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.
