As I listened through three days of information-dense sessions at the GHME conference in Seattle, a few major themes stuck with me. My short list of seven key takeaways, some of which I’ll be breaking down in longer, more in-depth posts next week:
7. Desire for data sharing. There is a strong need for data sharing across institutions, countries, and projects, but no well-maintained central repository for those data nor an organization taking responsibility for organizing the files. While the GHDx steps in and fills this role to a degree, the catalogue of datasets will only be as complete as what is submitted by researchers or sought out by IHME. A representative from the Gates Foundation spoke to their new data exchange policy, to be released in the coming months, which should be interesting.
6. A focus on developing country needs and wants. “Indicators should be owned by countries, but no one ever asks countries.” Country-recipients of donor funds should have a greater say in determining what data is collected about their respective nations and programs. Collecting and reporting data on indicators determined by outside actors (funders, academics, etc.) can be a huge burden for some developing country statistics agencies, program managers, and other stakeholders; many times, the data collected is not used in-country at all. It will be interesting to see how the arena of indicator selection evolves after the 2015 deadline for the Millennium Development Goals has passed: I am hopeful that the next round will be less donor-centric and more focused on developing realistic development targets on meaningful indicators. And, with the focus on noncommunicable diseases throughout the conference & the fall meeting focused on that exact topic, new targets and goals should include NCDs as well.
5. Women are more than mothers. The MDGs and other development programs have focused almost exclusively on maternal health, rather than women’s health, in many cases. Women are worth more than their uteruses, and women also die from many other illnesses and problems outside of childbirth. Despite the efforts of Women Deliver, we continue to see “woman as mother” and not “woman as citizen,” which is a paradigm shift that needs to happen. The MDGs were focused on maternal health, not women’s health, and neglected important items like family planning.
4. Strengthening country information systems is key. Sometimes research focuses so much on national surveys and other data collection done by external actors (i.e. the demographic and health surveys), developing in-country statistical capacity and strengthening the local health information system is neglected, noted Fatima Marinho de Souza from PAHO. In order to ensure sustainability of programs and provide opportunities for countries to measure and monitor the indicators that matter to them, we must emphasize local HIS strengthening as part of our global health and HSS aims.
3. Inequalities are important to know about. Multiple presenters spoke to the “tyranny of averages,” and even more highlighted the importance of identifying inequalities and inequities in wealth, gender, geographic, and other groups. Focusing only on country-level data – while useful for cross-national comparisons – is limiting, often missing the more nuanced story of health outcomes in rural districts or among the poor. The draft of the next set of global indicators includes stratification by six different factors, not just wealth, in order to better address the inequality question.
2. Health system strengthening is still sexy. Raj Shah spoke those immortal words at a CSIS address a few months back, and they still ring true. Measuring health systems strengthening and developing new performance metrics are even sexier. Julio Frenk, Chris Murray, and Martin McKee spoke over a lunch session on the importance of continuing to evolve a new generation of tools for measuring HSS: these are not to replace existing measures, but to evolve existing measures further and add new tools. We’ve come a long way in conceptualizing a health system since the 2000 World Health Report, but there is still much work to be done.
1. Global health metrics is changing. And according to Richard Horton, global health academia is the new black. Results-based programs, reliant on good data and metrics, are a central focus for today’s aid agencies, operating with more limited funding. A meeting like GHME happened (with over 600 attendees) because of the interest in global health metrics. Academic institutions are stepping into the roles filled in the past by large multilateral agencies and institutions, though there is still a need for those multilateral spaces for collaboration and goal-setting. Organizations like IHME and strong academic institutions are conducting pioneering, forward-thinking research on a wide range of global health topics. And there are some pretty incredible people working in global health today, which I found very inspiring.
Also cross-posted on PSI’s Healthy Dose Blog