Maximizing HMIS for Effective Health Management

1. Data Management and HMIS Facilitator: Dr. Lucie Blok Delhi, 31st Jan 2006

2. The Issue is not that we need more data…. .. but better use of data

3. A HMIS is a system of record-keeping, reporting, processing, analysis, interpretation, use, and feedback of information. HMIS: Definition

4. - Provides different levels of beneficiaries (clients, community, service providers, managers, planners and policy makers) with timely and relevant information HMIS: Functions • Used to formulate policy, to plan, implement, • monitor, supervise and evaluate health-related • activities • (adapted from Campbell, 1997)

5. Health status (through surveillance, surveys) Health-related interventions and services (activities, progress, quality) (through surveillance, program monitoring and evaluation) HMIS provides information on:

6. Monitoring and evaluation of control programs Plan actions, programs, and resources To prioritize the allocation of health resources To provide the basis for epidemiological research Accountability Purposes of HMIS: Evidence-Based Decision Making

7. Where are we now? Situation Analysis Where did we reach? Evaluation Where do we want to go? Objectives HMIS Is everything going according to plan? Monitoring Identifying constraints Taking action Which route shall we take? Strategy How shall we travel there? Plan of Activities Management cycle

8. Context: Political commitment Access and utilisation of services Socioeconomic conditions Epidemiological context (HIV, nutrition) M&E Framework in TBCP Input Process Output Outcome Impact Source: WHO: (2004); Compendium of indicators for monitoring and evaluating national tuberculosis programs,

9. Top-down control, leaving out lower level Unclear objectives and targets Too much working time spent on HMIS No guidelines Not enough skills Not enough staff Fragmentation in services Problems in HMIS 1: Design

11. Too many records Too late Poor quality Poor lay-out, confusing terminology Incomplete Potential exclusion of private and hospitalized patients Inflexible data collection Resistance to change Problems in HMIS 2: Collection

12. Data not analysed to produce information, but just forwarded upward No indicators to assess progress Presentation not clear, out of date Management culture does not value information (decision-making on intuitive or political basis only) Political use (coverage = 1 microscope per dist) Problems in HMIS 3: (Self-) Assessment

13. Inadequate training for managers Data not available for the right persons at the right time No feedback to lower levels, no pressure to use data Data not used for supervision Rigid criteria (success rate in the era of HIV) Problems in HMIS 4: Use

14. Provides all information required Is easy to implement Requires minimal staff time Is consistent with other management and recording systems in place Is useful for all stakeholders and is used A good HMIS system:

15. Question 1a: What are the main challenges in your country regarding design of the HMIS? Question 1b: What solutions do you suggest? Group work HMIS - challenges

16. Question 2a: What are the main challenges in your country regarding the collection andquality of data that you receive? Question 2b: What solutions do you suggest? Group work HMIS - challenges

17. Question 3a: What are the main challenges in your country regarding the use of data collected on TB management? Question 1b: What solutions do you suggest? Group work HMIS - challenges