Impact measurement, outcome, and output indicators

Robust monitoring and assessment are essential for the proper management of the programme budget and to guide necessary revisions to policies and programmes.

WHO will monitor, assess, and report on budget implementation, in line with the GPW14 results framework. Progress towards health impact including the triple billion targets, 18 outcomes and 42 outputs will be tracked and assessed, using clear measurement criteria consisting of:

An impact measurement system to track progress towards the recalibrated WHO triple billion targets,
Outcome indicators that are aligned with the health-related Sustainable Development Goals (SDGs),
Output/leading indicators measuring the contributions of the WHO Secretariat to these health outcomes and impact, accompanied by a scorecard assessing the Secretariat’s accountability for results and performance.

Figure 1 outlines the mechanisms through which the programme budget implementation will be monitored and assessed, in alignment with the Organization’s results-based management approach, to ensure transparency and accountability for results.

Figure 1: Overview of programme budget monitoring and assessment mechanisms:

Impact measurement:

Measurement lies at the core of the GPW 14 results framework, including healthy life expectancy and the triple billion targets. The preliminary triple billion targets, that have been recalibrated, to be achieved by 2028 are:

6 billion people with better health and well-being;
5 billion people who benefit from universal health coverage without financial hardship; and
7 billion people better protected from health emergencies.

These represent the joint responsibility between Member States, the Secretariat, and partners, and will be measured through the WHO composite indices for triple billion targets.

Outcome indicators:

GPW14 entails 18 outcomes, which represent the joint responsibility of Member States and the Secretariat. They will be measured through the outcome indicators aligned with the SDGs.

An inclusive process was adopted to update the outcome indicators, to reflect emerging global health priorities during the GPW14 period and beyond. A wide range of stakeholders –Member States, partners, technical experts, civil society and youth– were involved in the various consultations to represent different perspectives, relevance and applicability across different health contexts.

The following key principles were used to update the outcome indicators:

continuity with the GPW 13 and alignment with Sustainable Development Goals,
concrete criteria to select indicators that are meaningful, measurable and minimal,
reduced additional data collection burden on countries,
emphasis on data availability,
extensive consultations to ensure an inclusive process.

The draft list presented to the 156^th Session of the Executive Board includes 96 proposed outcome indicators across the triple billion targets, together with available baselines and targets.

The complete and final set, with baselines and targets, will be submitted to the 78^th World Health Assembly in May 2025.

Progress towards corporate outcomes 1, 2 and 3 will be measured through the output indicators, as they relate to WHO Secretariat’s performance and accountability.

Output indicators:

GPW14 entails 42 outputs, and they will be measured through the output indicators. Whereas impact measurement and outcome indicators represent the joint responsibility between Member States, partners and the Secretariat, output indicators show the WHO Secretariat’s performance and its contribution to the delivery of health outcomes and impact.

Output indicators have a clear and direct linkage to the outputs in the results chain and a plausible contribution to outcomes and outcome indicators. They are not intended to cover the full scope of the output. Instead, they focus on measuring immediate or intermediate changes that will make a strong contribution to the successful delivery of the output, highlighting areas in which the WHO Secretariat adds the highest value. They are informed and guided by lessons learned from GPW13, regional/country office key performance indicators (KPIs), programmatic indicators, as well as audit/evaluation recommendations. This includes the recommendation to have a single, unified set of output indicators across all three levels of the Organization to monitoring of the programme budget.

The draft output indicators were developed after three rounds of review and consultations:

a comprehensive and careful review of more than 1000 existing indicators, with a recommendation to move forward a “short list” for further consultations;
technical consultations across the three levels of the Organization to further refine the above “short list” and address gaps (conducted under the leadership of the Assistant Directors General);
dedicated consultations with WHO country offices on the outcome of the 3-L consultations to further assess country relevance.

The following specific criteria were used for their selection:

performance, accountability and added value of the WHO Secretariat,
clear link to the health outcome and the related outcome indicators,
measurability with the systems available in countries,
existence and of metadata,
annual availability of indicator values (or at least once every two years) for monitoring.

The final set of output indicators, with draft baselines and targets, will be submitted to the 78^th World Health Assembly in May 2025. The aim is to offer a single pool of output indicators from which countries can select during planning and subsequently monitor for annual corporate reporting on the programme budget.

Some output indicators will also gather the data needed to report on investment case commitments, underlining the commitment for sustainable financing that is critical for WHO’s ability to deliver its mandate.