Targets as a tool in health policy Part I: lessons learned

This article reviews the start of the use of targets as a tool in health po licy, summarises the fruitful uses and frequently-heard objections, and pro poses some conditions For successful health target setting. Targets as tool in health policy are based on the 'management by objectives' approach (195 4). The use in health policy was possible due to advances in the use of epi demiology for public health purposes. It provisionally ends with the new he alth targets adopted by WHO in 1998. The setting and monitoring of health t argets is one way in which a government can provide leadership, guidance an d strategic direction for the health sector. These benefits, and others, wi ll also be reviewed. Drawbacks - such as political accountability and the l imited malleability of society - will also be discussed. To overcome most o f the objections, the article ends with some SMART conditions fbr successfu l health target setting: specific, measurable, achievable, realistic and ti me-bound. When SMART conditions are met, political will and daring are the recipe for a successful health target approach. (C) 2000 Elsevier Science I reland Ltd. All rights reserved.