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Report of the Sub-Committee of the Regional Committee on the General Programme of Work, part IV. Regional strategy for health for all by the year 2000: review of the common framework and format for monitoring progress in implementing national, Regional and global strategies

31 декабря 1982 г. Всемирная организация здравоохранения

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HEALTH WORLD ORGANIZATION

REGIONAL OFFICE FOR THE WESTERN PACIFIC BUREAU RtGIONAL DU PACIFIQUE OCCIDENTAL

•

ORGANISATION MONDIALE DE LA SANT~

REGIONAL COMMITTEE Thirt;y-third session Manila 20-24 September 1982 Provisional agenda item 13.3 ·

WPR/RC33/10 7 July 1982 ORIGINAL: ENGLISH

REPORT OF THE SUB-COMMITTEE OF THE REGIONAL COMMITTEE ON THE GENERAL PROGRAMME OF WORK PART IV Regional Strategy for Health for All by the Year 2000 REVIEW OF THE COMMON FRAMEWORK AND FORMAT FOR MONITORING PROGRESS IN IMPLEMENTING NATIONAL, REGIONAL AND GLOBAL STRATEGIES At its thirty-second session, the Regional Committee adopted the revised Regional Strategy for Health for All by the Year 2000. The Regional Strategy is made up of information submitted to WHO in 1980 on draft national strategies, progress reports and observations. The Thirty-fifth World Health Assembly, in its resolution WHA 35.23, approved the plan of action for implementing the Global Strategy for Health for All by the Year 2000, of which the plan of action for the Regional Strategy, accepted by the Regional Committee at its thirty-second session, forms a part. That plan of action provides for the monitoring, by the Regional Committee, of progress in implementing the Regional Strategy every two years, starting in 1983; and for evaluation of its effectiveness in 1985 and every six years thereafter. At its meeting from 28 to 30 June 1982, the Sub-Committee on the General Programme of Work reviewed a common framework and format for monitoring progress in implementing national, regional and global strategies. It contains three sections, the most important of which is Section I which it is proposed should be used by Member States in preparing the reports on implementation of their national strategies due at the Regional Office in March 1983. The information provided on the basis of the questions contained in Section I will be used at the Regional Office to prepare the Regional Director's report to the Regional Committee on implementation of the Regional Strategy, using the questions contained in Section II as the basis; and the information provided by the six WHO Regions will be used to compile the Director-General's report to the Executive Board and the World Health Assembly on implementation of the Global Strategy, using the questions contained in Section III as the basis. The Regional Committee is asked to review the Sub-Committee's two recommendations: (1) that the common framework and format should be accepted in order to facilitate monitoring and reporting by Member States; and (2) that Section I, Part 3 of the framework should include the seven regional indicators contained in the Regional Strategy (see pages 52 to 53b of Annex l).

WPR/RC33/ 10 page 2 The Sub-Committee reviewed the common framework and format for monitoring progress in implementing the strategies for health for all by the year 2000, attached as Annex I. It reaffirmed the importance of this document, not only as a tool for monitoring and evaluation but also for ensuring that reporting was in a uniform format to facilitate the preparation of a regional synthesis. Since the purpose of the document was to help Member States to monitor their national strategies, it would be necessary, in answering each question, to make full use of national monitoring and evaluation mechanisms. The task should not be regarded merely as one of routine reporting to WHO, to be completed with undue haste and without using the appropriate mechanisms. Nor should it be delegated to the WHO Programme Coordinator, although the latter could, of course, be called upon to support the national health authorities. It was noted that the points that had been included for possible consideration had all been extracted from documents approved by the World Health Assembly. It was intended, however, that they should be considered in a flexible manner. Countries might, for example, wish to concentrate on those points that were particularly relevant to their individual situations and additional information could be provided as necessary. In general, the Sub-Committee considered the document to be well prepared and, after some questions had been clarified with regard to the indicators contained in the Global and Regional Strategies adopted by the World Health Assembly and the Regional Committee, it recommended that the common framework and format should be accepted by the Regional Committee in order to facilitate monitoring and reporting by Member States. The Sub-Committee also recommended that Section I, Part 3, of the document should include the seven regional indicators contained in the Regional Strategy, 1 together with notes on the elements to be considered in providing the information related to them. If the Regional Committee agrees with this recommendation, the contents of pages 52, 53, 53a and 53b will remain as part of Annex I.

1 Regional Strategy for Health for All, Manila, World Health Organization Regional Office for the Western Pacific, 1982, Section IX, page 60, paragraphs 7 and 8.

WORLD HEALTH ORGANIZATION

COMMON FRAMEWORK AND FORMAT FOR MONITORING PROGRESS IN IMPLEMENTING THE STRATEGIES FOR HEALTH FOR ALL BY THE YEAR 2000

Monitoring and evaluation are essential components of the Global Strategy for Health for All. Monitoring implies the continuous follow-up of activities during their implementation to ensure that they are proceeding as planned and are on schedule. Evaluation is a systematic way of learning from experience and using the lessons learned to improve current activities and promote better planning by careful selection of alternatives for further action. Whereas monitoring makes it possible to identify deviations so that activities can be put back on the right track, evaluation facilitates making health activities more relevant, more efficient and more effective. Monitoring and evaluation are integral parts of a country's managerial process for health development and should not be undertaken as a separate act1v1ty. To carry out the process, national mechanisms for monitoring and evaluation will have to be put to full use and strengthened as necessary. The Plan of Action for Implementing the Global Strategy for Health for All envisages a continuing process of monitoring and evaluation. The first report on monitoring progress will be made available in 1983 and the first report on the outcomes of evaluation 1n 1985. This document presents a common framework and format for monitoring progress in implementing national, regional and global strategies for health for all. Its main purpose is to facilita te the monitoring by countries of progress in implementing the1r national strategy for health for all. A common framework and format for this purpose is presented in Section 1. Section IT, printed on orange paper, and Section III, printed on green paper, contain respectively a common framework and format for monitoring the regional and global strategies for health for all. They are included for information of Member States. A common framework and format for evaluation will be prepared 1n due course.

DG0/82.1 Geneva, 7 June 1982

List of Contents Introduction: Section I; Common Framework and Format for Monitoring National Strategies for Health for All Section 11: Common Framework and Format for Monitoring Regional Strategies for Health for All Section 111: Common Framework and Format for Monitoring Global Strategy for Health for All 57 69 1

page 1

INTRODUCTION

It is stated in the Global Strategy for Health for All by the Year str~tegies

2000 that governments would wish to know if they are making progress 1n implementing their and whether these strategies are having the It is also

desired effect in improving the health status of the people.

stated that, to this end, they will consider introducing at the earliest stage a continuing process of monitoring and evaluation that is appropriate to their needs as part of their managerial process for national health development. 1

Monitoring implies the continuous

follow-up of activities during their implementation to ensure that they are proceeding as planned and are on schedule. Evaluation is a

systematic way of learning from experience and using the lessons learned to improve current activities and promote better planning by careful selection of alternatives for further action. Whereas monitoring makes

it possible to identify deviations so that activities can be put back on the right track, evaluation facilitates making health activities more relevant, more efficient and more effective. 2. The ma1n purpose of this document is to facilitate the monitoring by At the same time, it aims at making it possible for countries

countries of progress 1n implementing the national strategy for health for all. to present the outcomes of such monitoring in a compatible way so that regional and global consolidations will be possible. For, 1n addition

to the application of monitoring by countries to keep their strategies on the right track, the outcomes of such monitoring will also be used by Member States to prepare their first progress report that will be submitted to the Regional Offices by March 1983, as indicated in the Plan

lGlobal Strategy for Health for All by the Year 2000, Geneva, World Health Organization, 1981, "Health for All" Series, No. 3, Section VII, page 73. The continuing process of monitoring and evaluation is explained in document~ Health Programme Evaluation. Guiding Principles, Geneva, World Health Organization, 1981. 11 Health for All 11 Series, No. 6. A description of the place of monitoring and evaluation within the managerial process for national health development is given in document~ Managerial Process for National Health Development, Genev a, World Health Organization, 1981, "Health for All 11 Series, No. 5.

page 2

of Action for Implementing the Strategy. 1

A regional synthesis of

these first progress reports will be presented by the Regional Directors to the Regional Committee sessions in 1983. On the basis of these

regional progress reports, a global progress report will be presented by the Director-General to the 73rd Session of the Executive Board 1n January 1984 for final review by the 37th World Health Assembly in May

1984.

The above reports will also contain relevant infurmation on

activities undertaken by WHO in supporting national strategies, including the work of the Secretariat.

For the above mentioned process of monitoring progress a common

framework and format has been developed and is presented in this document. It contains three sections. Section 1: Common Framework and Section

Format for Monitoring National Strategies for Health for All. II:

Common Framework and Format for Monitoring Regional Strategies for and Section TIT: Common Framework and Format for These three sections

Health for All;

Monitoring the Global Strategy for Health for All.

are based on the guiding principles for health programme evaluation 2 appearing 1n the document 11 Health Programme Evaluation 11 •

In view of the relatively short time that has elapsed since the

strategies for health for all were launched, it is proposed that Member States concentrate at this stage and in this first progress report on the monitoring of the RELEVANCE of their health policies to the attainment of the goal of health for all and on the PROGRESS made in implementing these. The assessment of progress made by 1983 will consist of Member

States analysing whether the steps proposed in the Plan of Action have

1Plan of Action for Tmplementina the Global Strategy for Health for All

by the Year 2000, Geneva, World Health Organization, 1982, Series, No. 7.

Health for Al1 11

2 Geneva, World Health Organization, 1981, "Health for All" Series, No. 6.

page 3

been taken by them individually, by the governing bodies and by the Secretariat of WHO. being carried out. The ma1n emphasis will, therefore, be to find out It would also be useful to have indications of to what degree strategies have already been formulated and are actually

the reasons that, it is felt, have given iise to unusually positive progress or unusually negative events, in order to discern what factors promote or impede progress. 5. In addition - and to the extent possible- information should be 2

collected on at least the twelve global indicators agreed upon by the World Health Assembly. information refers. This should be based on the latest available information and should indicate the year to ""hich the Even the fact that the information is not available The is in itself of value and Member States should indicate this. information on these indicators collated in 1983 will constitute baselines for subsequent evaluation. As mentioned in the Global Strategy, "many countries will wish to use additional indicators in keeping with their needs and capacities 11 3

1As part of the continuing process of monitoring and evaluation, the various components of evaluation will be considered in the course of time. Such evaluation will concentrate on the assessment of the effect of the strategies on the health and related socioeconomic situation throtighout the world as well as on the status of the provision of health care and will be reported upon in the first instance in 1985. To facilitate this evaluation a further common framework and format will be prepared in due course. 2 These twelve global indicators are listed in Section I of this document on pages 34-51 below. Details on the use of indicators can be found in; Development of Indicators for Monitoring Progess towards Health for All by the Year 2000, Geneva, World Health Organization, 1981, 11 Health for All" Series, No.4. 3Global Strategy for Health for All, Geneva, World Health Orgnization, 1981, "Health for All" Series, No.3, Section VII, page 74, paragraph 6.

page 4

In the framework and format that follow, pertinent questions are

presented on the left-hand page and points which may be considered when dealing with these questions appear on the right-hand page. These points have been taken from documents to which Member States have agreed collectively, such as the Alma-Ata Report, the Global Strategy for Health for All, Development of Indicators for Monitoring Progress towards Health for All by the Year 2000, the Guiding Principles for Health Programme Evaluation and the Plan of Action for Implementing the Strategy for 1 Health for All. Some of these points may refer to more than one question and so flexibility should be applied in using them. I t is

stressed that Member States are expected to scan these points and concentrate on those that are particularly relevant to their situation. It is hoped that, in this way, when they report on the outcomes of the monitoring they will be able to do so succinctly. Of course, in reporting on their monitoring to Regional Committees, they are free to add additional relevant points that have not been mentioned in the document.

The responsibility for monitoring and evaluation will rest at the

national level with governments of Member States, at the regional level with the regional committees and at the global level on the Executive Board and the Health Assembly. for Health Programme Evaluation, 2 As explained in the Guiding Principles within countries the responsibility

is shared among the various levels of the health system and those concerned at any level are kept informed of the findings of monitoring and evaluation at other levels. The central health authorities may have to report to government and its appropriate institutions.

lGeneva, World Health Organization, 1981, "Health for All" Series Nos 1, 3, 4, and 6, and 1982, No. 7. 2Geneva, World Health Organization, 1981, "Health for All" Series, No. 6, p. 15

page 5

This principle is being extended to the international level, Member

States having agreed to report on the Strategy for Health for All to all other Member States in the region for consolidation and collective review in the Regional Committees. It is important that the feedback from such

Regional Committee reviews reach individual Member States in the region so that they can apply the lesson3 learned. Regional Committees will also present their monitoring and evaluation findings to the Executive Board which will have the responsibility of reviewing a consolidated global assessment and reporting to the World Health Assembly for ultimate review. It is important that feedback from these reviews also reach

Member States.

WHO Secretariat will provide on request the necessary support to It

governments for the monitoring and evaluation of national strategies.

will support the regional committees for their assessment of the regional strategies and the Executive Board and the Health Assembly for the global assessment.

page 6

page 7

SECTION I;

COMMON

FRAMEWORK FOR

AND

FORMAT

MONITORING

NATIONAL

STRATEGIES

FOR

HEALTH

FOR

ALL

COUNTRY;

DATE OF COMPLETION OF REPORT:

page 8

RELEVANCE Questions 1 - 4 below relate to Relevance

Question 1:

ARE

THE

EXISTING OF THE

NATIONAL GOAL

HEALTH

POLICIES FOR ALL

ATTAINMENT

OF HEALTH

RELEVANT TO THE BY THE YEAR 2000

Opposite is the section of the "Global Strategy for Health for All", that defines the fundamental policies for Health for All, and that could be considered with respect to this question. paragraph 9) ("Health for All" Series, No. 3, Section II, pages 34-35,

page 9 Points which may be considered with respect to Question 1: 1 (1)

Health is a fundamental human right and a world wide social goal.

(2) The existing gross inequality in the health status of people is of common concern to all countries and must be drastically reduced. An equitable distribution of health resources, both among countries and within countries, leading to universal accessibility to primary health care and its supporting services, is therefore fundamental to the Strategy. (3) People have the right and the duty to participate individually and collectively in the planning and implementation of their health care. Consequently, community involvement in shaping its own health and socioeconomic future, including mass involvement of women, men and youth, 1s a key factor in the Strategy. (4) Governments have a responsibility for the health of their people which can be fulfilled only by the provision of adequate health and other social measures. The political commitment of the State as a whole, and not merely the ministry of health, is essential to the attainment of health for all. (5) Countries must become self-reliant in health matters if they are to attain health for all their people. National self-reliance implies national initiative, but not necessarily national self-sufficiency. Where health is concerned no country is self-sufficient; international solidarity is required to ensure the development and implementation of health strategies and to overcome obstacles. Such international health solidarity must respect national self-reliance. (6) In conformity with the recognition by the United Nations General Assembly of health as an integral part of development, the human energy generated by improved health should be channelled into sustaining economic and social development, and economic and social development should be harnessed to improve the health of people. Health for all by the year 2000 cannot be achieved by the health sector alone. The coordinated efforts will be required of other social and economic sectors concerned with national and community development, in particular agriculture, animal husbandry, food, industry, education, housing, public works, and communications. Ministries of health or analogous authorities have an important role in stimulating and coordinating such coordinated action for health. See also Indicator 1 on pages 38 and 39

1 It is stressed that Member States are expected to scan these

points and concentrate on those that are relevant to their situation. Of course, in reporting on their monitoring to Regional Committees, they are free to add additional relevant points that have not been mentioned in the document. This comment holds throughout the rest of the document.

page 10

RELEVANCE (continued)

Question 2:

HAS

A NATIONAL FOR ITS

STRATEGY

FOR

HEALTH BEEN

FOR

ALL

AND

A PLAN

ACTION

IMPLEMENTATION

FORMULATED ?

Opposite are extracts from the Executive Board's guiding principles for "Formulating Strategies for Health for All" that illustrate what such a strategy might consist of, and that could be considered with respect to this question. ("Health for All" Series No. 2, Section III, pages 14-19, paragraphs 17, 21-31.)

page ll

Points which may be considered with respect to Question 2: National Health Policies, Strategies and Plans of Action A national health policy is an expression of goals for improving the health situation, the priorities among those goals, and the main directions for attaining them. A national strategy, which should be based on the national health policy, includes the broad lines of action required in all sectors involved to give effect to that policy. A national plan of action is a broad intersectoral master plan for attaining the national health goals through implementation of the strategy. It indicates what has to be done, who has to do it, during what time frame, and with what resources. It is a framework leading to more detailed programming, budgeting, implementation and evaluation. NATIONAL STRATEGIES (1) The strategies should incorporate the systematic identification and use of suitable entry points for fostering health development, ways of ensuring the involvement of other sectors bearing on health, the range of political, social, economic, managerial and technical factors, as well as obstacles and constraints and ways of dealing with them. (2) Political Commitment The introduction or strengthening of the development process needed to attain health for all will require unequivocal political commitment to bring about the reforms that are essential to convert this goal into a reality. This will most likely have to be set in motion by political decisions taken by the government as a whole, and permeating all sectors, at all levels throughout the country, and not merely by the ministry of health or the health sector alone. National political commitment will be reinforced by technical cooperation among countries and by international political support. (3) Social Considerations The overall social goal of health for all has to be broken down into more concrete social policies aimed at improvement of the quality of life and maximum health benefits to all. If the gap between "haves 11 and "have-nots 11 is to be reduced within and among countries, there will be a need in most countries to formulate and put into effect concrete measures for more equitable distribution of resources. In many countries this will imply the preferential allocation of health resources to those in greatest social need as an absolute priority, as a step towards attaining total population coverage. Sound health policies contribute to overall socioecnomic policies; thus, if the country's overall development policy gives priority, for example, to rural development, urbanization, or industrialization, the health policy has to give preferential attention to these priorities. (4) Community Participation Measures have to be taken to ensure free and enlightened community participation, so that notwithstanding the overall responsibility of governments for the health of their people, individuals, families and communities assume greater responsibility for their own health and welfare, including self-care.

page 12

RELEVANCE (continued) Question 2: (continued)

Opposite are extracts from the Executive Board's guiding principles that illustrate what plans of action might consist of, and that could be considered with respect to this question. ("Health for All" Series No. 2, Section III, pages 19-20, paragraphs

32-35.)

page 13 Points which may be considered with respect to Question 2 (continued) (5) Administrative Reform The strengthen1ng and adaptation of administrative structures and systems at all levels and in all sectors, not only the health sector, may be required. Financial Implications Tn most countries there will be a need to reallocate resources. Tn addition, in many countries it will be necessary to increase the national health budget to the greatest possible extent in order to provide the population with essential health care. Although most of the resources for national health development come from the country concerned, there will nevertheless be a need for substantial and continuing international support for developing countries. The nature of this support must be subject to decisions of the government of the developing country concerned. Tt is essential to consider the costs of programmes and services and how they can be borne. These might include government direct and indirect financing, social security and health insurance schemes, local community solutions and the use of external loans and grants. Enabling Legislation In some countries it may be necessary to legislate in order to introduce the necessary reforms.

(6)

(7)

(1)

(2)

(3)

(4)

NATIONAL PLANS OF ACTION What has to be done ? The national plan of action has to specify the policies to be followed, the objectives to be attained and related targets, quantified to the extent possible. It includes the political, social, economic and administrative dispositions and the technology required, together with any necessary legislation and managerial mechanisms and processes. Who has to do it ? The ministry of health or equivalent governmental authority is responsible for promoting and sustaining the development of plans of action. To do so effectively, it has to involve all levels of the health system, including all health workers, as well as the other social and economic sectors concerned. Time frame The implementation of plans of action is a long-term process for which it is difficult to specify a definitive precise timetable in advance. Nevertheless, it is useful to prepare tentative, rough timetables and to refine them progressively, realizing that implementation will depend on d variety of political social, economic, managerial and technical circumstances, including the extent to which resources can be made available in accordance with requirements. Resources Broad allocations and ways of financing have to be def1ned at the intial stages of formulation of plans of action. Without this, plans cannot be materialized.

page 14

RELEVANCE (continued)

Question 3:

DOES

THE

NATIONAL

HEALTH

STRATEGY DEVELOPMENT

FORM PLAN

AN ?

INTEGRAL

PART

A NATIONAL

SOCIOECONOMIC

Opposite is an extract from the Global Strategy for Health for All that illustrates the relationship between health and socioeconomic development and that could be considered with respect to this question. ("Health for All" Series No. 3, Section II, pages 35-37, paragraphs 10-12)

page 15

Points which may be considered with respect to Question 3 (1) The improvement of health not only results from genuine socioeconomic development as distinct from mere economic growth, it is also an essential investment in such development. In recongition of these intimate interrelationships and in compliance with the fundamental policies present e d above, the Strategy will be based on the mutual reinforcement of health development policy and socioecnomic development policy. Full account will be taken of the extent to which the achievement of health goals will also be determined by policies that lie outside the health sector, and in particular policies aimed at ensuring uni~ersal access to the means to earn an acceptable income, whatever their nature. In many countries the conquest of poverty will be the overriding priority. But merely to increase incomes will not guarantee health. While there is a close relationship between health and income at the very lowest income levels, as incomes begin to rise health hazards associated with economic development begin to emerge. Health authorities will have to display vigilance in identifying and introducing elements that are essential for health development in national, regional, and global socioeconomic development plans. This involves making economic planners and political decision-makers aware of the health implications of alternative development strategies, identifying those aspects of development schemes which can either promote or threaten health, and ensuring that safeguards to health are incorporated into their design. Health authorities will also assure economic planners and political decision-makers that endeavours to improve health in conformity with the fundamental policies for health for all outlined above are an investment in human development. Health authorities will use the very Strategy for health for all, based on social justice and on equity in the distribution of resources for health, as an example to be followed by other sectors. They will insist on seeing evidence that investments in economic development will indeed bring about improvements in the quality of life and standard of living of people. Other sectors will be encouraged to take appropriate action to minimize hazards to health and to take full account of health goals as part of their own sector goals.

(2)

(3)

page 16

RELEVANCE (continued) Question 4~

HAS SUCH

THE

EXISTING MADE HEALTH

HEALTH TO ON

SYSTEM THE AND PRIMARY

BEEN

REVIEWED CARE, ?

AND OF THE INCLUDING

ADJUSTMENTS NECESSARY

REFLECT

ESSENTIAL HEALTH

CHARACTERISTICS

A SYSTEM

BASED

PROGRAMMES

INFRASTRUCTURE

Opposite are extracts from the "Report of the International Conference on Primary Health Care", Alma-Ata, and of the "Global Strategy for Health for All" that illustrate the essential characteristics of Primary Health Care and of health systems based on it, and that could be considered with respect to question 4. ("Health for All" Series, No. 1, Section VII, page 4, paragraph 3, and "Health for All" Series No. 3, Section III, pages 39-40, paragraph 2.)

page 17 Points which may be considered with respect to Question 4 (1) Primary Health Care includes at least: education concerning prevailing health problems and the methods of preventing and controlling them; promotion of food supply and proper nutrition; an adequate supply of safe water and basic sanitation; maternal and child health care, including family planning; immunization against the major infectious diseases; prevention and control of locally endemic diseases; appropriate treatment of common diseases and injuries; and provision of essential drugs. While no universal blueprint of a health system can be imposed on countries, and much remains to be done to work out tha most appropriate ways of developing health systems in different national circumstances, the following principles have been defined that are applicable to all health systems based on primary health care: The system should encompass the entire population on a basis of equality and responsibility. It should include components from the health sector and from other sectors whose interrelated actions contribute to health. Primary health care, consisting of at least the essential elements included in the Declaration of Alma-Ata, should be delivered at the first point of contact between individuals and the health system. The other levels of the health system should support the first contact level of primary health care to permit it to provide these essential elements on a continuing basis. At intermediate levels more complex problems should be dealt with, more skilled and specialized care as well as logistic support should be provided, and more highly trained staff should provide continuing training to primary health care workers, as well as guidance to communities and community health workers on practical problems arising in connexion with all aspects of primary health care. The central level should coordinate all parts of the system, and provide planning and management expertise, highly specialized care, teaching for specialized staff, the expertise of such institutions as central laboratories, and central logistic and financial support.l

(2)

lrn some countries autonomy exists at regional level for this type of action.

page 18

RELEVANCE (continued)

question 4 (continued)

Opposite is an extract from the "Global Strategy for Health for All" that illustrates what needs to be taken into account when building up a health system based on primary health care, and that could be considered with respect to Question 4. paragraph 6.) ("Health for All" Series, No. 3, Section III, pages 41-42,

page 19 Points which may be considered with respect to Question 4 (continued) To develop such health systems countries will take into account the following: (1)

Action to be taken in the health sector will be identified, planned and coordinated. Action to be taken in other sectors will be identified, and the responsible authorities approached with a view to implementation. Ways will be devised of involving people and communities in decisions concerning the health system and in taking responsibility for self-care as well as family community care. Central planning will aim at enabling communities of different types and sizes to work out their own primary health care activities.l A supportive referral system will be devised and put into effect, particular attention being paid initially to the first referral level. A logistic system will be organized and operated for the whole country.l Health manpower will be planned, trained and deployed in response to specific needs of people as an integral part of the health infrastructure. Appropriate health care facilities will be planned for, designed, constructed and equipped so that they are readily available, accessible and acceptable to all the population. Health technology will be selected that is scientifically sound, adaptable to various local circumstances, acceptable to those for whom it is used and to those who use it, and maintainable with resources the country can afford.

(2)

(3)

(4) (5)

(6) (7)

(8)

(9)

lrn some countries autonomy exists at regional level for this type of action.

page 20

PROGRESS Questions 5 - 13 below relate to Progress

Question 5:

HAS AND

PROGRESS

BEEN

ACHIEVED

IMPLEMENTING

THE

STRATEGY

PLAN

ACTION ?

Opposite is an extract from the "Plan of Action for Implementing the Global Strategy for Health for All by the Year 2000" that illustrates what is expected of Member States, and that could be considered with i"espect to Question 5. All" Series No.7) ("Health for

page 21

Points which may be considered with respect to Question 5 (l) (2) (3) Continuation of review of national health policies; Continuation of preparation of national strategies; Formulation of national strategies by those that have not already done so; Updating of national strategies as necessary 1n the light of the Global Strategy; Consideration of defining specific national targets; Development of plans of action to implement their strategies; Review of health systems - commencement or continuation; Consideration by governments of ways of strengthening health ministries or analogous bodies; Action by ministries of health or analogous bodies to ensure wide national commitment;

(4)

(5) (6) (7) (8)

(9)

(10) Action by ministries of health or analogous bodies to establish or strengthen managerial process for national health development. (ll) Action to orient research towards priority problems of the Strategy; (12) Introduction of process and mechanisms for monitoring and evaluating

their strategies. (13) Selection of indicators for monitoring and evaluating their

strategies.

(14) Intercountry cooperation in support of health systems development information exchange, research and development, training, economic cooperation; (15) Intercountry cooperation in regard to human, financial and material

resources through exchange of information and through specific agreements;

(16) Submission of progress reports to regional committees on implementation of their strategies.

See also Question 8 on pages 24 and 25

page 46

INDICATORS (Continued)

Indicator 6

The strategy for health for all has been accompanied by explicit resource allocations and is receiving sustained resource support from more affluent countries.

Indicator 7

The porportion of the population for whom Primary health care is available.

page 47 Elements to be considered for Indicator 6 To be completed by developing countries. Information should be provided on the amount ~f external resources received, financial and other. The period to which the information refers should be specified. The amount of external resources should be compared with the total amount required, if such needs have been assessed.

See also Questions 8 and 12 on pages 24-25 and 30-31, respectively.

Elements to be considered for Indicator 7 At least the following indicators should be reported: (1) The proportion of the population to which safe drinking water is available in the home or within 15 minutes' walking distance. Safe water supply should include treated surface waters and untreated but uncontaminated water such as that from protected boreholes, springs and sanitary wells. Other sources of doubtful quality should be considered unsafe and not included in the estimate of coverage. The proportion of the population to which adequate facilities for hygienic waste disposal are available in the home or immediate vicinity. Facilities are considered adequate if they effectively prevent contact with and access to excreta by humans, animals and insects. The proportions of infants under 1 year of age who have been fully immunized against diphtheria (3 doses), tetanus (3 doses), whooping-cough (3 doses), measles (1 dose), poliomyelitis (3 doses) and tuberculosis (1 dose). If the target population includes older children, the age limit used should be specified. In addition, the proportion of pregnant women immunized against tetanus (2 doses) should also be reported. The proportion of the population to which local health care, i.e. first-level contact including the regular supply of at least 20 essential drugs, is available within one hour's walk or travel. The proportion of women who were attended during pregnancy and at childbirth, and the proportion of children cared for up to at least 1 year of age, by trained personnel. The criteria used to judge the adequacy of training of the attendant should be described. See also Question 5 on pages 20 and 21

(2)

(3)

(4)

(5)

page 48

INDICATORS (Continued)

Indicator 8

The nutritional status of children is adequate.

Indicator 9

The infant mortality rate for all identifiable subgroups.

Indicator 10

Life expectancy at birth.

page 49 Elements to be considered for Indicator 8 Two proportions to be reported are: (1) The proportion of newborn infants having birthweight of at least 2500g. The measurement of the weight should preferably be taken within the first hours of life, before significant postnatal weight loss has occurred. Data based on a representative sample of the newborn are acceptable, if national data based on all live-births are not available. The proportion of children under 5 years of age having a weight for age that corresponds to the reference values "median-2SD" given in Annex 1 to Development of Indicators for Monitoring Progress Towards Health for All by the Year 2000, World Health Organization, 1981 ("Health for All" Series, No. 4). Data could be based on a representative sample of children. If they relate to children of a particular age, e.g. 2 years to 5 years, this should be specified.

(2)

Elements to be considered for Indicator 9 In addition to the national rate, the range (maximum and minimum) of the rate observed among various population groups, e.g. geographical areas or ethnic groups, should be reported, if figures are available. A table showing the details of distribution would be helpful if attached as an Annex.

Elements to be considered for Indicator 10 A simple procedure for computing life expectancy is illustrated in Development of Indicators for Monitoring Progress Towards Health for All by the Year 2000, cited above, Part 2 (pages 70-72 of the English version). Life expectancy cannot be established with precision for a country with a population of less than 1 million, if based on data for a single calendar year. For such a country, data for a few years (say, 2-5 years) should be combined for the computation. For a country with a population less than 200 000, even such combination of data would not suffice. In such a case the average age at death may be used as a proxy indicator.

page 50

INDICATORS (Continued)

Indicator 11

The adult literacy rate for both women and men.

Indicator 12

The gross national product per head.

page 51 Elements to be considered for Indicator 11 The proportion of men and women (separately, if figures are available) aged 15 years or over who are able to read and write at least in one l~nguage should be reported.

Elements to be considered for Indicator 12 The gross national product per head should be expressed in the It may also be expressed in terms of US national currency. dollars, if available.

page 52 INDICATORS (Continued) 3. ADDITIONAL REGIONAL INDICATORS

Regional Indicator 1

The percentage of local commun1t1es at all levels that have well established voluntary and formal community organizations committed to continuous primary health care action programmes.

Regional Indicator 2

The community's contribution 1n cash and in kind to health and health-related action.

Regional Indicator 3

The daily

~apita

calorie availability.

Regional Indicator 4

The dai l y per capita protein avai lability.

page 53

Elements to be considered for Regional Indicator 1 One :indicator of the seriousness of the Government's political commitment is the level of community involvement in health decision-making and the existence of effective mechanisms for people to express their demands and needs. The voluntary and .formal community organizations include health corrnnittees, community development movement organizations, women's organizations, and farmer or other occupational groups.

Elements to be considered for Regional Indicator 2 Contributions in kind may include the following: free labour health-related construction work, collection of building materials construction of health-re.lated facilities, and voluntary services health care. for for for

Elements to be considered for Regional Indicators 3 and 4 It would be desirable to complement indic,1tors of the nutritional status of the population with indicators of the national food supplv, in total and for different groups in the population. No single indicator at present available is wholly satisfactory for this purpose. The per capita calorie availability, calculated from food balance sheets which take account of local food production, imports, exports, wastage and diversion for non-human use, is the best available indicator of total food availability but it must be interpreted with caution since it takes no account of seasonal variations, differences between income groups, or patterns of food distribution within households.

page 53a INDICATORS (Continued)

Regional Indicator 5

Maternal mortality.

Regional Indicator 6

Number of cases of diphtheria, tetanus, whooping cough, measles, poliomyelitis or tuberculosis.

Regional Indicator 7

The population growth rate.

page 53b

Elements to be considered for Regional Indicator 5 This rate reflects the risk to mothers during pregnancy and childbirth. It is influenced by general socioeconomic conditions, nutrition and sanitation as well as by maternal health care. Deaths due to abortion are sometimes excluded. Like infant and child mortality rates, it is difficult to , obtain when only a small · proportion of the births . and deaths are recorded. The use of lay reporting methods has been found effective. The use of traditional birth attendants in primary health care can also increase the coverage and provide an opportunity for collection of this information, at least on a sample basis.

Elements to be considered for Regional Indicator 6 If immunization for the six irmrtunizable diseases is available for the whole target population by the year 2000, it is expected that the incidence of these diseases will fall to zero, ex~ept for tuberculosis in infants.

Elements to be considered for Regional Indicator 7 Demographic factors - changes in the size of the population and its age and sex structure - are basic not only to the compilation of indicators but to all forms of planning in health and other fields. The population growth rate reduced to less than 1 per cent. is one of the health status targets included in the Regional Strategy for Health for All by the Year 2000. In addition to natural population growth, increase or decrease due to immigration or emigration, as well as internal migration, should also be taken into consideration in providing information.

page 54

OPTIONAL ADDITIONAL INFORMATION

IN THEY

ADDITION SO WISH

TO THAT

THE THEY

ABOVE,

COUNTRIES WOULD BE

MAY OF

PROVIDE FOR ON

ANY OTHER ANY

ADDITIONAL MEMBER STATES,

INFORMATION PARTICULAR INCLUDING INDICATORS

THINK

INTEREST THEY ARE

INFORMATION

ADDITIONAL

USING.

page 55

OPTIONAL ADDITIONAL INFORMATION (Continued)

Page 57

SECTION II

COMMON

FRAMEWORK FOR

AND

FORMAT

MONITORING

REGIONAL

STRATEGIES

FOR HEALTH

FOR

ALL

REGION:

------------------------------------------

DATE OF COMPLETION; __________________________________

Page 58-.

RELEVANCE

Questions l and 2 below relate to Relevance Question 1

ARE

TilE

REGIONAL

HEALTH

POLICIES,

STRATEGIES, • R.lLBY"'"'

PLANS TO

oF THE BASED

ACTION '•·AND . .~llOOIW!IME ··.OIHCT\I} . ... . ... OIJS ATTAINMENT ON THE OF HEALTH OF FOR PRIMARY ALL CONCEPT

H~t;Y .. .

THROUGH

HEALTH

SYSTEMS

HEALTH

CARE?

Question 2

ARE

THE

FUNCTIONS TO IN THE THE Otrr

AND

STRUCTURES OF TO

THE

REGIONAL TO

OFFICE MEMBER IN

RELEVANT STATES CARRYING

PROVISION REGION AND

ADEQUATE THE FOR

SUPPORT

REGIONAL HEALTH

COMMITTEE FOR ALL'!

THEIR

STRATEGIES

Opposite is .an extract from the "Report by the Director-General on the implementation of resolution WHA33.17 concerning the Study of WHO's structures in the light of its functions" that could be considered for responding to that part of question 2 which relates to the functions of the regional offices. (Document EB69/8 Add.l, page 16, para. 28.1)

Page 59

RELEVANCE

Points which may be considered with respect to Question 1 Note; A regional health policy is an expression of the goals for improving the health situation in the region, the priorities among those goals and the main direction for obtaining them. Regional health policies are reflected ~n

Regional Committee Resolutions, as well as in some regions in Regional Health Charters. These policies reflect the specific needs of the Member States in the region, as well as the regional implications of global health policies. It is realized that it will be difficult to have a complete review of regional policy and programme directions, but it is suggested that the process be started.

Points which may be considered with respect to Question 2 The functions of the Regional Offices will be reshaped as necessary to include intensification of dialogues with Member States; intercountry coordination in the region on behalf of the Regional Committees; ensuring technical cooperation between the Organization and supporting technical cooperation among Member providing the its Member States;

States, and in particular among developing countries;

right kind of information and other support to Regional Committees, as well as to regional advisory groups and in particular those involved in multisectoral and multidisciplinary action for health; and deploying national expertise for the work of WHO. and mobilizing

Page 60

· P~lS

~stion

'l'Q : WHAt- . UiiNT, IJAVB :,cotJII'B-1&~ : · .JtN . '!HB ".UGtOII< MADE IN -•CARa-YtliG - OUT " THEIR , S!l'ti'RCIIS · POl. HIA~'FR

PROGRESS ALL t

FOR

Question 4 ;.

WHAT

EXTENT

HAS

PROGRESS

BEEN

MADE

CARRYING

OUT

THE

ACTIVITIES

~~$t~

'N;)_ ~-~ ___ QQ.l~/4;

_ .COHMITT!!S ~

·· m: L~ tlifl'

GLOBAL

PLAN OF

ACTION'

Oppoai,,e:,,~a

·art

ear•~-t: ::O'f

'othe· uPlen of ACtie'n for ltii'P'l'e iMat)ing the

Global,; st:r:atJI.Gl.•- · fer:~ Hea:blili :&r •-Alil- ·b y :•

-Veet

act iv i b:MI· :.4t,. . .d ' bO i the ,kPd¥1 Coa8i consideJ,ed with qresp..ct to

tt••• • .-d that

- 20@0~ ·:~ba·t 1 'illu&tJretea the

ef>Uld tie -

Que~l:iiC-!fl; -4- ;(:Be.tldHfO~ - AU

:s.;r;i6s Jlo• 7. )-·

Page 61

_ ....,,!tll@qt to, b,e made in -the ligb.t of til-e reports by governments on progr~ae•u~de.

P()iat.f -which .,.Y be c:.onsidered with respect to Question 4 U . pfo\atin& and adaptation as, necessary of regional strategies in -.tWL,.l i.bc; .JlL ..the---GJ..Qll.al...iJ;~--~-~ . (2)

Se~_.,:f~~ef;~~~-· ~~it~el.\t~ .•. if. ~~ey ~a,ve_ n<;>.~_alrea~.Y done so,

to"ii$p.l~nt·; 'a6il'itor'~ a"'a·~...luate re.g ionill ' strateties (3) .W~c. o. f

De.ci•i.cms concerning geopolitical groupings of countries and prQIIOting". tha ;cA:tr.&tAI.W,J:lu:-O.\l&lL.tbelll.

(4) (~)

Consid~&ration

of defining :t:egional targets

Conai4eratioo , of toe aciqu,igJhof they n~ve not already done

reg~o1ld

11eaBh ch.arters i f

~lie,.xatioP. , .C?f, 1i'~g4Q,nal , plans

of acti.on fo~ imp~emel}_ting regional strategies , and review of global plan of " action

(7 (8)

a.Jular review of needs for international resource support re.ai~al

seJ.eetion of indicators for ~nitoring and evaluating the stra,tegy if th•y have not .already done so

(9)

Rev iew of regional progra"fiii,U budget propoaals 1984-1985

(lQ) Monito. z:,i og of progreu in i11plementing regional strategies (11) Adjustment of regional plans of action as necessary

Page 62

PROOUSS . (Cont 'd) Question 5

WHAT

EXTENT TO

HAS

PROGRESS THAT THE

BEEN MADE REGIONAL

CARRYING OUT MIGHT HAVE

ADDITIONAL

ACTIVITIES

COMMITTEE

ASSIGNED

ITSELF!

Question 6

TO WHAT EXTENT . HAS SUPPORT EXPECTED OF

TilE IT?

REGIONAL, OFFICE

PROVIDED

TilE

Opposite is an extract of the "Plan of Action for

lmple~Renting

the

Global Strategy for Health for All by the Year 2000" that illustrates the activities assigned to the Regional Offices and that could be considered with respect to question 6 (Health for All Series No. 7)

Page f)3

Eacb ~&ion could Sli!!t out .i-~a ~n' list in this column.

Points w}d.~ll,,!f!l· _ be . co~-~4eJ4'eA with reAJPAAt~ - ~c Que&tiOJ1 6 (l)

Support to gov.efnMnt.s in foraulatina. implementing, monitoring and - ev•luatina national atrateai•,. -Co~ti'aw•tion or c~eaent of ~~acta with Uti regional

(2)

cOIIIIli.a ions (3) .Gont:i.n~tion , or c~eaent o~ , C~JlCt~ts nona~er~tc4l o~:...izationa

with re_ levant re·gional

(4) · Review of r.egion«l Qlecnani••• fo_ r J:he exchang' of information,

for proptO-ting cele~ant research . art4 4ev•lqpment and appropriate technology, aQd £Q.r providing traiJ,tj,_ a g in the development of health aysteas Colla.tion of inforation regardin• provide S#l)p()rt to tbeStrategy peop~e ,and

(5)

groups who can proPQ.-als for

( 6) (7)

Sl!pport "o "'ve,l-opi~& countries exterft4:1 fUt)4i;ag for health

iJ?.

,~ep'llring

Support to~: i,egiOI'lal Co.aittees -in - ~ating and adaptating regional str•tqie• ,asneceasary Contacts with aeo:,Olitical gre»,,.lti.-• of cGuntries as decided by the Regional COJIIIait.tees Ensuring implemeQ;tation of regiQU,l: plans of action

(8) (9)

Page 64

Qu~• t ion

6 <COllt''_ :al

Page 65

Points "bien uy b.e considered with_ ~~ef#.t _ :t4. qyes~

iJ:

iclm:.f~~d)

flOl Sub,i.inion o'f regional prog-r•aune b.u dgets proposals -1984-1985 - in the liabt of tentative •~iu.r:.term programmes for the . . . . .:ri-olli '«if :the :...._.-'GerutJrali ..b:Qgralllbe .of ,Wo.ft

{li>

SuJ:nais•iOtr'bf' 'pt'ogresa r~i)O,rt·s to reg"iona~ 'colilmittees on ~atj:Qn O!f rePM,.l. :'fitt~•1 dls-~.n.ti4l.n

(V2:l 'fM't•r- t}i8' ••8 icrn41' coewiitte:~ ~~s~ti:~il in' 19thh

to Memb-er StatetJ - ~ t..III~HtJtaionL q,fl I~i.Qn.&.l C~itt••' • reports on mon~tor.ing prog-J:'e1Ul and ensure iatp). ,.utation .of .up.~~cl-~~~-;ot.~tion ..

·e"nsure

Continuip;aactivit:y: WHO's ·~~~"(i:l.li~•!· ca~i.a; ~~1 ~ 'li.AAr ~Jl; ,f,rp~~- ·;Q_~ , 'Wor.k. ,for

a .Specific · 1'-erioa· mould promote' · the_self~usfaintng development by

COliDtriu. -.of..~ - health- iAf~uct~-~-the ...clel-i~y , -thr-oup : it of approp-t"iate ~lth technology.

Page 66

INDIC4TORS I• TWEL'Vji: GLOBAL Il'JlH~ATORS

INFORMATION

SHOULD

PRESENTED

~·

THE

NUMBER

COUNTRIES OF

IN THE REGION ~A.VING REACHED. THE PERTINENT VALUES TWELVE GLOBAL INDICATORS AS ·- WE·LL AS mE FREQUENCY DISTRIBUTION QUANTIFIABLE OF THE INDICATORS , VALUES INDICATORS. WITH _ RESPECT

THE

'f:O

ADDITIONAL INDICATORS THAT ARE SPECIFIC TO THE REGION

INFORMATION SHOULD BE IN THE REGION HAVING

PRESENTED ON THE NUMBER OF COUNTRIES REACHED THE PERTINENT VALUES OF THE

SPECIFIC RE.GIONAL · INDICATORS AS WELL AS THE FREQUENCY DISTRIBUTION OF THE INDICATORS VALUES WITH RESPECT TO QUANTIFIABLE INDICATORS.

III. FURTHER INDICATORS OF REGIONAL INTEREST

Indicator$ presented by countries, in addition to the global and regional ones, that appear to have more general regional interest could be added here.

Pl,lge 67

The lj.•t of thee twelve indicatO\"s ol, U elesents relating to these appear i~ SeetiOll t c)\\ P4'!l88 34 to 51 ; .t~. The following minimum groupin&, .sh~~ld l>e ~.0- ~n PJ'e&entin.a-·..,~ ,~. .Q:P.ency. distribution of the nullber of cquntries M:cor.ciing to each ,ind·k ator: less .-ore Indicator 4: ~ban

l.O%, 1.0-1.9:%, 2.0-2.9%, ••• ,9.0-9~9%, 10.0% or

less ~han 10.0%, 10.0-19.9;, 7'().• 0% .or J~Qre.

lQ.0-2~.9%,

••• ,60.0-69 .. 9%,

Indicator 7;.

leas than 10.0%, 10.0-19.9%, 20.0-29.9%, ••• ,80 .0..,89.9% ,,tQ-•. Q~ , o r more. than 10.0%, lO.O•IJ.9%, 20.0-49 • 9% , ••• , 60 • 0-69~,~- ,'lf) .Q:~ . or JDOre. less than 10.0, 10.0-19..:9, 2&.0...29.9, ••• ,90.0-99.9, 100-lftf, 150-199, 2()0 ox- -~e. ~~ t:~an

Indicato;r 8:

I.e••

Indi.cat.QT 9;

Indicato.; Uh ..

40 •.0,

40.0-4~~9,

5Q.Q..,59.9, 60.0-69.9, 70.0 or

m(u"e. 1~~

Indicator

leJ-1 ~n 10.0%, lO.O-:l;9.9Jt 90.0% or RU:)re.

2.0 .~0 ... 29.9%,

••• ,80.0.,-89.9%,

Indicato-r 12-; ·. less tilan ·SlOO, SlOG-19'9, b00-299, il00-399, S400-499, ssoo-. 99-9, Sl000-1999, i2900'""2999, ••• , 59000-9999 , i 10000 or more.

li.

Elements .for

•e•Ff(ic

reaioQ,Al .i~ic&~or:s

Each region woul(l list here the specific regional criteria set for •dditio,nal indicator'S de¢,jd,ed upou by ,a.&iion&l ~o-.ittees.

Page 69

SECTION III

COMMON FRAMEWORK AND FORMAT

FOR

MONITORING THE GLOBAL STRATEGY , FOR HEALTH FOR ALL

DATE OF

COMPLETION~

------~------------~----------------

Page 70

RELEVANCE Questions l and 2 below relate to Relevance Question 1

ARE TO

THE THE

ORGANIZATION'S IMPLEMENTATION

PROGRAMME OF THE

DIRECTIONS

HIGHLY

RELEVANT

GLOBAL

STRATEGY~

To be reviewed by the Executive Board and subsequently by the Health Assembly.

Question 2

ARE TO THE

THE THE

FUNCTIONS PROVISION IN

AND OF

STRUCTURES SUPPORT THE THE WITH

HEADQUARTERS BY AND BOARD THE

RELEVANT STATES, HEALTH

THE

REQUIRED GLOBAL

MEMBER

REGIONAL

OFFICES, CONNEXION

EXECUTIVE

ASSEMBLY

STRATEGY?

To be reviewed by the Executive Board and subsequently by the Health Assembly. Opposite is an extract of the Plan of Action for implementing the recommendations of the Study of WHO's structures in the light of its functions that could be considered for responding to the part of Question 2 relating to the functions of Headquarters. Add.l, page 16, para. 28.2). (Document EB69/8

Page 71

RELEVANCE Points which may be considered with respect to Question 1 Note: It is realized that it will be difficult to have a complete review of the Organization's programme directions but it is suggested that the process be started.

Points which may be considered with respect to Question 2 The functions of Headquarters will be reviewedand reshaped as necessary to include~

global stimulation through the generation, worldwide

crystallization and promotion of ideas and knowledge;

coordination on behalf of the Executive Board and Health Assembly; collation, analysis, synthesis and dissemination of valid information on health matters~

central organization of global

programmes~

~mpport

Regional Offices;

and provision of the right kind of information and

other support to the Executive Board, Health Assembly and to global advisory groups, particularly those involved in multisectoral and multidisciplinary action for health and in the international transfer of resources for health.

Page 72

PROGRESS Questions 3 and 6 below relate to Progress Question 3

TO ALL?

WHAT

EXTENT IN

HAVE

THE OUT

MEMBER THEIR

STATES

AND

REGIONS FOR HEALTH

MADE FOR

PROGRESS

CARRYING

STRATEGIES

To be reviewed by the Executive Board and Assembly.

subsequ~ntly

by the Health

Question 4

TO PLAN

WHAT OF

EXTI';NT ACTION?

HAS

PROGRESS TO THE

BEEN

MADE

IN CARRYING IN THE

OUT

THE

ACTIVITIES

ASSIGNED

EXECUTIVE

BOARD

GLOBAL

To be reviewed by the Executive Board and subsequently by the Health Assembly. Opposite is an extract of the "Plan of Action for Implementing the Global Strategy for Health for All by the Year 2000 11 indicating the activities assigned to the Executive Board ("Health for All" Series, No. 7).

Page 73

PROGRESS Points which may be considered with respect to Question 3 Assessment to be made in the light of reports by the Regional Committees.

Points which may be considered with respect to Question 4 EB69 (1)

Commencement of consideration of feasibility of adopting further or refined global targets Preparation of Seventh General Programme of Work in support of Strategy Finalization of plan of action for implementing the Strategy Review of the international flow of resources for the Strategy Review of Director-General's report on health expenditures and the Strategy's financial needs

(2) (3) (4)

(5)

EB71 ( 6)

Review of Director-General's report on the implementation of the Strategy in accordance with resolution WHA34.36 Further consideration of global targets Review of programme budget proposals for 1984/1985

(7)

(8) EB73 (9)

Monitoring of progress in implementing Global Strategy and submission of report to Health Assembly, including recommendations for adjustment of global plan of action as . necessary.

Page 74

PROGRESS (Cont'd) Question 5

WHAT

EXTENT THAT

HAS THE

PROGRESS WORLD

BEEN

MADE

CARRYING HAS

OUT TO

ACTIVITIES ITSELF?

HEALTH

ASSEMBLY

ASSIGNED

To be reviewed by the Executive Board and subsequently by the Health Assembly. Opposite is an extract of the "Plan of Action for Implementing the Global Strategy for Health for All by the Year 2000 11 that illustrates the activities to be carried out by the Assembly ("Health for All" Series, No. 7).

Question 6

WHAT

EXTENT THE

HAS

THE

SECRETARIAT OF IT

AT ?

THE

GLOBAL

LEVEL

PROVIDED

SUPPORT

EXPECTED

To be reviewed by the Executive Board and subsequently by the Health Assembly. Opposite is an extract of the "Plan of Action for Implementing the Global Strategy for Health for All by the Year 2000'' that illustrates the activities assigned to the Secretariat at the global level (Health for All Series No.7).

Page 75

PROGRESS (Cont'd) Points which may be considered with respect to Question 5 WHA35 (1)

Review of Executive Board's recommendations concerning global targets Review and approval of plan of action for implementing the Strategy Review of the international flow of resources for the Strategy, and promotion of the sustained support of the more affluent countries to developing countries with well-defined strategies for health for all

(2)

(3)

WHA36 (4) (5)

Further consideration, if

nec~ssary,

of global targets

Review and approval of Programme Budget proposals for 1984-1985

WHA37 (6)

Review of progress in implementing Global Strategy and endorsement of adjusted global plan of action as necessary.

Points which may be considered with respect to Question 6 1981 (1)

Reprint in "Health for All" Series: Report of the International Conference on Primary Health Care, Alma-Ata, USSR (HFA Series No. 1) Executive Board document on "Formulating Strategies for Health for All by the Year 2000 (HFA Series No.2)

Page 76

PROGRESS (Cont'd) Question 6 (Cont'd)

Page 77

PROGRESS (Cont'd) Points which may be considered with respect to Question 6 (Cont'd) (2) Publication of: Global Strategy for attaining Health for All by the Year 2000 (HFA Series No. 3) Indicators for monitoring progress towards health for all by the year 2000 (HFA Series No. 4) Guiding principles for the managerial process for national health development in support of strategies for health for all by the year 2000 (MPNHD) (HFA Series No. 5) Guiding principles for health programme evaluation as part of the managerial process for national health development (HFA Series No. 6) (3) (4) (5) (6) Contacts with heads of UN agencies to promote intersectoral action on the specific matters included in the Strategy. Contacts with geopolitical groupings of countries that transcend regional boundaries Continuation or commencement of contacts with nongovernmental organizations concerning their role in implementing the Strategy Review of mechanisms for the exchange of information, for promoting relevant research and development and appropriate technology, and for providing training in the development of health systems Initiation of activities for developing methods of assessing health technology Analysis of health expenditures in countries and further estimation of the order of magnitude of the financial needs of the Strategy Taking of appropriate measures for promoting the rationalization of the international flow of resources for the Strategy and for increasing the flow if necessary

(7) (8)

(9)

(10) Review of policies and practices for the dissemination of validated information on health matters (11) Promotion of dialogues to prevent the brain drain of health personnel (12) Presentation of Strategy to the UN General Assembly (UNGA) and progress report on implementation of UNGA resolution 34/58

Page 78

PROGRESS (Cont 'd) Question 6 (Cont'd)

Page 79

PROGRESS (cont'd) Points which may be considered with respect to Question 6 (Cont'd) (13) Meeting with Health Resources Group for Primary Health Care with the aim of promoting the rationalization of the international flow of resources for the Strategy and increasing the flow if necessary, and submission of report thereon to the Executive Board

1982 04) Report to the Executive Board on presentation to ECOSOC and UNGA (15) Report to Executive Board on health expenditures in countries and further estimate of the order of magnitude of the financial needs of the Strategy (16) Consultation on methods of assessing health technology 07) Issue of draft guiding principles and related learning material for the organization of primary health care in communities (18) Issue of draft guiding principles and related learning material on the organization of health systems based on primary health care (19) Further report to ECOSOC on implementation of Strategy and of UNGA resolution 34/58 (20) Publication of:

Ways of organizing health systems based on primary health care

1983 (21) Submission of programme budget proposals 1984-1985 in the light

of tentative medium-term programmes for the implementation of the Seventh General Programme of Work

(22) Further report to ECOSOC on implementation of Strategy and of UNGA resolution 34/58 1984 (23) Submission of progress report to the Executive Board on implementation of Global Strategy

(24) (After World llealth Assembly in May 1984): Publication of progress report as approved by Health Assembly and ensuring implementation of adjusted global plan of action. Continuing Activity~

1. Support to regional offices for technical cooperation with

countries as required. 2. WHO's activities carried out under its General Programme of Work for a Specific Period should promote the self-sustaining development by countries of their health infrastructure and the delivery through it of appropriate health technology.

Page 80

INDICATORS

INFORMATION SHOULD BE PRESENTED ON THE NUMBER OF COUNTRIES IN THE WORLD HAVING REACHED THE PERTINENT VALUES OF THE TWELVE GLOBAL INDICArORS AS WELL AS THE FREQUENCY DISTRIBUTION . OF - THE INDICATOR VALUES WITH RESPECT TO QUANTIFIABLE INDICATORS.

To be reviewed by the Executive Board and subsequently by the Health Assembly.

Page 81

INDICATORS Elements for the twelve indicators The list of the twelve indicators and the elements relating to these The groupings to be used for appear in Section I on pages 34 to 51. presenting the frequency distributions should be based on those shown in Section II on page 67.

Основные сведения

Организация Всемирная организация здравоохранения (ВОЗ / WHO)

Тип документа Technical Documents

Дата принятия 31 декабря 1982 г.

Источник Всемирная организация здравоохранения