The concept of indicators development has already a long trajectory in the public health field. Since the end of the 18th century, information on the health of communities has been gathered on a health system level, and public health indicators have become more sophisticated over the years. The development and use of indicators is an integral part of planning and designing health services, as they are management tools for health care services and health systems.

The Council of the European Union, in its Recommendation of 8 June 2009 on an action in the field of rare diseases, recommends that “Member States elaborate and adopt a plan or strategy as soon as possible, preferably by the end of 2013 at the latest, aimed at guiding and structuring relevant actions in the field of rare diseases within the framework of their health and social systems".

EUROPLAN Indicators. In order to sustain this process, the programme of Community action in the field of Public Health supported “EUROPLAN 2008-2011", which aimed to develop tools and activities that would help EU countries to establish and implement national plans or strategies in the field of rare diseases. Among the documents and the tools elaborated, there is a “Report on indicators for monitoring the implementation and evaluating the impact of National Plan or Strategy for rare diseases".

The development and use of indicators is an integral part of planning and designing health and social services, as they can be used as management tools for health care and social services and health systems, as well as to monitor the implementation of National Plans for Rare Diseases.