February 2006 – August 2006
Read the final Working Group Report, Measuring Commitment to Health (PDF 232K)
Review a complete inventory of the original 78 indicators under consideration (Excel 108K)
Background
Many funders of international development programs use indicators as proxies for the ability of countries to use aid well. Increasingly, as the sometimes elusive concept of “good governance” has been associated with effective use of development assistance, both public and private funders have sought ways to measure such features as the quality of public administration, business friendliness, and efficient allocation of public resources toward poverty reduction. The Millennium Challenge Corporation, which implements the Millennium Challenge Account, originally used 16 indicators across a range of sectors to determine which countries are eligible to apply for funding. In 2006, the MCC sought input from the expert community about optimal metrics to consider in advance prior to its internal assessment of the quality and appropriateness of its health sector indicators. In response to this opportunity, and recognizing that other agencies also use a small number of indicators for similar purposes and may benefit from systematic analysis of the issue, CGD organized a working group to recommend prospective health indicators.
Working Group Approach
The Working Group was comprised of experts in the fields of public health and health financing, development economics and policy analysis who will seek to identify health indicators that meet the following criteria:
1) Development by an independent third party
2) Utilization of objective and high-quality data
3) Analytical rigor and public availability
4) Broad country coverage and comparability
5) Policy-link reflecting factors influenced by governments over the short term
6) Broad consistency from year to year
Within the subset of indicators that meet these basic criteria, working group members examined the linkage between the indicators and economic growth, gender equity, income equality, poverty reduction and improved health outcomes. This analysis informed a set of policy recommendations for the Millennium Challenge Corporation, developing country governments and other donor agencies to consider eight key indicators of a recipient country readiness to make use of foreign assistance: 1) DTP3 immunization rate; 2) government public health spending; 3) under-five mortality rate; 4) stunting; 5) skilled birth attendants; 6) contraceptive prevalence rate; 7) unmet need for family planning; and 8) access to water.
Working Group Members
- Ruth Levine, Center for Global Development
- Carla Abou-Zahr, World Health Organization
- Roger Bate, American Enterprise Institute
- Stan Bernstein, United Nations Population Fund
- Caren Grown, Bard College
- Sheila Herrling, Center for Global Development
- Marty Makinen, Abt Associates
- Kathryn McDonald, Stanford University
- Catherine Michaud, Harvard University
- Phil Musgrove, Health Affairs
- Mead Over, World Bank
- Michel Thieren, World Health Organization
- Amy Tsui, Johns Hopkins
- Abdo Yazbeck, World Bank