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Background: Systematic assessments of a country's health information system (HIS) help identify strengths and weaknesses and may stimulate actions for improvement. They represent a capacity-building process for the country assessed as well as for the assessor. The joint action on HISs (InfAct) developed a peer-to-peer assessment methodology adapting an established WHO support tool. The aim of this study is to identify lessons learnt and the added value of the InfAct peer assessment for the assessors., Methods: A qualitative evaluation of the peer HIS assessment was performed based on 12 semi-structured interviews: nine interviews were carried out with assessors from nine participating countries, and three with an observer (present during assessments). The interviews were carried out between May 2019 and January 2020. Interviews were analysed using qualitative content analysis., Results: The interviews revealed the experiences of the assessors mainly occurred in five areas: assessors strengthened their understanding of what a population-based HIS is; they strengthened their understanding of how a HIS operates in different countries; they learnt how to carry out a HIS assessment; they strengthened their organization, communication, negotiation and reporting skills and they strengthened the networks in health information within and between countries., Conclusion: Since the assessors are key personnel in their respective national health systems, the impact of the assessment is not limited to the assessor alone but may extend to stakeholders in their country. The deployment of the InfAct HIS peer assessment, anchored in systematic HIS capacity building across European countries, is recommended., (© The Author(s) 2023. Published by Oxford University Press on behalf of the European Public Health Association.)

Background: The Health in Prisons European Database (HIPED) aims to periodically collect data on prison health systems, services and health outcomes to inform equivalence of care for people living in prison. Recognized as the United Nations hub for health data in prisons, HIPED lacked an established framework to define its domains and indicators to measure progress. Therefore, the objectives of developing this framework were to inform surveillance systems at prison, local, regional, national and international level and to use it to guide improvement of prison health systems and cross-country comparison., Methods: The framework was conceptualized through identification of policy priorities and existing frameworks, notably the WHO Health System Framework. A consultation with a range of WHO stakeholders was conducted evaluating the components of existing frameworks and their relevance to the prison health context, as well as identifying areas needing further emphasis. The final stage identified the structure of the framework., Results: The framework consists of three main building blocks. The first captures the system-level aspects of prison health care (or inputs) whilst the second captures delivery aspects of prison health care (or outputs). These building blocks are in turn modified by two influencing factors. Ultimately, all these elements impact on the third building block, health outcomes. In addition, two cross-cutting principles associated with all these building blocks and influencing factors are included., Conclusions: A new framework for assessing prison health system performance is now available, crucial to support informed decision-making for policy design and implementation for prisons and other places of detention., (© The Author(s) 2022. Published by Oxford University Press on behalf of the European Public Health Association.)

Background: A Health Information System (HIS) assessment is an evaluation of the functioning of the main elements that compose a national HIS. Assessors from nine countries performed peer assessments of each other's national HIS in the Joint Action on Health Information (InfAct). The aim of this study is to evaluate the advantages and disadvantages of the InfAct peer assessment methodology as well as the different steps involved in this assessment process., Methods: Each peer assessment included a preparatory desk report, a country visit with semi-structured interviews with local stakeholders, a final report and a follow-up stakeholder meeting. A qualitative content analysis of the peer HIS assessment was performed based on 12 semi-structured interviews., Results: The main advantage of the assessments is its informal atmosphere, high degree of objectiveness and its networking opportunities. Disadvantages are its informal request format and setting for recommendation uptake. The peer assessment helped the assessors to broaden their understanding of the assessed and their own HISs, to gain knowledge on how to carry out an HIS assessment and to practice their organization, communication, reporting and negotiation skills. All steps of the HIS assessment are essential and each contributes to the enriching experience of the participants., Conclusion: The InfAct peer HIS assessment methodology strengthened capacity in national HISs by building up the knowledge and expertise in participating countries and as such addressed health information inequalities. This study confirms the value and relatively easy to implement methodology, and therefore recommends its wide and more systematic application across Europe., (© The Author(s) 2022. Published by Oxford University Press on behalf of the European Public Health Association.)

Background: The use of foresight studies is common in some policy fields, but not in public health. Interest in such studies is growing. This paper gives a general overview of the Dutch Public Health Foresight Study (PHFS) 2018, providing insight into what performing a broad scenario exercise in the field of public health entails and its societal impacts., Methods: The aim of the PHFS-2018 was: (a) to show how public health and healthcare in the Netherlands will develop over the next 25 years if we pursue our current course and detect 'new' developments; (b) to give options for dealing with the major future societal challenges. Part a was addressed by means of a quantitative business-as-usual scenario exercise complemented with qualitative thematic studies, and part b by elaborating courses of action for three key challenges, based on stakeholder consultation. Typical aspects of the PHFS methods are a multidisciplinary, participatory and conceptual approach and using a broad definition of health., Results: The PHFS-2018 is the basis for the upcoming National Health Policy Memorandum and the Trend Scenario is the baseline for the National Prevention Agreement. Unexpectedly, the findings about increasing mental pressure in young people received most attention. There still is room for expanding use of the study to its full potential., Conclusions: Long-term thinking could be stimulated by using back casting techniques and stronger involvement of policy-makers in the elaboration of options for action. Lessons learned from developing intersectoral policy at the local level could be applied at the national level., (© The Author(s) 2019. Published by Oxford University Press on behalf of the European Public Health Association.)

A European health information system (HIS) supports mutual learning between member states through international comparisons. In addition, it informs international policy agendas. Collaboration between the major stakeholders, most importantly the World Health Organization Regional Office for Europe (WHO-Euro), the European Commission and OECD, is important for member states, as this will contribute to better and more efficiently produced health intelligence. This paper focuses on this 'supra-international' collaboration. Although progress has been made, most notably in relation to joint data collections on monetary and non-monetary healthcare statistics, there is still room for improvement, both in relation to the harmonization of indicators and their underlying data collections, and the better coordination of reporting and research and development work. The working environment is complex, and differences between the (scope of the) health information activities of the three international organizations must be accepted. Yet there is enough common ground to build on. In addition, important barriers hampering further progress are the current semantic confusion about what constitutes a(n international) HIS, and inadequate coordination of national positions across various technical and political platforms of the international organizations. A pragmatic, bottom-up approach, instead of technically and strategically complex and comprehensive solutions, seems the best way forward. The current momentum created by EU-level developments and networks like the European Health Information Initiative of WHO-Euro provide an opportunity for taking the overarching European HIS to a next level., (© The Author 2017. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved.)

Background: For better supporting the science-governance interface, the potential of health assessments appears underrated., Aims: To identify what various types of health assessment have in common; how they differ; which assessment(s) to apply for which purpose; and what needs and options there are for future joint development., Methods: This review is based on five types of health assessment: monitoring/surveillance/reporting, assessment of health impact, of health technology, of health systems performance, health-related economic assessment. The approach is exploratory and includes: applying an agreed set of comparative criteria; circulating and supplementing synoptic tables; and interpreting the results., Results: Two of the assessments deal with the question 'Where do we stand?', two others with variants of 'What if' questions. Economic Assessment can take place in combination with any of the others. The assessments involve both overall 'procedures' and a variety of 'methods' which inescapably reflect some subjective assumptions and decisions, e.g. on issue framing. Resources and assistance exist for all these assessments. The paper indicates which type of assessment is appropriate for what purpose., Conclusions: Although scientific soundness of health assessments is not trivial to secure, existing types of health assessment can be interpreted as a useful 'toolkit' for supporting governance. If current traces of 'silo' thinking can be overcome, the attainability of a more unified culture of health assessments increases and such assessments might more widely be recognized as a prime, 'tried and tested' way to voice Public Health knowledge and to support rational governance and policy-making., (© The Author 2017. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved.)

Background: In recent years the literature regarding the cost-effectiveness of disease prevention and health promotion has grown exponentially. Aim of this study is to investigate: (i) how many and what type of economic evaluations have been published in 2008, (ii) the diseases or health problems World Health Organization International Classification of Diseases 10 chapters the economic evaluations of preventive interventions focus on, in relation to the global burden of disease and (iii) the cost-effectiveness of these interventions., Methods: Literature study of economic evaluations on preventive interventions in PubMed and Scopus., Results: In 2008, 232 economic evaluations of preventive interventions have been published. Of these studies, 75% (n = 175) used costs per (Quality Adjusted) Life Year [(QA)LY] gained as outcome measure. Most economic evaluations focus on the prevention of infectious diseases (31.5%, n = 73) and cancers (21%, n = 49) Infectious diseases are responsible for the highest global burden of disease (19.8%), followed by mental and behavioural disorders (11.7%). Of the included economic evaluations, 80% remained below a threshold of €50 000 and 60% below €20 000 per (QA)LY., Conclusion: This study shows that many economic evaluations of preventive interventions use a generic outcome measure. This adds to the comparability of different studies on the cost-effectiveness of prevention. Although the focus of published economic evaluations in general corresponds well with those diseases that cause a large share of the world's burden of disease, mental and behavioural diseases and diseases of the respiratory system remain underrepresented. Finally, it appears that the vast majority of published economic evaluations of preventive measures show favourable cost-effectiveness levels.