The SCORE for health data package uses five interventions:

Survey populations and health risks; Count births, deaths and causes of death; Optimize health service data; Review progress and performance; Enable data use for policy and action. Each intervention has a set of key elements, which is accompanied by a set of indicators. In total, there are 24 quantitative and qualitative indicators for assessing SCORE interventions at various levels. The SCORE Assessment methodology 2020 complements the SCORE Global report on health data and capacity, 2020, and explains how countries were assessed and scored by five interventions and the accompanying elements and indicators.

SCORE Assessment instrument and indicators:

The SCORE Assessment instrument and the accompanying indicators were used to collect data to assess the Health Information Systems (HIS) in countries. They were developed in consultation with World Health Organization (WHO) country representatives, and technical experts from WHO regional offices and headquarters, and also drew upon the expertise and experience of external agencies and individual experts. Data gathered for the Global report on health data systems and capacity were initially obtained through a desk review of qualitative and quantitative data from multiple sources, including global, regional, and national survey reports, regional and national health information databases, national birth and death registration portals, and health facility data. These preliminary data and assessments were shared with countries for review and input through WHO regional and country offices, and validated, most commonly, by the ministry of health. During the review and verification process, additional data were also submitted by multiple institutions, including ministries of health, national public health institutions, bureaus of statistics, ministries of finance, and other bodies responsible for specific data areas. Overall, 133 countries validated the data or provided permission to use the data from the desk review. Country sign-off: Collated data and assessments for each country (in the form of a summary sheet and draft country profile) were sent to respective governments for review and sign-off. Any changes requested or made by national authorities required supporting documentation verified by WHO SCORE focal persons. Some countries provided (caveated) permission to publish results which include an additional note indicating that validation is still awaiting completion due to delays related to the COVID-19 pandemic. When finalized these results will be updated online.

Scoring methodology:

Scoring is based on a maturity model where, at the end of a complete assessment, a country scores 1-5 for each of the five interventions: 1 reflects nascent capacity of the health information system and 5 represents sustainable capacity. For each intervention there is a set of key elements. Each key element is measured by one or more indicators and each indicator is defined by a set of attributes or items. Scoring begins at the indicator level by assessing the attributes. Reviewers assess each indicator attribute against a publicly available and verifiable source document (or website). Reviewers must provide documentation of the data sources for each indicator scored. In the case of multiple items, the indicator is scored by taking the sum of these item scores and comparing it to a maturity model. If there is more than one indicator within an element, the indicator scores are averaged to get the element score. Each intervention score is a weighted mean of the element scores within the intervention. Due to concerns about data availability and/or comparability, not all indicators or key elements were used in calculating a country’s score.