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

This paper reviews 10 years of experience in using health goals targets and objectives as a planning mechanism. The US was the first country to develop national health goals in 1980. In 1985 the World Health Organization (WHO) produced a defined set of "Targets for Health for All." This review includes the experiences in the US Australia New Zealand England and Wales and the WHO Regional Office for Europe. These countries used different approaches in defining targets and in achieving the defined targets. Each countrys approaches are described. The WHO uses goals and targets in order to define differences in health status between populations and to reduce these differences. Better data are now available for improving the understanding of the personal economic environmental social and health service factors associated with health. Monitoring of defined targets in the US over a 10-year period has resulted in more improvements in targeted areas than nontargeted areas. In 1988 Australia established national targets. Targets in Australia influenced the formulation of its first national health policy. A stronger infrastructure for health promotion was developed. The evidence that links objective setting to health improvement is not readily available. It appears that target setting may result in a focus on a comprehensive health policy changes in resource allocation and methods and structures for improving population health. All countries were concerned about greater efficiency in health system investment. Wales is developing less emotional methods for decision making about health services. The US spent more time on data collection than on implementation. Australia was preoccupied with health issues where there were data. A balance between these two approaches is desirable. New Zealands program priorities and resource allocation changed with changes in politics. Health goals should be used to guide and measure the results of health system investments.