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Intelligence for Health Governance: Innovation in the Monitoring of Health and Well-Being

  • Ildefonso Hernández-Aguado
  • Lucy Anne Parker
Chapter

Abstract

Good health governance requires appropriate health intelligence, and consequently, health information needs to be reshaped in order to foster health policy innovation. Several key aspects should pervade the new approaches to the management of health information: advocacy, monitoring broad health determinants, accountability, and transparency. Strong advocacy is needed if we wish to convince non-health sectors of the relevance of health in their policies. Successful advocacy is based on new and innovative ways of framing health information which contributes to moving health higher up the media, public, and policy agendas. The goal is to put across the effects that all societal sectors have on health and well-being. Advocacy in the terms mentioned is also required to transform public health from an underfunded pyramidal bureaucracy into a strengthened public health with higher-profile leadership. This represents a shift of approach from an individual-centred prevention linked to health services to a public health that makes healthy choices easier and is capable of promoting multifaceted policies from diverse sectors emerging through network governance.

We also propose the monitoring of the social determinants which have an established relationship with health. Health outcomes are usually the long-term effects of exposures that act during the whole life course. Consequently, in order to measure the effects of policies which take decades to manifest, we need to assess the evolution of health determinants addressed by these policies. In fact, responsibility for health is now so diffused at various levels and different sectors that it is very important to point out through appropriate information who is accountable for relevant health issues such as inequalities.

Health-related information should be produced and framed in a way that is suited to the relevant level of governance in order to target accountability and transparency. The aim is to identify what part of government (local, national, regional, or global) is accountable for any health-related issue. Recent innovations such as health impact assessment are the starting point for the development of policy-linked indicators: “avoidable burden of disease by policies” or “health expectancy gained through policy.” These indicators may be estimated at every governance level and are understandable to policy makers and to the public. Transparency and intelligibility of health information is a keystone for population engagement that brings about demands for political actions in health, and consequently should guide innovation in health monitoring.

Although, as far as possible, new policies must be evidence based, the absence of evidence is a stimulus to innovation. Future advances in the monitoring of health and well-being must combine research and implementation. The challenges are evaluation of complex social programs; proper surveillance of new policies with health effects; provision of good data on the economic and social effects of health investment; assurance of a high societal visibility of health issues; and engagement of all stakeholders in the call for accountability and transparency.

Keywords

Health Information Health Impact Assessment Public Health Surveillance Health Determinant Health Investment 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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© Springer Science+Business Media, LLC 2009

Authors and Affiliations

  1. 1.Department of Public HealthFacultad de Medicina, Universidad Miguel HernándezCampus de San JuanSpain

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