ncd global monitoring framework & who indicators in …...indicator #3: cervical cancer...
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NCD Global Monitoring Framework & WHO Indicators in Cancer Control
André Ilbawi, M.D.
Medical Officer, Cancer Control Department of Management of NCDs, Disability,
Violence and Injury Prevention (NVI) World Health Organization
• Assess service delivery – Type, quantity and quality of services – Performance or outcomes
• Planning & implementing – Set agendas and targets – Accountability identify areas for improvement – Determine best practices
Why measure?
What gets measured gets done.
Outline MDGs to SDGs via GAP
MDGs
• No NCDs
2011 UN HLM
• Recognizing the problem
GAP
• NCD targets established for 2025 (9)
• Tracer targets
• Reporting 2015, 2020, 2025
SDGs
• Defining the agenda to 2030
• Variables – Types of indicator – Site, frequency & method of collection
• Consider – Not value neutral – Huge resource requirement – financial and human – Assessing overall health system function
Measurement consideration
• NCD GMF: – Variable status by country and indicator
• NCD Progress Monitor: – Reporting before 2018 UN High-level meeting
• Other cancer indicators – Registry data (GLOBOCAN) – Data gaps globally
Where are we now?
Indicator #1: Premature Mortality
Definition Likelihood of death for person aged 30yo to die from NCDs by age 70
Target 25% reduction by 2025
Rationale Outcome of policies / programmes / clinical services
Data source National vital registration records
Limitations - Complex statistical calculation - Ageism?
Indicator #1: Premature Mortality
Indicator #1: Premature Mortality
Indicator #2: Cancer Incidence Definition Age-standardized rates of cancer types
Target None specified
Rationale Outcome of policies / programmes
Data source Population-based cancer registries (GLOBOCAN)
Limitations Registry coverage
Global Cancer Atlas. Online. http://canceratlas.cancer.org/taking-action/cancer-registries/
Indicator #2: Cancer Incidence
GLOBOCAN. IARC.
Indicator #3: Cervical Cancer Screening
Definition % women aged 30−49yo screened for cervical cancer
Target None specified
Rationale National systems response
Data source Household survey (representative sample) / WHO STEPS
Limitations - <30% countries have accurate data - Substitute with national response data (NCD country capacity survey)
Indicator #3: Cervical Cancer Screening
Assessing national capacity for the prevention and control of NCDs WHO. 2016.
Indicator #4: Availability of Essential Medicines & Technologies
Definition Available & affordable medicines and technologies to treat NCDs (at least ASA, statin, ACEI, diuretic, CCB, metformin, insulin, inhalent)
Target >80% of specified medicines & technologies
Rationale National systems response
Data source Facility survey
Limitations Inadequate cancer-specific medicines and technologies
• Bridge gaps in data – >100 countries do not accurately count births
and cause of deaths – Only 1 in 5 LMIC have adequate data to drive
decision-making • Issues in cancer control
– Access, cost, quality • Link to larger data initiatives
– GICR – Health data collaborative
• Quality of care working group
Where do we want to be?
Assessing national capacity for the prevention and control of NCDs WHO. 2016.
• NCD GMF & Progress Monitor are the current focus of global cancer/NCD data monitoring
• Resource mobilization needed to – Strengthen infrastructure for data collection – Expand data collection to include access, cost,
quality including link to larger data initiatives
Conclusions
Assessing national capacity for the prevention and control of NCDs WHO. 2016.
THANK YOU
André M. Ilbawi [email protected]