Health targets and priorities in Catalonia, Spain.

Background: The strategy of Health for All (HFA), which was formulated by the World Health Organization (WHO), was endorsed by the Spanish Government in 1990. After that, Catalonia, one of the 17 regions of Spain, created the Catalan Health Service and developed the health plan for Catalonia in which health targets were formulated as a tool for policy making. This paper describes the process of elaboration, implementation and evaluation of the health plan. Methods: The dynamic process of drawing up the health plan was done through several steps: situation analysis, selection of main problems and priority interventions and formulation of health targets to be achieved by the year 2000. The health plan was disseminated and political accountability was defined. Implementation was conducted through a process of consensus on the activities to be carried out and its inclusion in a services contract. Evaluation was by checking the attainment of targets from an epidemiological basis and monitoring process and outcome indicators. Results: Up to now, three editions of the health plan have been produced, each including new operational targets based on the resuts of former evaluations. Five consensus documents on preventive activities have been published and several evaluation studies have been carried out. When estimating the expected results, it turns out that the attainability of general health targets is much better than for risk reduction ones. Conclusions: Setting targets is a useful tool in establishing priorities in health policy. It has facilitated situation analysis, implementation of interventions, evaluation and teamwork. However, in the practical use of health targets we are at the beginning of the learning process, which is still a challenge. [ABSTRACT FROM AUTHOR]