EUROHIS: Developing Common Instruments for Health Surveys [antikvár]

Foreword The availability and quality of data from population health surveys in Europe have greatly improved over the last 10-15 years, particularly in the countries of central and eastern Europe. The survey approach is now fully recognized to be a valuable method for health monitoring that is complementary to the registration approach. Nevertheless, the comparability of health survey data remains a challenge. Difficulties arise from two main sources: "man-made" variations between surveys owing to methodological differences (for example, in the way that indicators and health conditions are defined) and "natural" differences between populations caused by varying attitudes, behaviour and concepts of health. Moreover, it is not always possible to reliably identify and separate the two. The establishment of agreed standards in terms of recommended common methods and measurement instruments can largely improve control of the first main source of incomparability and, at the same time, increase the relevance and reliability of survey data. This has immediate benefits for public health practice, as we continuously make international comparisons to provide evidence for health policies. In the long term, however, we must reach beyond international harmonization of instruments: we must greatly improve the scientific understanding of the causes of any significant incomparability of health surveys between countries. These tasks are impossible without sincere international collaboration, with careful consideration of the similarities and differences among health concepts, approaches and patterns in different countries and organizations. The knowledge derived from such projects should be used to customize health strategies, models and skills so that they are better tailored to the specific needs and resources of each country. The special added value of such research arises from the cross-fertilization of ideas between cultures (including organizational cultures), the facilitation of multidisciplinary research, and the creation of links between health research, health policy and the individual citizen. The EUROHIS project has capitalized on this thinking. The project has required financial and scientific input from many different sources as well as a carefully planned programme of work. In particular, the support and generous financial contribution of the European Commission's Biomedical and Health Research Programme (BIOMED 2), which has financed the project as a Concerted Action, is gratefully acknowledged. EUROHIS demonstrates how WHO and the Commission can work collaboratively to deliver results that have greater impact than if the organizations worked alone. The project has contributed to the objectives of both organizations. It has allowed greater cross-cultural diversity and has therefore produced results of more general validity and relevance. The success of the EUROHIS project is clear, but the full impact of it will be decided by the use of its recommendations by the public health authorities in the Member States.