Table 3 Possible sources of data for computing national HDGI

1.1 Leadership responsibilities

Conduct a survey among samples of stakeholders, e.g. civil society, health workforce.

1.2 National health policy (NHP)

Review of NHP.

1.3 National health strategic plan (NHSP)

Review of NHSP.

1.4 Dissemination of NHP and NHSP

Conduct a survey among samples of public and private health sector managers at various levels of health system, e.g. headquarters, provinces/regions, and districts. The survey questionnaire should be administered to civil society organizations and partners.

1.5 Implementation of NHSP

Review of annual health sector review reports & other monitoring & evaluation reports. Plus review of national health information systems (NHIS) data.

2.1 Existence of health-related legislation

Review of existing health-related laws.

2.2 Enforcement of health-related legislations

Inclusion of relevant questions in the survey mentioned in 1.4 above.

3.1 Participation in NHP and NHSP development

Conduct a survey among parliamentarians and civic leaders or administrative leaders (especially chiefs).

3.2 Participation in NHSP implementation

Inclusion of relevant questions in the survey mentioned in 3.1 above.

3.3 Participation in tracking of progress

Inclusion of relevant questions in the survey mentioned in 3.1 above.

3.4 Responsiveness to communities non-medical expectations

Exit client surveys among samples of different levels of health facilities, e.g. tertiary, provincial/regional and district hospitals, and health centres.

4.1 Intersectoral action

In-depth interview with prime minister/president's office.

4.2 Public-private partnerships

Review of health-related legislation & interviews of leaders of faith-based and private-for-profit health service providers.

4.3 Alignment of aid flows to national health development priorities

Interviews with Ministry of Finance and health development partners.

4.4 Strengthen capacity by coordinated support

Interviews with Ministry of Health regarding existence of Sector-Wide Approaches, multi-donor steering committees or equivalent mechanisms.

4.5 Use of country procurement and public financial management systems

Review reports of the Public Expenditure and Financial Accountability (PEFA) initiative [44]. If the data does not already exist use PEFA framework [45] to conduct the assessment.

4.6 Strengthen national capacity by avoiding parallel implementation structures

4.7 Aid is more predictable

4.8 Aid is untied

4.9 Shared analysis

4.10 Sufficient integration of global programmes and initiatives into NHSP

Interviews with Ministry of Health, Ministry of Finance, GFATM and GAVI.

5.1 Horizontal equity

Analysis of household surveys, e.g., World Health Surveys [43], LSMS [49], DHS [50], and MICS [51]. Other sources include household budget surveys, census data, facility-based surveys (exit polls), and routine data from NHIS, vital registration, etc [48].

5.2 Vertical equity

5.3 Fairness in financial contribution

6.1 Allocative efficiency

National NHIS: (i) health facility service data, e.g. numbers of curative and preventive outpatient visits, numbers of hospital admissions and discharges, numbers of hospital deaths, numbers of diagnostic services, volume of community-based health services; (ii) quantities and values of resources, e.g. supplies, health workforce, finances, infrastructure. If data is not available centrally, there may be need to collect it from health facilities, using existing questionnaires [63, 64].

6.2 Technical efficiency

6.3 Productivity growth

6.4 Institutionalization of efficiency monitoring

7.1 Existence of transparent results-oriented reporting and assessment frameworks

This data should be obtained simultaneously with that in 4.5-4.9.

7.2 Diagnostic reviews

7.3 Use of information from diagnostic reviews

7.4 Publishing of audit reports for public consumption

8.1 National health research systems (HRS)

Review existing Health Research Systems Analysis (HRSA) reports; and where non existent conduct an assessment of HRS using HRSA toolkit [65].

8.2 Health knowledge management systems (HKMS)

Review existing HKMS reports; and where they do not exist undertake an assessment of HKMS using "Research Matters" Knowledge Translation Toolkit [68].

8.3 Health management information systems

Review existing NHIS reports; and where non-existent conduct an assessment using Health Metrics Network tool [69].

8.4 Information, Communication and Technology Connectivity

Include relevant questions in the survey questionnaire mentioned in 1.4.

9.1 International ethical guidelines for medical practice and health research

This data should be collected simultaneously with that in 8.1 using same methods and tools.

9.2 Bioethics review system

9.4 Institutionalization of ethics training

10.1 Link between NEDP, PRSP and NHP/NHSP

Review of the NEDP, PRSP, NHP and NHSP

10.2 Existence of a MTEF

Review of MTEF document complemented with in-depth interviews with Ministry of Finance and Ministry of Health.

10.3 Political stability

Review of the national constitution, in-depth interview with chairperson of national legal bar association, and reference to both the Economist Intelligence Unit Democracy Index [40] and the Ibrahim Index [41].