Implementation of the Tallinn Charter in the WHO European region: where is the evidence? A systematic comparison of online information before and after the end of the year of signature.
BACKGROUND
The "Tallinn Charter: Health Systems, Health and Wealth" signed by 53 member states of the WHO European Region provides guidance for strengthening health systems.


OBJECTIVES
A systematic search was conducted to compare studies and actions related to the commitments of the Tallinn Charter.


MATERIALS AND METHODS
Target keywords were identified directly from the Charter. Structured web search was conducted on Pubmed/Google. Results for 2007-2010 were analyzed as frequencies before/after the end of the year of signature and classified by relevance and category of content.


RESULTS
Searches for 2007-2010 extracted N=717 papers in Medline and N=634 links in Google using combined keywords. Additional N=165 direct links to the Charter were found by Google for 2008-2010. An increase by 18% (scientific literature) and 10% (grey literature) was observed after 2008.


DISCUSSION
The number of conceptual, methodological, analytical or system evaluation reports related to the themes of the Charter increased after 2008, while benchmarking and cross-country comparisons were less frequent. Opposite trends were observed for the grey literature.


CONCLUSIONS
The implementation of the Tallinn Charter is supported by more information available on the topic. The methodology used to perform a rapid search may be usefully repeated to monitor the process.