"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…
WHO World Health Report 2000: Rankings
WHO 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, Malta and Singapore are rated close behind second- placed Italy."WHO Director-General Dr Gro Harlem Brundtland says: "The main message from this report is that the health and well- being of people around the world depend critically on the performance of the health systems that serve…
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 best available evidence on attainment of these outcomes. But, what was the contribution of the health system to these outcomes? And how efficiently have resources invested in the health system been used? Figure 3 shows the theory of overall efficiency. Country A could have achieved…
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 the countries where information could be obtained. These data were also used to estimate values when particular numbers were judged unreliable, and to estimate attainment and performance for all other Member States. Several of these measures are novel and are explained in detail in the…
