Workshop on Health Statistics. Annotations for the Agenda. Venue : Union internationale des chemins de fer (UIC P) Centre de conférence

Transcription

1 Social Statistics Sector Workshop on Health Statistics Annotations for the Agenda Venue : Union internationale des chemins de fer (UIC P) Centre de conférence 16, rue Jean Rey, PARIS Metro: Bir Hakeim (Ligne 6) Paris, 1 5 October

2 Annotations for the agenda Context of the meeting: The Medstat III project seeks to promote the production and dissemination of quality statistics in order to support evidence-based policy-making and foster democratic development. Medstat III will provide more and better data in six priority thematic sectors - agriculture, energy, migration, social statistics, transport, trade and balance of payments - and will promote the increased use of this data in the framework of the European Neighbourhood Policy (ENPI) for the 8 Mediterranean Countries. It will also improve crosscountry comparisons. The Medstat III programme builds on the achievements of Medstat I ( ) and Medstat II ( ), and aims at consolidating and further strengthening these results. The Medstat III project ( ) aims at improving the statistical capacity and ensuring the institutional structure of the national statistics institutes and the national statistical system in the ENPI South Countries in order to collect updated, timely, relevant, and high-quality data, necessary for supporting political decision-making and good governance. Furthermore, it promotes the harmonisation of statistical data in line with European and international standards, as well as consolidating the data exchange process between Eurostat and the national statistical systems. In the framework of the extension of the Medstat III programme until end of 2013, the European Commission made the decision to broaden the scope of the Social Statistics Sector by including public health statistics as a sub-sector. Additional resources are allocated to provide expertise in this sub-sector in the form of working days for short-term expertise (Technical Assistance) and the possibility of holding consensus-building workshops on health and social indicators. In this context, it is crucial to initiate activities for helping Mediterranean ENP countries disseminating Health Statistics that are consistent with European and international standards, and for including national Health Indicators in the already approved list of Regional Harmonised Social Indicators (RHSI) for the Mediterranean ENP countries. At the international level, the Health Metrics Network also sets a framework for Country Health Information Systems (HMN Framework). This framework is becoming increasingly accepted for guiding the collection, reporting and use of health information for developing countries. Amongst the Mediterranean Partner Countries (ENP-South), only two (Syria and Tunisia) have expressed interest in joining the programme and receiving funds and technical advice for up grading their Health Information System. However, the planned support for these two countries did not materialise further than drafting assessment reports on current capabilities. In addition, the WHO Regional Office for the Eastern Mediterranean countries (WHO-EMRO) have designed and publishes yearly a set of indicators for countries of Eastern Mediterranean countries including indicators on demographic, socioeconomic, health expenditure, human and physical resources, morbidity, as well as indicators of coverage with primary health care services, and health status. A country profile is also provided covering demographic, social and health indicators for countries of Eastern and Western Mediterranean countries. 2

3 Therefore, it is useful to consult these references in order to synchronise the proposed harmonised health indicators with other international efforts on health information. On the other hand, a number of household-based surveys are currently undertaken in many countries on health related issues. The first generation of Demographic and Health Surveys (DHS) were adapted to the specificities of the Mediterranean region through the PAPCHILD surveys in the 1980 s, and later the PAPFAM surveys in 1990 s. Since the 2000 s a revised DHS with customised modules to fit national needs. Four countries have already conducted DHS original or associated surveys: Egypt (5 rounds), Jordan (5 rounds), Morocco (4 rounds) and Tunisia (1 round). In parallel, UNICEF has developed a household-based Multiple Indicators Clusters Surveys (MICS) to collect specific data on the mother and the child, and more general data on living conditions. Several countries in the region have conducted or are planning to conduct the MICS (rounds 1 to 4): Algeria (1, 2, 3, 4), Egypt (1), Lebanon (2, 3; and 4 for Palestinian refugee camps), Morocco (2), Occupied Palestinian Territory (1, 2, 4), Syria (1, 2, 3), and Tunisia (4). Also, the UNICEF online database DevInfo provides also a major source of information for monitoring human development including on health issues. The EU funded EPISouth project, which started in October 2006 and was completed in June 2010, aimed at creating a framework of collaboration on epidemiological issues in order to improve communicable diseases surveillance, communication and training across the countries of the Mediterranean and the Balkans. All Mediterranean Partner countries (ENP- South) participated in the project. The project received funds from the European Commission (DG SANCO) and the Italian Ministry for Health (EpiMed Project); ECDC, WHO EURO, WHO EMRO and WHO LYO provided leadership and technical advice. An effective collaboration among the Mediterranean countries enables to have a wider and clearer picture of the peculiar context in this region, EpiSouth being one of the few existing projects with a pure Mediterranean focus. The network of epidemiologists, created in the context of EpiSouth, represents a vital source of information for the European Union as well as for the participating countries to further strengthening their capacity to early and effectively respond to possible health threats and to more efficiently contain the further spread of infectious diseases. The EpiSouth local focal points could be approached and involved, together with the MEDSTAT III national coordinators for social statistics, in the process of integrating health indicators in the Regional Harmonised Social Indicators (RHSI). Finally, the EU DG SANCO has funded a number of health related projects relevant for European public health monitoring. The most relevant project on health information is the European Community Health Indicators (ECHIM, formerly ECHI) which started under the Health Monitoring Programme and the Community Public Health Programme , that was subsequently consolidated and expanded under the second Health programme (ECHIM) from 2008 to The output is a list of 88 health indicators out of which 41 are currently implemented and 47 under development. Although this list of indicators was developed for the 27 EU member States, it will be used as a reference for developing a set of harmonised health indicators that are more relevant to the ENP-South countries, which should be compliant with the EU related metadata, for international comparison. Under the leadership of the Medstat III Team Leader, the KE for the Social Statistics Sector will be responsible for implementing the activities scheduled for this sub-sector in full coherence with the overall approach developed for the Social Statistics Sector since the inception of the Medstat III programme. 3

4 Preparation of the workshop: In order to prepare the workshop, it was important to understand the overall as well as the country specific structure and capabilities of the Health Information System (HIS). In addition, the elaboration of a regional set of health indicators requires establishing a mapping of national capacities for producing and disseminating health data and health related statistics. A standard list of health indicators that are validated at the international level, was selected according to their importance to the Mediterranean context and to their relevance to the policymaking process. Hence, Early July 2012, we have circulated to all National Principal Coordinators and National Social Coordinators, a questionnaire on the structure of the national health information system, as well as on the availability of the pre-establish set of internationally comparable health indicators at the national level. The overwhelming response we received from the partner countries provided valuable information that will be discussed during the workshop. The results of this enquiry are provided in separate documents in your folders. Objectives of the workshop: The main purposes of the workshop are to: a. Review with the participants the status of the national Health Information Systems (HIS) in the ENP-South partner countries, based on the assessment carried out during the preparation phase; b. Assess the availability and comparability of currently produced health indicators in each partner country according to the set of pre-established list of health indicators, and in line with EU health indicators; c. Discuss a proposal for a list of a Regional Harmonised Health Indicators and its associated metadata, in line with a set of EU indicators on Health; d. Reach consensus on the Harmonised Health Indicators that would be produced by all partner countries as part of the current Regional Common Harmonised Social Indicators. Deliverable: the workshop would conclude on a commitment by the participants to engage their respective administrations to produce and disseminate a structured list of common harmonised health indicators (headline and secondary). Structure of the workshop: The workshop is jointly facilitated by M. Bahjat Achikbache, Key expert for social statistics of the Medstat III programme and M. Jacques Bonte, international expert in Health Statistics. The workshop is organised in two major parts: a. Part 1: Review of the state-of-art of statistics on public health in terms of survey data, data on causes of death and morbidity, statistical data collections, and administrative records. This part will include presentations by Ms. Monica Pace and M. Jakub Hrkal, senior statisticians from Eurostat (Directorate F: Education, Health and Social Protection) and M. Gaetan Lafortune from OECD, senior economist in the Health Division, on the current international practices in the health statistics area. He will particularly insist on the three main components of OECD framework, which are quality, access, and costs. 4

5 The participants will have the opportunity to present briefly the structure and capabilities of their national health information system (HIS). In addition, representatives from two partner countries (Palestine and Morocco) will be requested to present in detail their national experience and best practices in terms of production and dissemination of Health Statistics. Palestine and Morocco are two cases presenting remarkable Health Information Systems that would be of great interest to share with the other countries. This part will be completed during the first two days of the workshop. b. Part 2: Exchange of information on national methodological issues and practical requirements for establishing a list of Health Indicators that would be relevant for the Mediterranean ENP south partner countries and compliant with international and European Union recommendations. These discussions will cover issues related to definitions of the proposed set of regional health indicators, quality assessment, and associated metadata. This part is scheduled from Tuesday afternoon until Thursday evening. M. Cervera-Ferri, team leader of the Medstat III programme, will take this opportunity to introduce the cooperation instruments that the European Union is currently making available to the Mediterranean ENP south partner countries for developing regional and bilateral technical assistance. The workshop will conclude on Friday by establishing a consensus on the need to produce and disseminate a set of health indicators that are comparable between the Mediterranean ENP south partner countries, and harmonised with the methodologies and standards used by Eurostat for the member states of the European Union. Expected outcome: The participants are expected to: Learn about the current methodologies for collecting, disseminating, and analysing health measurements; Better understand the production process of household-based data and administrative records, its constraints, conceptual implications, and the comparability requirements; Identify the gap between the metadata of their national health statistics and health indicators and the most relevant international standards, in particular the statistical standards of Eurostat and of the European Union Community Health Indicators (ECHIM); Agree on a list of regional harmonised health indicators and its associated metadata, in line with EU indicators on Health, as a sub-set of the regional harmonised social indicators that will be produced by the Medstat III programme; Agree to advocate for the standardisation of their national health data and indicators with European recommendations, and to promote the dissemination of comparable indicators. 5