Measuring people’s views on health system performance: Design and development of the people’s voice survey

• People should be at the center of health system performance assessment. Populations can provide critical insight on quality of care, confidence in health services, and health outcomes. • However, today’s measurement approaches overlook key dimensions of population perspective such as confidence in the health system. Surveys are rarely standardized to enable cross-country comparison. • The People’s Voice Survey (PVS) aims to fill this gap. The PVS is a novel multicountry survey of people’s perspective on health system performance. It measures a wide range of domains, including health status, health system utilization patterns, ratings of care quality, and confidence and trust in the health system. • The survey allows for a flexible, mixed mode design that uses telephone, online, and in-person data collection approaches to achieve a nationally representative sample of adults. Critically, the survey includes both health system users and non-users. It can be adapted for use in high-, middle-, and low-income countries. • We describe the motivation for this new instrument, the multistep collaborative development and validation process, and policy use cases for 19 countries participating in the first wave of data collection. • Findings from the survey can be used to integrate people’s voices into health system policymaking and guide strategic investments towards higher quality health systems.