"Our measurement of the health-related SDG indicators is subject to the limitations of the broader GBD 2017 study and its estimation processes; details can be found in the accompanying GBD 2017 capstone papers23–27 and in appendix 1 (part 1). Beyond these limitations, there are other important limitations that are specific to this analysis."First, for measurement of health worker density we used ISCO 88 codes as the base classification system instead of ISCO 08, which is a more recent system than ISCO 88 that offers greater detail and standardisation. However, few occupational data sources currently include ISCO 08 codes, and benchmarking…
Sustainable Development Goals Health Index: Comparisons With Other Assessments
"International agencies and the GBD study began producing annual reports of country estimates for the health-related SDG indicators in 2016. Of the 52 health-related indicators, GBD 2017 reported on 41, WHO reported on 37 in its 2018 World Health Statistics report,6 the World Bank covered 33 in its 2018 SDG Atlas,7 and the Sustainable Development Solutions Network included 27.4 Standardisation of definitions and methods used to calculate the health-related SDG indicators could improve comparability across organisations and collaborations involved in monitoring the SDGs. The complete set of metadata for SDG indicators, provided by the UN and other international organisations, comes…
Sustainable Development Goals Health Index: Methodology
"Each year, the GBD study produces age-specific, sex-specific, and location-specific estimates of all-cause and cause-specific mortality, non-fatal outcomes, overall disease burden (ie, disability-adjusted life-years), and risk factor exposure and attributable burden from 1990 to the current study year."This analysis of the health-related SDGs is based on GBD 2017 estimates. Broader GBD 2017 methods are described elsewhere,21,23–27 while further detail on data sources and estimation approaches used for this analysis are available in appendix 1 (part 1). We used previously established GBD methods to generate indicator-specific estimates for 1990–2017, including the Cause of Death Ensemble model for causes of death,23,28 DisMod-MR…
Sustainable Development Goals Health Index: Results
"Although nearly all countries were projected to have improved health-related SDG index scores by 2030, progress varied by country and across individual indicators. Performance on health-related SDG indicators differed subnationally for several countries, as well as by sex and across SDI quintiles, highlighting the need for disaggregated data to ensure that no one is left behind. For many indicators, the annualised rate of change required to meet defined targets far exceeded the pace of progress achieved by any country in the recent past. Yet, even for those indicators with a mean projected value that fell short of the 2030 target,…
Healthcare Access and Quality Index: Methodology
"Drawing from methods established in GBD 2015,20 our analysis involved four steps: mapping the Nolte and McKee cause list to GBD causes; constructing MIRs for cancers and risk-standardising non-cancer deaths to remove variations in mortality not directly amenable to health care; calculating the HAQ Index on the basis of principal components analysis (PCA), providing an overall score of personal health-care access and quality on a scale of 0–100; and examining associations between national HAQ Index scores and potential correlates of performance."Our study draws from GBD 2016 results,31–33 which entail several improvements since GBD 2015, including 169 new country-years of vital…
Sustainable Development Goals Health Index: Overview
"Evidence before this study"Measuring country progress on the UN’s Sustainable Development Goals (SDGs) has been an important international priority since the SDGs were introduced in 2015. The UN, the Sustainable Development Solutions Network, WHO, and the World Bank also report on the SDGs, but their analyses do not consistently measure indicators for each location and year. The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2015 estimated 33 health-related SDG indicators and the overall health-related SDG index from 1990 to 2015 for 188 countries. In GBD 2016, the number of indicators included was expanded to 37, and projections…
McKee on the WHO World Health Report 2000
"The main criticisms were, however, of technical aspects of the methods used to assess performance. By common consent those undertaking this exercise faced a major problem if they were to include all 192 WHO Member States, some of which barely functioned as states and certainly lacked control over all of their territory. Many lacked even the most basic of information. Only a minority had any functioning system of vital registration, so if measures such as health outcomes were to be included they had to be modelled. This would be complicated enough if only the simplest of measures, such as life…
Reinhardt and Cheng on the WHO World Health Report 2000
"First, the WHO research team should have been sure that their estimates are robust. Can they, in good conscience, make that claim? An artificially high ranking, for example, could take the wind out of the sails of desirable health-reform efforts. Similarly, an artificially low ranking could assign a bad grade to past reform efforts that were actually commendable. Rumour in the health services research community has it that France’s no.1 rank was driven in part by a flawed measure of national educational attainment. Under the methodology used by WHO, the more the level of educational attainment or of health spending…
WHO World Health Report 2000: Methodology
"Undoubtedly, many of the concepts and measures used in the report require further refinement and development. To date, our knowledge about health systems has been hampered by the weakness of routine information systems and insufficient attention to research. This report has thus required a major effort to assemble data, collect new information, and carry out the required analysis and synthesis. It has also drawn on the views of a large number of respondents, within and outside WHO, concerning the interpretation of data and the relative importance of different goals. The material in this report cannot provide definitive answers to every…
Healthcare Access and Quality Index: Summary of Results
"Amid gains on personal health-care access and quality, striking disparities remained regarding HAQ Index scores achieved by 2016, and how quickly locations improved over time. In 2016, HAQ Index performance diverged along the development spectrum, ranging from more than 97 in Iceland to less than 20 in the Central African Republic and Somalia. Subnational inequalities were particularly pronounced in China and India, although high-income countries, including England and the USA, also saw considerable local gaps in performance. The global pace of progress accelerated from 2000 to 2016, a trend fuelled by many low-SDI and low-middle-SDI countries in sub-Saharan Africa and…
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