PLANNING FOR HEALTH FOR ALL - INTERNATIONAL EXPERIENCE IN SETTING HEALTH GOALS AND TARGETS

In recent years several countries and regions within countries have de veloped national health goals and targets in order to make explicit th e achievements they expect from their investment in health, as a guide to health policy development, and/or to assist in decisions about res ource allocation. These health targets have been developed using diffe rent conceptual frameworks, and widely differing mechanisms for implem entation and monitoring have been adopted. This review examines experi ence in setting and using national health goals and targets in Jive de veloped countries and regions about which published information is ava ilable. Overall, it appears that the potential of health goals and tar gets to influence national health policy, resource allocation and popu lation health outcomes has not yet been achieved fully in the countrie s and regions examined. Most have achieved important successes in re-o rienting health systems and in increasing health promotion activity. T o date, only the US has had experience in using targets to guide publi c policy over an extended period, and here the evidence of effect is e ncouraging. In the 1990s a more systematic approach to the achievement of targets has been adopted, particularly in the US, the UK and Austr alia. In each case more explicit steps have been taken to link the ach ievement of targets to health system planning, management and, to a le sser extent, funding, and greater emphasis has been given to the need for all sectors of government to contribute to improving health of the population. Progress will need to be carefully monitored in these cou ntries to identify the strengths and weaknesses of these approaches.