Targets, Timelines, and Indicators

Areas requiring targets: What areas covered by the FCGH require targets? For example, along with funding, targets areas might cover gains in health equity, improvements in health indicators, coverage of health care and the underlying determinants of health, and progress along the various right to health elements included in the FCGH.

Targets and timeframes: In areas for which the FCGH sets targets, what should the targets be? What about benchmarks and timeframes for achieving them? What are appropriate indicators? Would the FCGH itself include indicators, or charge WHO, the FCGH Secretariat, or another institution with developing indicators?

Process for developing targets and timeframes: Should targets be defined in the FCGH itself or in protocols, or some of each? What is the appropriate level of specificity for these targets and timelines at the international level? Should the FCGH outline target areas, and possibly general guidance on targets and timelines, with these being further developed at regional or national level? Should the FCGH outline these processes (e.g., inclusive, participatory), and if so, and to what level of detail? Should the FCGH include a mix of specific global, regional and national targets?

Target dates: How should target dates (e.g., achieving a certain requirement under the FCGH within a given number of years after ratification) be structured? What is the proper balance between creating global-level accountability and standards, with specific target dates for progress incorporated directly into the FCGH, compared to tailoring timing to country differences by having timelines determined primarily at the national level? Should the FCGH itself establish target dates, but with a recognized process for countries justifying later target dates (or holding itself to more ambitious timeframes)? Should the FCGH include a common set of timeframes for different groups of countries (based, e.g., on income or current levels of achievement in target areas) to achieve various targets, or should it aim to catalyze ambitious yet achievable timelines that differ for each country, developed nationally through participatory processes, with the FCGH providing guidance including areas that target dates should cover? Should the FCGH incorporate a process to revise timelines based on the level of progress, or would that undermine accountability?

Historical bests as target timeframes: Should targets be based on the fastest that countries have historically scaled up certain health services, or universal health coverage more generally? What are the best achievements in this respect? Would there be a way to adjust such best achievements for factors that will affect pace of achievement (e.g., current nature of health workforce, geography affecting the number and proportion of the population living in hard-to-reach areas)? Should historical bests set the default targets in the FCGH, with states required to report on whether these will be their national targets, or if they will vary from these targets, explaining and justifying these variations, with the variations developed through and affirmed in inclusive national processes?

Timelines and funding: Should the FCGH include timelines for achieving funding targets, or pace of required scale-up?

FCGH implementation strategy: Should the FCGH require countries to develop FCGH implementation strategies, which would include targets, benchmarks, timelines, and indicators? Would the FCGH then include a review process for these strategies? What sort of process? A review by the FCGH Secretariat? A special multi-stakeholder body that the FCGH could establish for this review process? Some form of peer review by other countries? A process similar to the Joint Assessment of National Health Strategies, where the countries stakeholders involved in developing the national health strategies, along with and individuals and institutions not involved in the planning process (e.g., local consultants, international agencies, regional partners), jointly review national health strategies? Should there also be an ongoing review of progress on implementing these strategies? [Note this question also in the Accountability and Compliance section.]