PARIS 21 Meeting Ghana 27-28 July 2005

1. PARIS 21 Meeting Ghana 27-28 July 2005

2. Challenges in health information • Health Metrics Network • HMN Framework and profiling tool

3. An Information Paradox: Reporting of Mortality in the World

4. Data, Data, Everywhere ….

5. GHS report Maternal health survey SPA CWIQ CWIQ DHS 3 DHS 4 DHS 5 WHS Living Standards Survey 5 Living Standards Survey 4 Living Standards Survey 3 Census MICS 3 Data Collection in Ghana 1991-2008 (non-routine only) DHS 2

6. Data not trusted or used for policy-making at country level. Sectional interests, donor demand, inertia etc. Decision Making Weak Demand Donors focus on theirs Weak own Health data Little investment in health information systems. Information needs Limited capacity to generate or analyse data. System The Vicious Cycle

7. HMN Goal, Principles, Objectives Goal:Increase the availability and use of timely and reliable health information in countries and globally through shared agreement on goals and coordinated investments in health information systems Principles: Country ownership; Stakeholder involvement Objectives: • Develop framework and standards for health information systems • Support countries to implement plans adherent to the HMN framework • Develop incentives for enhanced dissemination and use of sound health information

8. HMN Framework • Description and standards for core data elements, data collection methods, data management, resources, data analysis and use. • Diagnostic tool; standardized self-assessment and learning tool DQAF for health • Principles and processes for strengthening country health information systems

9. Health Information System Comprehensive Approach Facility-based data disease surveillance patient & facility records facility surveys health system data (infrastructure, supplies, human, financial resources) Population-based data census vital statistics household surveys demographic surveillance HMN Ministry of Health National Statistics Office

10. Context, processes & resources 2. Data platforms Country Health Information System Profile • Outputs/results for selected indicators • Data synthesis, analysis and use Health Information System Profile

11. Rating Context, Resources and Processes; Thailand & Ghana 2005 % rating • Legal framework, coordination and planning • Human resources availability and skills • Infrastructure, equipment, information technology • Data flow and management, feedback Inadequate Satisfactory

12. Rating Context, Resources and Processes; Thailand & Ghana 2005 % rating • Legal framework, coordination and planning • Human resources availability and skills • Infrastructure, equipment, information technology • Data flow and management, feedback Inadequate Satisfactory

13. Criteria for assessment Contents Capacity Practices Dissemination Integration Data collection methods Census Vital statistics Population surveys Surveillance (acute & chronic) Services data (health facilities) System (administrative, financial) Assessment of Data Sources & Data Collection Methods

14. Rating Data Collection Platforms: Thailand & Ghana, 2005 Inadequate Satisfactory

15. Rating Data Collection Methods: Thailand & Ghana, 2005 Inadequate Satisfactory

16. Criteria for assessment Data collection method Timeliness Periodicity Consistency Representativeness Disaggregration Estimation method Core indicators Child mortality Maternal & adult mortality HIV/AIDS, TB, malaria Smoking, hypertension Immunization Service utilization Water & sanitation Assessment of Outputs % Indicators

17. Reconciling Data Sources

18. Reconciling Data Sources

19. Reconciling Data Sources

20. Rating Outputs/Indicators: Selected Countries, 2005 Inadequate Satisfactory

21. Rating Outputs/Indicators: Selected Countries, 2005 Inadequate Satisfactory

22. Data synthesis, analysis and use • Indicators in national data set linked to planning • Data available and compared across public, voluntary and private sectors • Summary reports covering key indicators produced at all levels • Summary reports targeted to different audiences, including policy-makers, parliamentarians, media, civil society • Evaluation of data and indicators documented • Ghana score: Inadequate Satisfactory

23. From Diagnosis to Action • Establish national coordinating mechanism - MOH, Bureau of Statistics, research & academic bodies, disease-specific programmes • Select essential indicators and develop integrated database – Data warehouse • Develop national health information system plan; better planning and coordination of household surveys • Develop health information system components; sample registration that includes causes of death; avoid less cost-effective methods such as maternal mortality surveys • Enhance synthesis and use of data for decision-making (linking inputs and outcomes) by combining data from all sources and linking to budgets and expenditure. • Support Health Statistics Resource Centre (software library, PDF electronic library).

24. HMN Support to Countries • Low and lower-middle income countries: technical and financial support up to $500,000 in a given year. Highest priority for HMN action. • All countries except high income countries: technical assistance plus limited financial support up to $100,000 in a given year • All countries except high income countries: technical assistance if they generate their own in-country financial resources. These countries can serve as regional centres of excellence and facilitate sharing of experiences.