health interventions, including publication of an SHA Web page, linked to the PAHO Home Page. At present, the SHA computerized information system includes mortality and population databases, the Information System of the Core Health Data Initiative, as well as country health profiles. The main publications are: the Epidemiological Bulletin, Health Statistics from the Americas, the Selected Bibliography of Epidemiology (Bibliografía Seleccionada en Epidemiología), the International Classification of Diseases, and other ad hoc epidemiological publications. In the period 1999-2002, the PAHO Public Health Surveillance Network will be adopted in order to integrate the various public health surveillance databases available in PAHO.
4. Support for Training in Epidemiology, Statistics, and Health Situation Analysis
The SHA Program, in conjunction with the Division of Health Systems Development, will provide long-term support for a training program based on epidemiological principles of health management. The program has two basic lines of action:
To develop a variety of training materials for professionals working in general health care services and programs.
To provide training activities such as: (1) continuing education in epidemiology and situation analysis; (2) training events in specific areas, such as the use of epidemiology in health services planning and evaluation, public health surveillance; computer software for research and epidemiological surveillance; and (3) coordination and execution of the Summer Session in Intermediate Epidemiology.
5. Research and Development of Methodological Tools and Analytical Processes to Document Inequity in Health
This important component is designed to promote, support and develop comparative analysis of existing research on health and inequity in health, as well as to develop methodological tools for identifying groups of the population with the greatest levels of disease burden and inequity in health. Likewise, this component will support: operational epidemiological research to monitor the health situation and its trends; prioritization of health initiatives; identification of unmet health needs; and evaluation of population-based health-related interventions.
6. Support for Health Outcomes Assessment
The SHA Program will coordinate an interprogram workgroup that will examine the development of methodologies and techniques for assessing health outcomes in the Region of the Americas. Activities will include a review of the conceptual frameworks, protocols, procedures, and guidelines available. The results of applications and projects geared toward priority subgroups of the population will be also be reviewed. Likewise, methodological recommendations will be prepared as a tool to promote the maximum potential benefits of policies, programs, and health services.
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Epidemiological Bulletin, Vol. 20 No. 1, March 1999