This page presents detailed findings from the final review of impact indicators of the Strategic Plan of the Pan American Health Organization 2020–2025 (SP20–25). Impact results measure sustainable changes in the health of populations, such as improved health and well-being and reduced morbidity, mortality, and disparities. The SP20–25 established 28 impact indicators with 35 targets. The indicator assessments present trends over the past two decades, considering the most recently available data that have been standardized to facilitate comparative analyses among countries and territories in the Region of the Americas. Each assessment includes a summary table with the indicator baseline, target, status considering the most recent data available, and rating. An analysis is presented for each impact indicator, followed by recommendations from the Pan American Sanitary Bureau (PASB) to improve health outcomes.
EOB 2024-2025
Impact Indicators
Impact indicators were rated as follows:
- Achieved: Target reached or projected to be reached by 2025. Efforts must be maintained to protect the gains.
- Right track: Positive trend, but insufficient speed to have reached the target by 2025..
- Stagnating: Little or no movement; current trajectory insufficient to have reached the target by 2025, even with extended projections.
- Wrong track: Trend moving in the opposite direction from the 2025 target.
- Not enough data: Assessment of progress toward the 2025 target was constrained by weak or insufficiently mature data systems.
Impact indicators show a mixed performance.
Notable improvements achieved in neonatal mortality, dengue case fatality, mortality attributable to air pollution, and within country gaps in health outcomes. Several indicators related to noncommunicable diseases (NCDs), communicable disease incidence, violence and injuries, and maternal health showed slow progress or regression. Nine (32%) indicators either reached their targets (4) or were on the right track (5), while 16 (57%) were either stagnating (11) or on the wrong track (5) and required acceleration; and 3 (11%) did not have enough data for robust assessment.
Six years of successive shocks and transitions, including COVID-19, affected progress toward impact results.
This situation generally reflects a combination of delayed service recovery after the COVID-19 pandemic, insufficient implementation coverage, persistent disparities, and in some cases weak integration across service delivery platforms.
Impact indicators by status
Select an Indicator
▲Achieved (4) ↗Right track (5) ▶Stagnating (11) ▼Wrong track (5) −Not enough data (3)
Main takeaways
Progress was strongest where interventions were scaled up built on the foundation of resilient health systems.
Meaningful progress was made, with improvements concentrated in areas where multiple enabling conditions converged. These included sustained implementation of interventions at scale through routine service delivery, supported by well-defined technical cooperation approaches and relatively mature and stable data systems. However, many impact indicators continued to face structural constraints that limited acceleration efforts to reach the 2025 targets.
Important policy gains are translating into impact results.
The Region made important advances in policies, frameworks, and service models, including in areas such as HIV, congenital syphilis, suicide prevention, and long-term care. These have contributed to improved coverage of key services. However, there is a need for more effective, integrated, and sustained implementation at scale to translate more consistently into measurable population-level impact.
Addressing health disparities remains a defining challenge.
Even where regional trends appear aligned with targets, they often conceal substantial variation. Neonatal mortality illustrates this pattern: while regional progress has been broadly aligned with targets, many countries remain above desired levels, and preventable causes continue to account for a large share of deaths.
Inadequate data systems constrain progress tracking.
Robust regional assessment continues to be constrained by data limitations. Indicators relying on mortality estimates and population-based surveys are particularly affected by time lags and methodological constraints. At the same time, improvements in measurement approaches are laying the foundation for stronger impact monitoring in the SP26–31 cycle. This underscores the importance of sustained investment in health information systems, data comparability, and analytical capacity.