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Congratulations to Mongolia on its 800 Anniversary from HMN. Reforming Health Information Systems: The HMN Framework High Level Forum on Strategic Planning for Statistics Ulaanbataar 9-11 October 2006 Dr. Lene Mikkelsen. www.healthmetricsnetwork.org. What is health information? .
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Reforming Health Information Systems: The HMN Framework High Level Forum on Strategic Planning for Statistics Ulaanbataar 9-11 October 2006 Dr. Lene Mikkelsen www.healthmetricsnetwork.org
What is health information? Information about: “…all resources, organizations and actors that are involved in the regulation, financing, and provision of actions whose primary intent is to protect, promote or improve health” WHO 2000
Edu. Agri. Health Labour National Strategies for the Development of Statistics Integrating Health Statistics into Overall Statistical System
A complex field Users: general public, patients, communities, service providers, managers, policy-makers, donors and global agencies. Information covering: mortality, morbidity, disease outbreaks, determinants of health, access to, coverage and quality of services, cost and expenditure. Sources: vital registration, census, household, facility and district surveys, routine clinic based data, disease surveillance, national health accounts and modeling.
Why do we need to reform HIS? • Widespread dissatisfaction among both users and producers of HI • Complex and unwieldy; fragmented by disease-focused programs and donors; • epidemic of indicators; burdensome demands on health personnel; • Poor quality of data; lack of common standards; data inconsistencies and inefficiencies; difficult to analyze and synthesize • Oversupply of data coexisting with large unmet needs • Poorly integrated into national statistical system and into broader statistical and development processes
What is Health Metrics Network? • Global health partnership launched in 2005 to assist LDCs in improving their HIS • Partners include developing countries, global agencies, foundations and technical experts in various countries • Funding • USD 50 millions from Gates Foundation • Also Danida, DFID, USAID, EC & WHO • Timeline • First phase 2005-2012
HMN Support to Countries • All countries have access to HMN framework, assessment and monitoring tools. • Low and lower-middle income countries are eligible for long-term technical and financial support up to $500,000 in a given year. • All countries can participate in HMN workshops and training activities but only low and lower-middle income countries will be funded
HMN Goal and Objectives Goal: • Increase availability and use of timely, reliable health information through shared agreement on goals and coordinated investments in health information systems Objectives: • Promote a harmonized framework for health information systems • Strengthen country health information systems by assisting them applying the framework, by offering technical and financial support • Improve access, quality and use of health information nationally and at the global level
HMN Guiding Principles The process should be: - nationally led and owned - link health and statistical constituencies and involve all stakeholders - respond to country needs and build upon what exists - draw on best international standards and be guided by the Fundamental Principles of Official Statistics - be tackled as a gradual process requiring long-term investment
HMN Framework Health information system components & standards Roadmap for implementation Principles HIS resources Indicators Process Data sources Tools Data management Information products HMN GoalIncrease availability, accessibility, quality and use of health information that are critical for decision making at country and global levels. Dissemination and use
Census Civil registration Pop based surveys Health & disease records Health administrative records Service records (HMIS) Health Data Sources Population-based Health services based
HMN’s Assessment and Monitoring Tool Purpose: - to provide a diagnosis of the national HIS What it is and does: - a set of structured questions (274) and a scoring mechanism - identifies strengths, weaknesses and gaps in all six components of current HIS - establishes a baseline for the country What is its value-added: - involves all major stakeholders - encourages consensus building - provides the evidence for the strategic plan - ensures that the same measure is used for all countries
Use of Initial HMN Grants • Assessment of the current status of the health information system, using HMN tool, standardized framework for quality review • Development of a 2015 plan for health information system development, linked to national health sector and poverty monitoring strategies and planning cycles • Building capacity for data generation, analysis and use • Focus on specific issues: monitoring vital events , private sector data, data dictionaries, data warehousing
Round 2 Grants In 2006 HMN has had workshops in L-A, Caribbean and the Middle East • 2nd Call for Proposals. Deadline August 31, 2006. • Limited to countries not receiving support in Round 1 • Grant ceiling set to $50,000 covering only the assessment with stakeholders and developing a 10 year strategic improvement plan • 58 Proposals received which will be reviewed by HMN Secretariat, (based on criteria set forth by Independent Review Ctte)
Ways that NSO statisticians can contribute to strengthening HIS • Provide high level support and guidance for the assessment and strategic improvement plan • Active and continued participation in the assessment of the HIS together with other stakeholders to ensure a good outcome • Send participants to HMN training workshops • Participation in the group tasked with drafting the strategic 10 year plan for reforming the HIS • If requested, organize training to health staff in data collection and data quality issues • Help link to broader statistical and development processes as well as integrating health statistics into NSDS
The Vicious Cycle Decision-making Weak demand based on sectional interests, donor demand, inertia etc. for data for policy-making. Data not trusted or used. Weak health information Systems. Donors focus on their own data needs; Limited capacity to generate or analyse data. Little investment in health information systems.
Creating a Virtuous Cycle GFATM, GAVI. President's Initiative, MDGs: results-based decision-making Health sector reform, SWAPs. PRSP, civil society, media, use of IT Global initiatives Increased Demand Donors agree to align efforts Increased Multiple stakeholders – health and statistics Focus on building systems able to respond to country and donor needs. Coordination