Measuring Health System Progress in Reducing Mortality from Noncommunicable Diseases

Noncommunicable diseases (NCDs) place a heavy burden on developing countries, whose relatively recent adoption of Western-style health behaviors and lifestyle choices has led to increased prevalence of risk factors for NCDs over the past decade. NCDs are compounding the burden of infectious disease on health systems in those countries. In response, the World Health Organization (WHO) has launched several risk reduction initiatives. WHO is drafting a monitoring framework and voluntary targets as the basis for a consultation process with member states. However, the indicators and targets that a global consultation process will produce will inevitably provide high-level, aggregated information, such as progress toward reducing premature NCD mortality. Regional and national decisionmakers and planners, on the other hand, will need more proximal and granular information to track progress toward high-level goals and will be constrained by the resources and demands in their respective jurisdictions. The relative importance of different risk factors and manifest NCDs differs across countries, and so do health systems' capabilities and resources. Thus, national and regional decisionmakers will need: (1) a comprehensive set of indicators to guide on-the-ground prioritization decisions and track progress toward high-level targets and (2) actionable data to predict the impact of changes in proximal indicators on high-level targets. As a first step, this article outlines a roadmap toward a comprehensive system for national and regional decisionmakers to (1) track progress toward the key WHO goal of reducing NCD mortality by 25 percent by 2025 and (2) prioritize resources and interventions to achieve that goal.