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World Health Organization
Without high-quality data, the promise of the UN 2030 Sustainable Development Agenda to ‘leave no one behind’ simply cannot be fulfilled.
Data is essential for monitoring progress towards the health-related Sustainable Development Goals (HRSDGs), WHO Triple Billion targets, and national or subnational health priorities. It also enables us to be better prepared for health emergencies and to respond to them more effectively.
The COVID-19 pandemic has created an unprecedented demand for high-quality health data and also highlighted many long-standing gaps. Health information systems around the world today are being stretched like never before. Not only do these systems need to track COVID-19 for effective pandemic response and recovery, but they must also continue tracking and responding to other health priorities.
The SCORE for Health Data Technical Package represents the most comprehensive strategies and interventions for strengthening country health information systems. First launched in August 2020, it is a one-stop solution to improve the availability of timely, reliable and comparable health data to track progress towards the Triple Billion targets and health-related Sustainable Development Goals.
SCORE is the first time that all elements comprising an optimum health information system – Survey, Count, Optimize, Review, Enable – are captured in a single, harmonized package.
SCORE supports countries to take action by providing guidance on the best technical practices to strengthen health information systems using universally accepted tools and standards. This technical package helps focus investments on priority interventions that will improve the collection, quality control, synthesis, analysis and use of health data with maximum cost-effectiveness.
Peshawar, Pakistan. WHO Polio Eradication Officer Dr Samreen Khalil, checks the register for potential cases during surveillance at the paediatric unit at the Khyber Teaching Hospital.
SCORE global report on health data systems and capacity, 2020
The SCORE global report on health data systems and capacity 2020, launched on 1 February 2021, is a key component of the SCORE for Health Data Technical Package.
It presents findings from the first ever global assessment of country data and health information systems, covering 133 country health information systems or 87% of the world’s population. Conducted by WHO between 2018 and 2020, it uses the five SCORE interventions to determine the extent to which a country has a fully mature health information system with the capacity to meet its evolving data needs. The report provides recommendations to address gaps and inequalities in these systems with guidance for investment in areas that will have the greatest impact on data quality and use.
Country participation in SCORE global report, 2020
Note: validated means countries verified the data and permitted the data use by WHO. Approved means countries did not verify the data, but approved the data use by WHO.
Key findings
The SCORE global report 2020 shows key areas of health information systems that have benefited over time, such as a high availability of data on immunization coverage, tuberculosis and HIV/AIDS. But it also highlights critical areas in need of strengthening that require focused national and international collaboration.
- Globally, 68% of countries have well-developed and sustainable capacity for public health threat surveillance. Yet this varies between regions and income groups.
- Nearly 4 in 10 of the world’s deaths remain unregistered and are therefore not adequately counted. Globally, more than two-thirds of all low-income countries are yet to establish a standardized system to report causes of deaths. This limits our ability to understand the true impact of COVID-19 on mortality.
Registered births and deaths
- Optimizing health service data is critical to ensure equitable, quality services for all. Yet 50% of countries have limited or less capacity for systematic monitoring of quality of care.
- Approximately 60% of 133 countries have a well-developed or sustainable system for conducting analytical reviews of progress and performance of their health sector, representing more than 75% of the world’s population.
- 59% of countries have well-developed or sustainable capacity for using data to drive policy and planning, but only 42% of countries have good capacity for data access and sharing.
Bologna, Italy. A nurse at an ICU for COVID-19 patients at the St Orsola-Malpighi Polyclinic.
Key recommendations
All countries are encouraged to conduct independent Post-Enumeration Surveys (PES) after each census to assess and improve the quality of census data. Countries should also strengthen both their death registration and general health data systems through investments across all major health programmes rather than focusing on specific programmes alone.
Improvements in health data disaggregation will also be essential to identify health gaps among underprivileged groups and address inequalities. In addition, strong data governance regulations are needed to improve data access and sharing and to translate data into evidence-based policies.
Conclusion
The COVID-19 pandemic has brought many of the disparities outlined by the SCORE global report into focus, whereby countries face serious challenges in both measuring the full burden of the virus as well as accurately counting deaths.
Over half of all countries have moderate or better capacity for each of the five SCORE interventions. Yet no single country achieves sustainable capacity across all five, nor meets best practice guidelines across the full spectrum of the health information system. Therefore, all countries could benefit from understanding the gaps in their own health systems and following SCORE recommendations for improvement.
The SCORE for Health Data Technical Package provides an important set of recommended tools and standards that countries can use to maximize health information system performance and data quality. Released alongside the first global report, the SCORE Assessment Instrument and methodology will also support regular performance reviews. Moreover, the SCORE Online Data Portal will be another important tool to enable evidence-based policy design and build more resilient health systems for the future.
As COVID-19 has shown, investing in stronger health information systems is not only urgent but also cost-effective. With high-quality data on health gaps and trends, countries can design more effective policies and programmes to precisely address these gaps and ultimately support stronger social, political and economic outcomes.
Health has an impact on all areas, both directly and indirectly. With an increasingly interconnected world, we must promote the greater capacity for enabling data access and information-sharing while also respecting privacy and promoting trust. The SCORE Technical Package provides a roadmap for all relevant sectors to work together more seamlessly and we hope to include additional countries in future releases.
