Chapter 7. Forward Look: What Empirical Evidence Says about the Uses and Misuses of Public Health Data

CHAPTER 7. FORWARD LOOK: WHAT EMPIRICAL EVIDENCE SAYS ABOUT THE USES AND MISUSES OF PUBLIC HEALTH DATA

Main takeaways

• Overhauling data systems as part of health system reforms is an urgent area for action for the MENA region. • High-quality, reliable, and timely data that can be linked across databases and across time, generate tremendous benefits for health systems in general and for a country’s pandemic response in particular.

Improving the existing health systems in MENA is a comprehensive task. Describing them in detail goes beyond the scope of this report. While Haldane and others (2021) provide high-level guidance for policy consideration, Duran and Menon (2020) discuss MENA-specific policy priorities. These priorities, which vary by country, include: accelerating reforms to improve the level and distribution of health financing, and physical and human resources; improving the flexibility and quality of services at community, primary and hospital levels; proactively involving the private sector; and improving surveillance capacity and integrated health information systems. Yet, what is common across MENA countries is the lack of reliable, high-quality digital data to inform transparent and accountable decision-making. That such data are essential to health and other public service delivery is an overarching lesson from the pandemic. This means it is urgent for the region to overhaul data systems as part of health systems reform, and to encourage a culture of openness and data use to inform policy actions. In an uncertain environment with the potential for new mutations of the coronavirus that further threaten lives and livelihood, data are becoming even more relevant.

Figure 7.1 documents the difficulty of finding and accessing commonly used indicators to assess pandemic response of countries in the region. The figure shows that many indicators are either not publicly available or not collected, and in many cases the authors of this report were unable to verify which was the case.

While researching the availability of a variety of data related to Covid-19 across MENA countries, nine indicators were collected for 18 countries. The selected indicators provide basic information about key aspects of public health and about the conditions facing frontline health workers during the pandemic. These indicators included health system data (such as health worker infection rates and hospital occupancy, spending on public health functions such as contact tracing) and population-level information (such as the total number of births and deaths, and the percentage of households that incurred catastrophic levels of spending in response to an emergency).

The top panel shows the availability of indicators by country. The bottom panel shows availability across countries for each indicator. Only about half of the time, was the data found to be publicly available. Some types of data were collected, but not publicly available. In many cases, it was not possible to ascertain whether the data was or was not available. This shows that even if data is collected, it is often difficult to find and access.

What is needed are high-quality, reliable, and timely data that can be linked across databases and across time. This would generate tremendous benefits for the health system in general and a country’s pandemic response specifically.