Planning for Health for All: international experience in setting health goals and targets

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Abstract
In recent years several countries and regions within countries have developed national health goals and targets in order to make explicit the achievements they expect from their investment in health, as a guide to health policy development, and/or to assist in decisions about resource allocation. These health targets have been developed using different conceptual frameworks, and widely differing mechanisms for implementation and monitoring have been adopted. This review examines experience in setting and using national health goals and targets in five developed countries and regions about which published information is available. Overall, it appears that the potential of health goals and targets to influence national health policy, resource allocation and population health outcomes has not yet been achieved fully in the countries and regions examined. Most have achieved important successes in re-orienting health systems and in increasing health promotion activity. To date, only the US has had experience in using targets to guide public policy over an extended period, and here the evidence of effect is encouraging. In the 1990s a more systematic approach to the achievement of targets has been adopted, particularly in the US, the UK and Australia. In each case more explicit steps have been taken to link the achievement of targets to health system planning, management and, to a lesser extent, funding, and greater emphasis has been given to the need for all sectors of government to contribute to improving health of the population. Progress will need to be carefully monitored in these countries to identify the strengths and weaknesses of these approaches.

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