Attribute | Characteristics | |
---|---|---|
 | From literature review | By expert group |
Process of development | • Participation of various stakeholders to bring on board various perspectives, increase transparency, appreciation, and ownership | • Some categories of stakeholders indicated include public, communities, and funders |
• Use of data to explain causal links | • Data use said to make framework more believable and more likely to be used for decision-making | |
Relating with health system framework | • Embedded in an explicit health system with clarity of HS conceptual framework including determinants of health, goals, elements, and actors | • May require working with stakeholders to develop health system conceptual framework if not in place already |
Relating with policy/organizational context, societal values and principles | • Relating to general model of government | • Derivation of health system performance assessment attributes in this paper should be recognized as a specific perspective and not as generic |
• Relating to organization of the health system, inter- and intra-linkages at different levels of the system | ||
• Societal values and principles determine system goals and trade-offs | ||
• Governance and empowerment influence relationship between values and explicit policies | • Health financing – levels & structure – sources, mechanisms as one of the issues to monitor | |
• Governance related to levels of literacy | ||
The elaboration of the framework | • Includes conceptual framework, purpose, dimensions, sub-dimensions, and indicators | • Highlighting linkages and accountability relationships to facilitate attribution |
• Dimensions and sub-dimensions should reflect linkages between different functions and elements of the system | ||
• Indicators – may require some flexibility & dynamism to allow for learning and ownership | ||
• Choice of indicators determined by perceived importance, scientific soundness, and feasibility | ||
Institutional set-up | • With appropriate institutional set-up, with linkages to other entities, champions, & resources (infrastructural, financial, human) provision | • Information management system requirements should consider feasibility & costs versus benefits |
• Regular and systematic application | ||
• Should be usable at lower levels for self-assessment | ||
Mechanisms for change | • Linking measurement of performance with changes in policy & management | • Packaging of information should consider types and needs of users |
• Making comparisons across time, different levels, systems, and settings | ||
To consider negative/unintended effects of incentives including on data quality and increasing inequity | ||
• Analysis and use of complementary information from various sources | ||
• Incentives – financial accreditation recognition – name and shame | ||
Adaptability |  | • History of use over time and in different places and contexts |