Furthermore, many of the indicators featured across all of these tools are investment-focused and capacity-focused. Future monitoring and evaluation efforts might benefit from deeper engagement with outcomes of health systems-strengthening and health security-strengthening efforts, such as health service coverage, health equity and health system failures. Subsequent iterations of the GHS Index specifically will have to contend with gaps in public data availability that disproportionately affect scores in LMICs. Inclusion of metrics capturing the quality and effectiveness of decision-making during a crisis might strengthen the tool even further.