Implementation of the Tallinn Charter in the WHO European region: Where is the evidence? a systematic comparison of online information before and after the end of the year of signature
Introduction
The “Tallinn Charter: Health Systems, Health and Wealth” [1], endorsed at the 58th WHO Regional Committee for Europe (resolution EUR/RC58/R4 [2]), provides guidance and a strategic framework for strengthening health systems in the WHO European Region.
It stipulates that “health systems need to demonstrate good performance” and commits Member States (MS) to “promote transparency and be accountable for health system performance to achieve measurable results”. The Charter similarly commits WHO to “…provide cross-country coordination in implementation of the Charter, including the measurement of performance and the exchange of experiences…”.
Resolution EUR/RC58/R4 requested the Regional Director to report to the Regional Committee in 2011 with an “Interim Report” and again, with a “Final Report”, in 2015 on the support provided by WHO Europe and the progress accomplished by Member States in the framework of the follow-up to the WHO European Ministerial Conference on Health Systems held in Tallinn.
During the first post Tallinn Conference held in February 2009, MS requested WHO Europe to support their efforts to implement the Tallinn Charter. More recently, WHO RC Resolution EUR/RC60/R52 [3] endorsed the Regional Director's proposal to formulate a new European health policy (“Health 2020”), with a renewed focus on public health.
In October 2010, a meeting was convened in Copenhagen and a Working Group was nominated to support the preparation of such Interim Report. The main objective of this work was to highlight actions taken by MS in the implementation of Tallinn Charter, particularly for the central themes of performance measurement/evaluation, response to the crisis, and multi-sectoral action.
The first draft of the “Interim Report” has been presented at the 1st European Health Policy Forum, Andorra, 9–11 March 2011 [4].
To explore the level of dissemination and actions coherent with commitments of the Tallinn Charter, the Working Group agreed that a structured Web Search should have been conducted as part of its assignment. This report presents the main results obtained by such investigation.
Section snippets
Objectives
Scope of this work was to review the evidence of the implementation of the Tallinn Charter through:
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a systematic search of online information aimed at highlighting studies and significant actions related to the commitments of the Tallinn Charter
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a pre-post comparison of the results obtained before and after the end of the year of signature of the Charter (2008)
Keywords
The semantics of the Tallinn Charter is well specified in its preamble, including a series of declarations and official acts endorsed by
Results
The results obtained from our search are summarized in Table 1.
A brief description of the results related to each web search is provided in the following sections.
Discussion
The Tallinn Charter is a high level document directed mainly to National Governments of the European Region to implement actions aimed at improving health and wealth through strengthened health systems.
The document includes specific commitments to undertake rigorous monitoring of health systems in a broader framework that regards investing in health as a key strategy for the development of European society. Implementing such vision has become particularly hard with the start of the financial
Conclusions
A systematic online search of scientific papers and grey literature related to the major themes of the Tallinn Charter highlights an increasing presence of published reports since its signature.
Scientific papers include a higher production of conceptual, methodological and analytical papers, while more analytical work, system evaluations and cross-country comparisons emerge from the grey literature.
Among the dimensions identified by the WHO to evaluate health systems, “responsiveness” appears
Disclaimer
The views and opinions expressed in this paper reflect those of the individual authors and do not represent in any way the opinion of WHO or any of its affiliates.
Acknowledgments
The author thanks J. Kutzin (WHO Global Headquarters) and A. Guisset, M. Von Krauss and H. Kluge (WHO Europe), for their open and informal exchange of ideas on the implementation of the Tallinn Charter, which was of great help in the preparation of the present paper.
References (14)
- WHO Europe, The Tallinn Charter: Health Systems for Health and Wealth, Tallinn. Available from:...
- WHO Resolution, Stewardship/governance of health systems in the WHO European Region, Regional Committee for Europe,...
- WHO Resolution, Addressing key public health and health policy challenges in Europe: moving forwards in the quest for...
- WHO Europe, Interim Report on the Implementation of the Tallinn Charter. Available from:...
- PubMed, US National Library of Medicine. Available from: http://www.ncbi.nlm.nih.gov/pubmed [accessed...
- Google Search Engine. Available from: http://www.google.com [accessed...
- Pybliographer, a tool for managing bibliographic databases. Available from: http://pybliographer.org/ [accessed...
Cited by (0)
- 1
Member of the WHO Working Group for the Interim Report on the Implementation of the Tallinn Charter.