WHO has developed a hierarchical approach to monitoring and assessing pharmaceutical situations that consists of three levels of indicators and corresponding data collection tools: Level I structure and process indicators that can be completed by knowledgeable individuals with no ad hoc data collection; Level II access and rational use outcome indicators that are measured using facility and household surveys; Level III indicators that are measured using in-depth surveys of specific aspects of pharmaceutical systems.

The WHO pharmaceutical sector monitoring and assessment methodology has continuously evolved to meet emerging needs, while incorporating improvements based on feedback from countries using the methods. The present approach, developed in 1999 for Level I and in 2000 for Level II indicators, has been applied in many countries. The approach has many advantages: numerous countries measuring indicators using consistent methods; possibility of comparing and disseminating results; and the possibility to assess progress towards defined targets.

A meeting of experts was organized in July 2006 to discuss the current status of WHO indicator-based pharmaceutical assessment and monitoring approaches and to make recommendations for future improvements. The objectives of the meeting were: (1) to review global progress on measuring pharmaceutical indicators; (2) to address perceived limitations in the Level I tools; (3) to review existing Level III tools to determine if key Level III indicators could be incorporated in the current Level II tool; (4) to assess the adequacy of the existing Level II household survey in measuring population-based indicators of access and rational use; and (5) to discuss the feasibility of formulating and validating composite indicators based on Level I data as proxy measures for Level II outcome indicators...