The ability of African countries to improve information and communication infrastructure in order to face the challenges associated with reforming health financing systems, including health insurance schemes, is likely to be the key determining factor of the pace of progress towards universal coverage in the region. Improved monitoring and evaluation mechanisms are necessary to support the reform of health delivery and health financing systems in line with universal coverage goals, within the specific political, social and economic conditions in individual countries. Monitoring and evaluation systems are critical for informing policy decisions and for assessing progress towards universal coverage, based on the goals, objectives and targets set in their country strategic frameworks. This requires setting an explicit, core set of indicators for monitoring and evaluation of progress towards universal coverage.

Strengthening monitoring and evaluation systems could be facilitated in the Africa region by the favourable environment associated with new information and communication technologies. These technologies open new opportunities for strengthening vital registration systems, health information and management systems, referral systems, identification systems, provider payment systems, financial and administrative management systems, and information-based decision-making in health care provider organizations, health insurance organisations, public health administrations and health insurance regulatory agencies. African countries could leverage opportunities provided by the improving information and communication infrastructure in individual countries, in combination with household surveys, facility surveys, public expenditure tracking surveys, actuarial studies and national health accounts to strengthen management capacities, transparency and accountability mechanisms, and monitoring and evaluation systems in the health sector.