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Monitoring Provision and Quality of Services. Health System Metrics Meeting Glion, September 28-29, 2006. Bakhuti Shengelia Regional Adviser for Health Policy and Equity Division of Country Health Systems WHO-EURO. Stewardship (oversight). Responsiveness (to people’s non-medical
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Monitoring Provision and Quality of Services Health System Metrics Meeting Glion, September 28-29, 2006 Bakhuti ShengeliaRegional Adviser for Health Policy and Equity Division of Country Health Systems WHO-EURO
Stewardship (oversight) Responsiveness (to people’s non-medical expectations) Delivering services (provision) Creating resources (investment and training) Health OUTCOMES INPUTS Fair financial contribution Financing (collecting, pooling and purchasing The Goals and Functions of Health Systems
OECDFRAMEWORK Outcomes Process Structure
Challenges for the Framework • Capturing the parameters strictly specific to health service delivery function • Universality • Accommodating differences in the level of health system development and the resources • Keeping pace with development of knowledge and technology • Adapting to the changing health care needs
Effective coverage Equity Efficiency Technical efficiency Quality Accessibility Efficiency of infrastructure Physical access Waiting time Productivity of human resources Use of pharmaceuticals Efficiency of operations Multi Tier Framework for Service Delivery Safety Effectiveness Appropriateness Affordability Adequate supplies and technology Amenities
Implications For Measurement • Building effective coverage measures into population surveys • Improving the quality measures at outpatient level • Greater investment in facility surveys