Methodology
“The tables in this technical annex present new concepts and measures which lay the empirical basis for assessing health system performance. The main body of the report provides detail on the different goals for health systems and the measures of performance. Both the text of the report and the annex are based on the WHO framework for health system performance assessment.1 The work leading to these annex tables was undertaken mostly by the WHO Global Programme on Evidence for Health Policy in collaboration with counterparts from the Regional Offices of WHO. This analytical effort was organized in eleven working groups. Membership of these working groups is listed in the Appendix. The material in these tables will be presented on an annual basis in each World health report. Because this is the first year of presentation for the material in Annex Tables 1 and 5-10, working papers have been prepared which provide details on the concepts, methods and results that are only briefly mentioned here. The footnotes to these technical notes include a complete listing of the detailed working papers.
“As with any innovative approach, methods and data sources can be refined and improved. It is hoped that careful scrutiny and use of the results will lead to progressively better measurement of performance in the coming World health reports. All the main results are reported with uncertainty intervals in order to communicate to the user the plausible range of estimates for each country on each measure.
“Although not provided in any table, extensive use has been made of estimates of income per capita in international dollars, average years of schooling for the population over age 15 years, percentage of the population in absolute poverty and the income Gini coefficient. In all cases, there are multiple and often conflicting sources of information from international agencies on these indicators; in addition, there are many countries for which there are no published estimates. To facilitate the analyses presented here, consistent and complete estimates of these key indicators have been developed through a variety of techniques including factor analysis, multiple imputation methods for missing data, remote sensing data from public use satellites and systematic reviews of household survey data. The details on methods and data sources for the final figures on income per capita, educational attainment, poverty and income distribution are outlined elsewhere.2“
Source: World Health Organization. The World Health Report 2000: Health Systems : Improving Performance. Geneva: World Health Organization, 2000.
Breaking News
- 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 ...
- 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 ...
- 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 ...
- WHO World Health Report 2000: RankingsWHO World Health Report Annex Table 10: Health System Performance in all Member States, WHO Indexes. Click on thumbnails to view pages as individual image files (jpg format) or click on the link below to view a PDF of the data. whr2000-annex-table-10-1Download 1 2 3 4
- WHO World Health Report: Results“The U.S. health system spends a higher portion of its gross domestic product than any other country but ranks 37 out of 191 countries according to its performance, the report finds. The United Kingdom, which spends just six percent of GDP on health services, ranks 18 th . Several small countries – San Marino, Andorra, ...
- WHO World Health Report 2000: Overview and Defense“Differentiation between attainment and efficiency in health systems is crucial. Every society should be concerned about attainment of standards of health, responsiveness, inequalities in both of these, and fairness in financial contribution. What explains variation in these five key outcomes is an important scientific issue. Table 9 in the World Health Report 2000,9 contained the ...
- WHO World Health Report: Overview“To assess a health system, one must measure five things: the overall level of health; the distribution of health in the population; the overall level of responsiveness; the distribution of responsiveness; and the distribution of financial contribution. For each one, WHO has used existing sources or newly generated data to calculate measures of attainment for ...
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Page last updated March 29, 2025 by Doug McVay, Editor.