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WORLD HEALTH. 1988 Jan-Feb; 10-11.In 1979 WHO invited its member states to participate in a global strategy for health and to monitor and evaluate its effectiveness using a minimum of 12 indicators. Members' 1982 implementation reports and 1985 evaluation reports form the basis for evaluating each measure. Indicators 1-6 have strong political and economic components in both developed and developing countries and are not complete. Indicator 7, for which rates of reply are satisfactory, asks whether at least 5 elements of primary health care are available to the whole population. The 8th gauge seeks information on the nutritional status of children, considering birth weight (a possible indicator of risk) and weight for age (a monitor of growth). Infant mortality rate and life expectancy at birth, indicators 9 and 10, are difficult to estimate in developing countries, and health services are not always kept informed of current estimates. Indicator 11 asks whether the literacy rate exceeds 70%; it can provide information on level of development and should emphasize literacy for women, for whom health information is critical. The last global measure yields information about the gross national product, which is not always the most recent, despite the trend of countries to publish their gross domestic product. Failure to make use of the best national sources, such as this, is one of several problems encountered by WHO's member states in collecting accurate data. Other problems include lack of universally acceptable definitions, different national accounting systems, disinterest of health authorities in economic matters, lack of staff, lack of financial resources in developing countries, and inadequately structured health system management. Each country must choose the most appropriate methods for collection of data. If an indicator cannot be calculated, the country is encouraged to seek and devise a substitute. WHO must produce more precise and reliable indicators. It must respond to requests for ways of improving or strengthening national systems.
In: Addendum. Manual IX: The methodology of measuring the impact of family planning programmes on fertility, by the Population Division of the Department of International Economic and Social Affairs of the United Nations. New York, New York, United Nations, 1986. 9-14. (Population Studies No. 66; ST/ESA/SER.A/66/Add.1)This chapter describes and applies a new methodology for estimating the fertility impact of contraception obtained through a family planning program. This approach is called the prevalence method because the principal data required for its application are estimates of the prevalence of contraceptive use at a given point in time. It is the objective of the prevalence method to estimate the number of births averted as well as the reduction in the crude birth rate that results form the use of program contraception. A single application of the procedure produces these estimates for 1 year, but repeated applications for different years can yield a time-series of births averted or other impact measures. The procedure for calculating births averted by program users consists of 6 parts to obtain, consecutively, estimates of: natural fertility, potential fertility, fertility impact of program use, births averted, birth rate impact, and method-specific results. Each of these steps is described in some detail. This new approach provides a simple and straightforward alternative to existing methods for estimating the gross fertility impact of program contraception. In contrast to several of the other procedures, the prevalence method does not require detailed input data on numbers of past acceptors and continuation rates. Instead, estimates of the prevalence of program and non-program contraception by age and method are required as principal input data. While such data were rarely available in the past, prevalence estimates are now routinely obtained from national surveys in many developing countries, thus making the application of the prevalence method possible.