Division of Information, Evidence, Research and Innovation ...€¦ · European action plan on...
Transcript of Division of Information, Evidence, Research and Innovation ...€¦ · European action plan on...
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Division of Information,
Evidence, Research and
Innovation
– what can we do for you?
Meeting of the WHO European
Healthy Cities Network and National
Network Coordinators
4th April 2016, WHO Regional Office for Europe,
Copenhagen, Denmark
Dr Claudia Stein MD, PhD, FFPH
Director
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European Health Information Initiative (EHII)
• Provides overarching
guidance for health
information activities
WHO Europe;
• Multi-partner network;
• Goal: Integrated health
information system for
Europe
• 4 Steering Group
meetings held to date.
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Why do we need this initiative?
• Health information and evidence in
Europe is fragmented and expertise
scattered;
• Member States’ information often
incomplete, not harmonized with
international standards and not
always reported;
• Networks are often ad-hoc and
based on personal relationships.
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Malta: Chairing Small
Countries Health
Information
Network
… and we have grown!
Turkey: 1. Hosted first autumn
school Oct 2013
2. Chairing strategy sub-
group
Poland: Hosted autumn school
Oct 2014
Russian Federation: 1. New WHO Collaborating
Centre on health information;
2. Hosted Autumn School 2015
Kazakhstan &
Kyrgyzstan: Staff & infrastructure for
regional health information
network in CARK countries
European
Commission (4 DGs)
OECD
Lithuania: Established PhD
programme in EIP
Ireland
Germany
Andorra
Bulgaria
UK: 1. WHO Collaborating
Centre on Health 2020
indicators
(Manchester)
2. Public Health England
Switzerland: WHO Collaborating
Centre Swiss
Tropical & Public
Health Institute
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EHII key areas
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European Health 2020 policy
• Emphasis on health and well-being
• The right to health and access to care
• People at the centre
• Addressing the determinants of health
• Whole of society approach
• Whole of government approach
• Importance of partnerships
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19 core and 17 additional
indicators for 6 targets
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Headline target Indicator
Age adjusted mortality from diseases of digestive system, ages 30-70 years, per 100 000, disaggregated by sex
1. Reduce premature
mortality in Europe by
2020
Age-standardized prevalence of overweight and obesity in people aged 18 years and over, disaggregated by and and sex
Proportion of children of official primary school age not enrolled, disaggregated by sex
Life expectancy at birth (years), disaggregated by sex
5. Universal coverage
and the "right to
health"
Gini coefficient on income distribution
Private households' out-of-pocket payments on health as % of total health expenditure
Total health expenditure as % of GDP, WHO estimates
Age adjusted mortality from malignant neoplasms, ages 30-70 years, per 100 000, disaggregated by sex
Age adjusted mortality from diseases of circulatory system, ages 30-70 years, per 100 000, disaggregated by sex
Age adjusted mortality from diseases of respiratory system, ages 30-70 years, per 100 000, disaggregated by sex
Life satisfaction, disaggregated by age and sex (subjective well-being)
Percentage of population with improved sanitation facilities (objective well being)
Social support available, disaggregated by age and sex (objective well-being)
2. Increase life
expectancy in Europe
3. Reduce inequities in
Europe (social
determinants)
4. Enhance well-being of
the European
population
Total per capita alcohol consumption among people aged 15 years and over, within a calendar year, disaggregated by sex
Percentage of children vaccinated against measles, polio and rubella
Unemployment rate (%)
Infant deaths per 1000 live births, disaggregated by sex
Age adjusted mortality from external causes of injury and poisoning, all ages, per 100 000, disaggregated by sex
Age-standardized prevalence of regular tobacco use among people aged 18 years and over, disaggregated by sex
Wellbeing –
subjective &
objective
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The SDGs and Health 2020
are fully aligned
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Headline target Indicator
Age adjusted mortality from diseases of digestive system, ages 30-70 years, per 100 000, disaggregated by sex
1. Reduce premature
mortality in Europe by
2020
Age-standardized prevalence of overweight and obesity in people aged 18 years and over, disaggregated by and and sex
Proportion of children of official primary school age not enrolled, disaggregated by sex
Life expectancy at birth (years), disaggregated by sex
5. Universal coverage
and the "right to
health"
Gini coefficient on income distribution
Private households' out-of-pocket payments on health as % of total health expenditure
Total health expenditure as % of GDP, WHO estimates
Age adjusted mortality from malignant neoplasms, ages 30-70 years, per 100 000, disaggregated by sex
Age adjusted mortality from diseases of circulatory system, ages 30-70 years, per 100 000, disaggregated by sex
Age adjusted mortality from diseases of respiratory system, ages 30-70 years, per 100 000, disaggregated by sex
Life satisfaction, disaggregated by age and sex (subjective well-being)
Percentage of population with improved sanitation facilities (objective well being)
Social support available, disaggregated by age and sex (objective well-being)
2. Increase life
expectancy in Europe
3. Reduce inequities in
Europe (social
determinants)
4. Enhance well-being of
the European
population
Total per capita alcohol consumption among people aged 15 years and over, within a calendar year, disaggregated by sex
Percentage of children vaccinated against measles, polio and rubella
Unemployment rate (%)
Infant deaths per 1000 live births, disaggregated by sex
Age adjusted mortality from external causes of injury and poisoning, all ages, per 100 000, disaggregated by sex
Age-standardized prevalence of regular tobacco use among people aged 18 years and over, disaggregated by sex
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AREA TARGET QUANTIFICATION CORE INDICATORS
Healthy
people,
well-
being
and
deter-
minants
4.
Enhance
the well-
being of
the
European
population
To be set as a result of
the base-line of the
core well-being
indicators
Life satisfaction
Availability of social support
% of population with
improved sanitation facilities
GINI coefficient (income
distribution)
Unemployment rate
Proportion of children of
primary school age not
enrolled
Still work in
progress,
including
additional
indicators on
subjective
well-being
Subjective well-being
Objective well-being DIR conducting
detailed mapping of all
SDG indicators, H2020
and NCD framework
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Cultural contexts of health (CCH)
• Tackling the challenge of measuring and
reporting on subjective health
experiences;
• Health 2020 emphasises resilience, well-
being, life-course, patient centeredness;
• New demands of whole-of-government
and whole-of-society approaches;
• WHO must get better at engaging with
cultural contexts of health and well-
being;
• WHO Euro launches CCH project.
“The neglect of culture is the single biggest
obstacle to developing equitable health care”.
- UCL-Lancet Commission Report
on Culture and Health
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CCH in Healthy Cities
More research into the effects of cultural factors in
relation to the environment and health is needed:
• How does cultural capital contribute towards a
healthy life in a healthy city? And how do we measure
this?
• How can cultural practices be better harnessed to
promote health-enhancing behaviours on the local
level? How do these vary throughout the life-course?
• In what ways do cultural values influence how citizens
relate to urban spaces? How does this play out in
relation to migrants?
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Setting targets for Health 2020 –
a European or national issue?
Austria Health Objectives
• Objective 1. Healthy living and working conditions
• Objective 2:Health equity between the sexes and socio economic
groups
• Objective 3:Increase health literacy
• Objective 4:Secure a healthy environment
• Objective 5: Strengthen Social Cohesion
• Objective 6:Healthy childhood
• Objective 7:Healthy diet with high quality food
• Objective 8:To encourage healthy movement and safe environment
• Objective 9:Increase Psychosocial health
• Objective 10:High quality and efficient health care for all
Overarching Health 2020 targets
1. Reduce premature mortality in Europe by
2020
2.Increase life expectancy in Europe
3.Reduce inequities in health in Europe
(social determinants target)
4. Enhance well-being of the European
population (to be further elaborated
during 2012/13)
5. Universal coverage and “right to health”
6. Member States set national targets/goals
Sub-
national
and city
targets!
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Austrian Objective 2 : Health equity between socio economic groups
Income level and life expectancy at birth differences by Austrian regions
Source: WHO/Europe, Atlas of Health Inequalities, 2012
Salzberg
Tirol
Vorarlberg
Kärnten Oberösterreich
Wien
Steiermark
Burgenland
Niederösterreich
Need for more detailed data & targets
How do you monitor these indicators…?
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Regional Profile Comparisons
WHO tools can be adapted to any setting
WHO preparing additional tools for 2016
Local
evidence
for local
action!
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How does eHealth contribute to
Healthy Cities?
• Self-management
• Healthy ageing
• Mental health
• Literacy
• Empowerment
• Evidence
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mHealth and what it means for
Healthy Cities
• Cost savings
• Patient-centred
• Health apps
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eHealth and innovation
within the local context
• Improves Health for All and reducing health
inequalities;
• Improves participatory governance;
• Expands community resources and enables
mutual support;
• Promotes intersectoral collaboration.
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One
vision
and goal
4 guiding
principles
4 key
action
areas Expected
results
Deliverables
Key
targets
and
indicators
Proposed
actions
Timeframe of 5 years
Monitoring and Evaluation
Regional Committee 2016: European action plan on evidence for policy making:
Local knowledge and evidence for local policy
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The 4 key action areas
1. Strengthening health information systems, harmonizing health indicators and establishing an integrated health information system for the European Region;
2. Establishing and promoting health research systems to support the setting of public health priorities;
3. Increasing country capacities for the development of evidence-informed policies (knowledge translation);
4. Mainstreaming the use of evidence, information and research in the implementation of Health 2020 and other major regional policy frameworks.
For
adoption
and
resolution
at RC 2016
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Thank you,
Danke, Merci,
Спасибо
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Extra slides
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Disseminating health information:
sources of evidence
Health Evidence
Network (HEN)
• 3-6 evidence syntheses annually;
• HEN report on culture and health in
preparation.
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Culture and Health in the
EURO public health journal
• Aimed at dissemination of good
practice and successful
implementation of
evidence-informed policies;
• Bi-lingual (English/Russian):
• Each issue has special theme
Special theme on Culture and
Health for 2017
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24-25 March 2015:
First meeting of the EHII
Steering Group
We’re
together
again!
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WHO/EU collaboration towards a single
integrated Health Information System
for Europe (53 Member States)
OECD
a partner since
2012
Vilnius Declaration 2015
Regional Committee 2015:
Strong support from Member States for
strengthening health information
Moscow Declaration 2010
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The SDGs and Health 2020
are fully aligned
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Special focus 2016:
Baseline reporting for
SDG 3 indicators and
other SDG health
indicators
One concrete starting point for countries
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Revitalizing: Country Profiles &
Highlights on Health and Wellbeing
New concept:
• Focus on Health 2020
• Country profile (detailed)
• Highlights summary
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Key features of the publications
Country Profiles Highlights on Health Format
Comprehensive and detailed Short, highlighting key issues for policy
Systematic, follow template Flexible format
Target audience: public health
professionals
Target audience: policy makers
Content
Demographic and economic information Health 2020 indicators & implementation
Health status and burden of disease Risk factors and determinants of health
Risk factors and determinants of health Health system
Health system Conclusions
Health 2020 implementation
Conclusions
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Publication
imminent:
Greece
Moldova
Slovenia
Next in
line:
Bulgaria
Ukraine
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Collaboration of WHO/EURO and Institute of
Health Metrics and Evaluation
• To collaborate on burden of disease assessments in European Region;
• To improve coherence of quantitative messages;
• To facilitate national burden of disease studies, including training.
WHO country profiles
Highlights on Health
revitalized & to include
burden information
Country interest increasing:
12 countries completed,
conducting or planning NBD
studies
(6 EU, 6 non-EU)
EURO and IHME joint
work: joint missions to
countries, training
events.
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Cultural contexts of well-being
Expert Group on Cultural Contexts
of Health and Well-being - main
recommendations:
• Explore different types of qualitative evidence more fully
• Commission further work in the area of culture and
health
• Adopt the UNESCO definition of culture
• Investigate cultural contexts of health more
systematically
• Use a multisectoral and multidisciplinary integrated
research approach.
Next meeting
of expert
group: April
2016
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Country
Profile
with H2020
indicators
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Launch of the European Regional eHealth Report:
From Innovation to Implementation
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European Regional eHealth Report:
Highlighting the importance of eHealth as a
national strategic asset
• Based on the results of the 2015 Global Observatory for eHealth
(GOe) survey (to which 47 of the 53 European Region Member States
responded – a response rate of 89%);
• Present findings across a range of thematic eHealth areas (eHealth
foundations, Electronic Health Records, Telehealth, mHealth,
eLearning in Health, Social media in Health, Health analytics and big
data, legal frameworks fro eHealth);
• Russian language report is due for publishing in early May, 2016.
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October 2014 in
Poland
Focus: Health 2020
monitoring (country case
studies, inequalities,
reporting)
2015 School in
Russian Federation
Capacity building:
Autumn school of health information and
evidence for policy making
‘Advanced
course’
added
annually
(June)
2016 School in
Ukraine
(collaboration with
World Bank)
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Health Information Networks in Europe
• Launched in
European
Region in 2012;
• Uses multi-
stakeholder
country teams
to translate
research
evidence in
policy-making;
• Now “live” in
19 countries.
Kazakhstan, Kyrgyzstan,
Tajikistan, Turkmenistan,
Uzbekistan
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Small Countries Health Information Network
• Initiative of the Minister of
Health, Malta;
• Countries agreed to establish
health information network;
• Terms of Reference and Scope
and Purpose for network
agreed;
• Malta chairing the network in
phase 1;
• First meeting held 3-4 March
2016 in Malta, and work plan
established.
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45
Purpose of a South-eastern European Health
Information Network:
to promote coordination and collaboration among countries in the SEEHN,
in order to strengthen national health information systems, including data collection, processing,
analysis and dissemination.
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Health information strategies
• Member States requested practical
support tool
• Tool developed by Working Group (17
countries), co-chaired by Netherlands and
Russian Federation
• Based on WHO HMN tools and materials,
adapted to European context
• Available in English & Russian
• Currently implementing the tool in Member
States with view to evaluate this tool. Piloted in:
Bulgaria
Moldova
Albania
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One
vision
and goal
4 guiding
principles
4 key
action
areas Expected
results
Deliverables
Key
targets
and
indicators
Proposed
actions
Timeframe of 5 years
Monitoring and Evaluation
Regional Committee 2016: European action plan on evidence for policy making
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Date of presentation
The 4 key action areas
1. Strengthening national health information systems, harmonizing health indicators and establishing an integrated health information system for the European Region;
2. Establishing and promoting national health research systems to support the setting of public health priorities;
3. Increasing country capacities for the development of evidence-informed policies (knowledge translation);
4. Mainstreaming the use of evidence, information and research in the implementation of Health 2020 and other major regional policy frameworks.
For
adoption
and
resolution
at RC 2016
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Expected outcomes of this meeting
• Review of progress with EHII activities;
• Revision of work plan;
• Guidance and next steps on EHII
strategy;
• Identification of any new EHII activities
and their actors.
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Housekeeping
• Declarations of Conflict of Interest → please submit missing forms;
• Queries relating to administrative issues:
– Logistic issues: Liliana
– Technical issues: Claudia, Khassoum.
• Meeting rooms:
• We will be in this room both days;
• Toilets are just outside to the right;
• Lunch vouchers – Liliana will distribute in the coffee break;
• Wireless: information on the walls;
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Housekeeping
• Bus from outside UN City does not operate in the afternoon! Instead take
S-train from Nordhavn station;
• Taxis can be requested from the reception desk;
• EHII members speak before WHO staff…. (the chair will be strict );
• Reception TONIGHT at 17:30-18:00 in Atrium 1 (ground floor to the right).
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Happy belated birthday to our Chair, Annemiek!
Housekeeping
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How will WHO report on these
indicators? • Annual report of the Regional
Director;
• Annual European ‘Core Health Indicators’;
• ‘European Health Statistics’ (mobile app);
• New EURO health information web-portal;
• The European health report (every 3 years).
Round 2 of
well-being
indicators:
2016/17
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What makes a good indicator for
Health 2020 – results from the expert group
• High validity and reliability;
• Available for majority of countries;
• Not already capture in other monitoring frameworks;
• Ideally should be routinely reported;
• One indicator that serves several targets;
• Data accompanied by meta-data;
• All rates age-standardized;
• Indicator data reported disaggregated, i.e. by age,
gender, ethnicity, socio-economic strata, vulnerable
groups, sub-national;
• Comparable across the region.
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AREA TARGET QUANTIFICATION CORE INDICATORS
Burden
of
disease
and risk
factors
1. Reduce
premature
(30-69 yrs)
mortality in
Europe by
2020
1.5% relative annual
reduction in overall
premature mortality
from CVD, cancer, DM
and chronic respiratory
disease
Premature overall premature
mortality rate for CVD, cancer,
DM and chronic respiratory
disease
Prevalence of current tobacco
use
Total per capita alcohol
consumption
Prevalence of overweight and
obesity
Elimination of selected
vaccine-preventable
diseases
% of children vaccinated
against measles, polio, and
rubella
Reduction of mortality
from external causes
Mortality rates from all
external causes and injuries
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AREA TARGET QUANTIFICATION CORE INDICATORS
Healthy
people,
well-
being
and
deter-
minants
2. Increase
life
expectancy
in Europe
Continued increase in
life expectancy at
current rate +
reduction of
differences in the
Region
Life expectancy at birth
3. Reduce
inequities in
Europe
Reductions in the
gaps in health status
associated with social
determinants within
the European
population
Infant mortality per 1000 live
births
Life expectancy at birth
Proportion of children of
primary school age not
enrolled
Unemployment rate
(Sub)national policy
addressing reduction of health
inequities established and
documented
GINI coefficient (income
distribution)
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AREA TARGET QUANTIFICATI
ON
CORE INDICATORS
Processes,
governanc
e and
health
systems
5. Universal
coverage and
“right to
health”
Moving towards
universal
coverage by
2020
Private household out-of-
pocket expenditure as a
proportion of total health
expenditure
% of children vaccinated
against measles, polio, and
rubella
Total gross expenditure on
health (as % of GDP)
6. National
targets/goals
set by
Member
States
Establishment of
processes for the
purpose of
setting national
targets (if not
already in place)
Establishment of process for
target-setting documented
Evidence documenting: a)
establishment of national
policies aligned with Health
2020, b) implementation plan,
c) accountability mechanism
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Target 6. Setting national targets
0% 10% 20% 30% 40% 50% 60% 70%
No
Yes, included elsewhere
Yes, stand alone
Policy addressing health inequity or social determinants of health existsAll answers (n=31 and 36 for 2010 and 2013, respectively)
2013
2010
0% 10% 20% 30% 40% 50% 60%
No, and not planned for the future
No, but planned for the future
Indicators defined
Targets defined
National or subnational target setting process exists
All answers (n=31 and 36 for 2010 and 2013, respectively)
2013
2010
0% 10% 20% 30% 40% 50% 60% 70%
No and not planned for the future
No, but planned for the future
Yes, another strategy
Yes, comprehensive health policy
National health policy is aligned with H2020All answers (n=31 and 36 for 2010 and 2013, respectively)
2013
2010
0% 10% 20% 30% 40% 50% 60%
No, and not planned for the future
Yes, in process
Yes, adopted
There is a health policy accountability mechanism in placeAll answers (n=31 and 36 for 2010 and 2013, respectively)
2013
2010
Source: WHO. Qualitative indicators for Health 2020 policy targets monitoring, 2014
On-line survey
Internet Explorer.lnk
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Expert group for the measurement and
target setting for well-being
How did the group define well-being?
“Well-being exists in two dimensions,
subjective and objective.
It comprises an individual’s experience
of their life (‘subjective’) as well as a
comparison of life circumstances
(‘objective’) with social norms and
values.”
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We’re mixing a hot cocktail
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AREA TARGET QUANTIFICATION CORE INDICATORS
Healthy
people,
well-
being
and
deter-
minants
4. Enhance
the well-
being of
the
European
population
To be set as a result of
the base-line of the
core well-being
indicators
Life satisfaction
Availability of social support
% of population with improved
sanitation facilities
GINI coefficient (income
distribution)
Unemployment rate
Proportion of children of
primary school age not
enrolled
Still work in
progress,
also still
working on
additional
indicators on
subjective
well-being
Subjective well-being
Objective well-being
Round 2 of
well-being
estimates:
2016/17
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Country
Profile
with H2020
indicators
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Exportability
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Reusable
interactive
graphs for
the web site,
the intranet
and beyond
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Researc
h
Pro
ble
ms
Good luck
with bridging
this gap….
IEA World Congress of Epidemiology
Plenary Session
7 August 2011
Researc
h
Pro
blem
s
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Evidence and Intelligence for Policy-
making (EIP) (including Health
Evidence Network, Country Profiles
and European Health Report)
(SO*10)
Health for All Information Systems
and Dissemination (HFA) (SO10)
eHealth (including e-Learning) (EHL)
(SO10)
Library, Languages and Publications
(LLP) (SO12, 13)
Director’s Office (DIR)
Division of Information,
Evidence, Research and
Innovation (DIR)
Evi
dence a
nd
Rese
arc
hH
ealth I
nfo
rmation
, M
on
itori
ng
an
d A
naly
sis
Kn
ow
led
ge M
an
ag
em
en
t
an
d D
issem
ination
Research Policy and Coordination
(RPC) (SO10)
Innovations for Health (including
social networks) (INH) (SO10)
Knowledge Management (KNM)
(SO10)
Monitoring and Surveillance Systems
and Databases (MSD) (SO10)
Country Health Information Systems
(CHI) (SO10)
* Strategic Objective October 2010
Inn
ovation
an
d
eH
ealth
The Division of Information, Evidence,
Research and Innovation (DIR)
2. Health
information,
monitoring &
analysis
3. Health
informatics (incl.
gateway)
1.Translating
evidence into
policy and
Research
5. Translations
6. Publications
4. E-health and
Innovation
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DIR: Crossing the barrier between evidence & policy
Collect, & help
stakeholders to
collect, high-
quality evidence
Appraise &
interpret
information,
evidence &
research
Package and
share knowledge
in user-friendly
way
Provide innovative
mechanisms/tools/str
ategies for evidence
gathering & policy
translation
Evaluate translation
of evidence into
policy
Assess impact of
policy on health
outcomes & break
down barriers
Presentation title (change in view slide
master)
Date of presentation
European Health 2020 policy
• Emphasis on health and well-being
• The right to health and access to care
• People at the centre
• Addressing the determinants of health
• Whole of society approach
• Whole of government approach
• Importance of partnerships
Presentation title (change in view slide
master)
Date of presentation
European Health 2020 policy
• Emphasis on health and well-being
• The right to health and access to care
• People at the centre
• Addressing the determinants of health
• Whole of society approach
• Whole of government approach
• Solutions that work and make a difference
“Adopts….together
with a set of
regional goals as
set out in that
document and the
appropriate
indicators for the
European Region.”
Presentation title (change in view slide
master)
Date of presentation
19 core and 17 additional
indicators for 6 targets
Presentation title (change in view slide
master)
Date of presentation
Exportability