Global Report: Health

OGP members have taken an extremely varied approach to dealing with health, from citizen monitoring of local expenditures to bringing members of the public into major regulatory and policy decisions. Major areas for future initiatives may include improving universal health coverage and primary care, reproductive health (including prenatal, maternal, and neonatal care), and improving the general budget and integrity. A general overview of key points is below:

Data on the policy area

• Health outcomes data and data on reproductive health lag far behind data on inputs. OGP members may consider commitments to centralize and make comparable data on health facilities, outcomes, and reproductive health, with special focus on disaggregation by genderOGP participating governments are bringing gender perspectives to popular policy areas, ensuring diversity in participatory processes, and specifically targeting gender gaps in policies to address gov... and at local levels.

Information on the policy process

• Universal healthcare planning and tracking: The majority of OGP members covered by the World Health Organization’s Universal Health Coverage database have plans in place to achieve this goal, but a minority regularly publish data on progress. While methods vary on measurement, OGP members may consider publishing performance metrics and monitoring toward universal health coverage.
• Health procurement: According to in-country experts, most OGP members did not have fully open, competitive bidding processes. Notably, about one-third did have strong systems. OGP members may address this by expanding user-centered open-contracting systems for key elements of the health system.
• Program-level budgeting: Most OGP members had program-level budgeting, but fewer reported on expenditures and outcomes. Most reporting focused on inputs and outputs, rather than performance. OGP members wishing to focus on this area may work on disaggregating budget data and introducing output tracking into these systems.

Participation and accountability

• OGP members, where they do focus on improving participation and accountability in health, have largely focused on citizen input into policy and strategy. A smaller group has focused on budget and supply tracking. Four governments have focused on accountability for patient outcomes. Where OGP members wish to focus on improving systems of accountability, actions can focus on creating the institutions for social accountabilityTransparency of public service delivery is not enough on its own; giving citizens opportunities to monitor progress on the ground and hold their governments accountable improves the quality of these s... within the context of other more formal systems of accountability such as ombudsman’s offices and auditors.