Three baseline countries (BRA, DOM, GLP) did not complete the assessment. These 3 countries were not counted towards the overall indicator assessment.
PASB Comments
The countries of the Region have made great efforts to incorporate the vaccine into their national vaccination schedules; as of December 31, 2023, only 4 countries had not introduced the HPV vaccine. 26 countries in the Region are vaccinating children and 12 countries have switched to a single-dose schedule.
There was no consensus on the assessment results for 1 target country (CYM). In addition, 1 baseline country (DOM) did not complete the assessment. These 2 countries were not counted towards the overall indicator assessment.
PASB Comments
As part of the deinstitutionalization process, a mental health crisis management course was delivered to first responders in Saint Kitts and Nevis and the Bahamas. Deinstitutionalization processes were accelerated across several countries to shift toward community-based services. For instance, Paraguay made progress transitioning patients from a national psychiatric hospital into integrated community-based mental healthcare, supporting 156 patients through new municipal-level centers last year. Mobile crisis response gained more prominence as an alternative to hospitalizations. Another example is the Bahamas emergency response service, which has prevented avoidable hospital admissions. Similar assistance programs now run across 3 Argentine provinces.
One baseline country (DOM) and one target country (BRA) did not complete the assessment. These 2 countries were not counted towards the overall indicator assessment.
PASB Comments
The Report of the PAHO High-Level Commission on Mental Health and COVID-19 and the new Strategy for Improving Mental Health and Suicide Prevention provide the vision and the recommended actions for increased technical cooperation in MH in the Region. Several countries have started to take important actions to improve and reform their mental health systems. The recommendations of the Commission emphasize the importance of intersectoral work and integration of mental health into all areas of government to better face the long-term crisis of mental health in the Americas. In the area of suicide prevention, comprehensive strategies aligned with global best practices were developed with the support of PAHO, including the promotion of intersectoral collaboration and policy developments. For instance, PAHO helped Uruguay establish a multi-stakeholder network for suicide prevention across healthcare, education, social services, and civil society. Prioritized policy recommendations have also been formulated. Bolivia targeted action across societal, community, relationship, and individual levels based on the WHO LIVE LIFE framework.
Furthermore, 70 media professionals were trained on responsible reporting on suicide in Guyana (25), Barbados (22), and Grenada (23).
There was no consensus on the assessment results for 3 target countries (BMU, BON, KNA). In addition, 1 baseline country (BRA) and 5 target country (DOM, GUF, MTQ, GLP, CUW) did not complete the assessment. These 9 countries were not counted towards the overall indicator assessment.
PASB Comments
The number of countries that have generated and produced analytical health reports which include disaggregated data on a regular basis has increased from 5 to 17. Additionally, countries are increasingly making these reports and other health data and information more accessible both internally and externally. Improved national health information systems and advances in digital transformation have led to increased data demand and utilization. Such data increasingly include the social determinants of health and allow countries to monitor progress and gaps. PASB provided technical cooperation through ongoing capacity-building efforts in health analysis, particularly for monitoring SDG3 indicators among interdisciplinary country teams at national and subnational levels. This has been crucial to the progress achieved for OCM 21.b. An additional 13 countries are on track to achieve this indicator.
No agreement was reached for three countries and territories. PASB assessed that the criteria as detailed on the technical note for the indicator were not met, and no documentation was submitted or otherwise available at the time of the assessment.
Eight target countries (BRA, CAN, CUW, DOM, GLP, GUF, MTQ, PRI) did not complete the assessment. These 8 countries were not counted towards the overall indicator assessment.
PASB Comments
The majority of countries and territories express satisfaction with PAHO/WHO's leading role on global and regional health issues, indicating that the Organization’s efforts and initiatives are generally perceived positively across the region. This widespread satisfaction underscores PAHO/WHO's role as a leading public health authority, engaging countries and territories in the regional and global public health agenda at the highest level – politically, strategically, and technically. Efforts will continue to ensure alignment between biennial work plans and the priorities indicated by national health authorities. This commitment involves ongoing coordination and collaboration with national health authorities to tailor PAHO/WHO's biennial work plans to address the specific health challenges and priorities identified by each country.
There was no consensus on the assessment results for 1 baseline country (BHS). In addition, 1 baseline country (DOM) and 5 target countries (BRA, CUW, GLP, GUF, MTQ) did not complete the assessment. These 7 countries were not counted towards the overall indicator assessment.
Two target countries (BRA, DOM) did not complete the assessment. These 2 countries were not counted towards the overall indicator assessment.
PASB Comments
DPT vaccination coverage has been affected by the COVID-19 pandemic. PASB is working to improve coverage and reduce dropout rates to ensure that under-vaccinated individuals receive the necessary immunizations.
Two baseline countries (BRA, DOM) and 1 target country (CUW) did not complete the assessment. These 3 countries were not counted towards the overall indicator assessment.
PASB Comments
As of 31 December 2023, 27 baseline countries achieved this output indicator and two partially achieved it. This assessment was conducted based on the information entered by the countries through eJRF.
Two baseline countries (BRA, DOM) and four target countries (CUW, GLP, GUF, MTQ) did not complete the assessment. These 6 countries were not counted towards the overall indicator assessment.
PASB Comments
A comprehensive maturity assessment of IS4H was conducted by PASB of progress made between 2016 and 2023. Using over 240 standardized indicators, the evaluation assessed national health information systems with respect to governance, strategy, laws, financial sustainability, human resources, data management, and quality, including vital statistics, analysis capabilities, information flows, project management, and information technology (IT) infrastructure. Information for the assessment was gathered through country visits, expert consultations, database and gap analyses, and reviews of policies, procedures, and technical documentation. Site visits allowed for direct observation of information platform use and interoperability, especially in primary care, and for data collection and interviews with frontline administrative and clinical staff.
A comprehensive report on the regional IS4H maturity assessment will be published in late 2024; however, the assessment found that 42.8% of the countries are still at level 1, “building awareness.” These countries are characterized by early adoption of health information systems, with mostly analogue data and a growing recognition of the need for digitalization. With very limited capacity to generate data and assure its quality, including on health indicators whose data source relies on civil registration and vital statistics, they depend largely on international organizations in this regard. Investments in digital health have often not expanded infrastructure as expected due to gaps in access to electricity and connectivity, as well as a lack of long-term planning and sustainable financing.
A third of the countries, 34.7%, have reached level 2, “implementing best practices.” They are developing their health information systems with data from various sources and managing health information effectively. However, they face challenges such as incomplete development of indicators, insufficient data exchange, and limited implementation of data standards and public health communication strategies. Another 18.4% have reached level 3, “standardization and continuous improvement,” reflecting advances in IS4H policies and strategies and the use of high-quality data for decision-making. Only 4.1% of countries are at level 4, “integration and alignment,” marked by highly integrated information systems that are aligned with national and international standards.
No country in the Region has reached level 5, the maximum maturity level in IS4H, which entails complete deployment of all components of the model and a constant search for innovation.
Two baseline countries (BRA, DOM) did not complete the assessment. These 2 countries were not counted towards the overall indicator assessment.
PASB Comments
Significant progress was made in the 2022-2023 biennium; 37 countries have full-time personnel dedicated to health emergencies. Training played a crucial role, with 5,682 health professionals certified in Health Facility Assessment, totaling 14 767 certified individuals. Additionally, the “Emergency Risk Management in Health and Disasters” virtual course trained 1,466 health professionals, including 17 facilitator trainers.
Three additional countries achieved this indicator during the biennium. The indicator measures country progress toward mainstreaming disaster risk reduction and climate change adaptation/mitigation in the health sector.
In the 2022-1023 biennium, 17 countries included the criteria for disaster mitigation and climate change adaptation under the SMART H initiative, ensuring the operation of health services during and in the aftermath of disasters. As part of this group of countries, three additional countries achieved this indicator during the biennium. Two countries have had delays in implementation of interventions after the assessment, but both are working to achieve the indicator.
Two target countries (BRA, DOM) did not complete the assessment. These 2 countries were not counted towards the overall indicator assessment.
PASB Comments
Progress has been made in many countries; however, some continue to show either no progress or partial achievement. PASB will continue to provide support to integration of gender approaches in key strategic programs, policies, and plans, with an emphasis on countries that did not complete the assessment.
There was no consensus on the assessment results for 2 target countries (BRB, VEN). In addition, 1 baseline country (DOM) did not complete the assessment. These 3 countries were not counted towards the overall indicator assessment.
PASB Comments
PASB has provided technical support and promoted the right to health and other health-related rights, supporting legislative processes at national levels, including capacity building with relevant stakeholders on a variety of issues, including healthy nutrition (front-of-package nutrition labeling, trans fats and sodium, breast milk substitutes), mental health, violence (police and armed forces), LGBT+, persons with disabilities (review of a course for NGOs prepared in PAN), and elimination of diseases among persons deprived of liberty, as well as inter-programmatic work, mapping and analysis of legislation, regulations, and policies across the 33 Member States of the Region, including systematization and analysis of relevant judicial decisions, national/international human rights standards, and intellectual property discussions. Regarding lessons learned and challenges, data collection is generally a challenge, especially when it requires coordination with other authorities and branches of government (legislative and judiciary). Even if the human rights approach is sometimes politically present, inclusion of human rights norms/principles/standards in national legislation, policies, plans, programs, and mechanisms is not always reflected in operational and preventive terms. Therefore, capacities on health-related human rights perspectives and approaches should be strengthened systematically and continuously at the national level.
There was no consensus on the assessment results for 1 baseline country (ECU). In addition, 1 target country (BRA) did not complete the assessment. These 2 countries were not counted towards the overall indicator assessment.