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Monitoring Health Information Systems Meeting on Health System Metrics Glion, 28-29 September 2006

Monitoring Health Information Systems Meeting on Health System Metrics Glion, 28-29 September 2006. www.healthmetricsnetwork.org. Monitoring the performance of the health information system.

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Monitoring Health Information Systems Meeting on Health System Metrics Glion, 28-29 September 2006

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  1. Monitoring Health Information Systems Meeting on Health System Metrics Glion, 28-29 September 2006 www.healthmetricsnetwork.org

  2. Monitoring the performance of the health information system • HMN approach – country-based effort to monitor all components based on a comprehensive framework for the health information system • Development of simplified approaches that could lead to comparable data that can be monitored on a regular basis • Scoring health statistics • Single data source: civil registration coverage • Scoring data production efforts

  3. 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

  4. Components of a HIS • Resources ─ policy, legislative, regulatory, management and financial environment that must be in place; and the infrastructure and resources required to ensure a fully functional health information system. • Indicators ─ defining core health indicators covering the domains of health information. • Data sources ─ key data sources, standards for their use, their role in generating health information and potential linkages between them. • Data management ─ optimal processes for collecting, sharing, and storing data, data flows and feedback loops. • Information products ─criteria for assessing the quality of available data. • Dissemination and use ─norms for presenting, disseminating data and sharing information among stakeholders and creation of incentives for evidence-based decision making.

  5. HMN Situation Analysis Tool • Spreadsheet based tool with over 200 items • Broad based application within country with participation of large number of stakeholders • Objectives: • Establish a baseline and monitor progress in country • Identify strengths and weaknesses; priority areas • Rates aspects of the health information system • Country scores are converted to quintiles for the overall report • Lowest quintile (<20th percentile) >> Not adequate or not functional • Second quintile >>> Present but not adequate • Third quintile >>> Partial adequate • Forth quintile >>> Adequate • Fifth quintiles >>> Highly adequate

  6. Not adequateat all Present but not adequate Adequate Highly Adequate Partial adequate Key: Rating Context & Resources for HIS; Thailand & Ghana 2005 Note: Results of assessment based on early version of tool.

  7. Potential for use of HMN tool to monitor HIS • Strengths: • Attempt to take a comprehensive approach • Aims direct link with planning and investments into HIS • Based on participatory approach • Country specificity taken into account • Aim to complete once every 3 years • Limitations • Comparability of data between countries may be limited (initial work with anchoring vignettes not successful) • Too extensive to complete on a more frequent basis

  8. Monitoring the performance of the health information system • HMN approach – country-based effort to monitor all components based on a comprehensive framework for the health information system • Development of simplified approaches that could lead to comparable data that can be monitored on a regular basis • Scoring health statistics • Single data source: civil registration coverage • Scoring data production efforts

  9. Criteria for assessment Data collection method Timeliness Periodicity Consistency Representativeness Disaggregration Estimation method Core indicators Health status Mortality (child mortality, MMR) Morbidity (HIV, TB, underweight Health service coverage (measles, skilled birth attendances) Health system (financial resource, HR) Risk factors Assessment of Outputs & Indicators

  10. Rating Outputs/Indicators (17 indicators): Selected Countries, 2005 (based on 5 raters)

  11. Potential for use of HMN tool to monitor HIS • Strengths • Component of overall HMN HIS assessment tool • Uses DQAF derived criteria for assessing the quality of the late health statistics • Includes a wide range of indicators • Limitations • Current tool still leaves considerable room for subjective judgment which may limit comparability • Use as a monitoring tool untested • Major effect of a national household survey that could be temporary if survey frequency is low • Does not provide information on other key components of HIS

  12. Monitoring the performance of the health information system • HMN approach – country-based effort to monitor all components based on a comprehensive framework for the health information system • Development of simplified approaches that could lead to comparable data that can be monitored on a regular basis • Scoring health statistics • Single data source: civil registration coverage • Scoring data production efforts

  13. Single indicatorCoverage of death registration data

  14. Potential for use of HMN tool to monitor HIS • Strengths: • Relatively easy to obtain data on a regular basis • Results easy to communicate • Priority area for intervention identified by HMN and its partners • Limitations • Captures only one data source of health information systems • Changes occur very slowly, only useful to monitor with long intervals

  15. Monitoring the performance of the health information system • HMN approach – country-based effort to monitor all components based on a comprehensive framework for the health information system • Development of simplified approaches that could lead to comparable data that can be monitored on a regular basis • Scoring health statistics • Single data source: civil registration coverage • Scoring data production efforts

  16. Criteria for assessment Contents Capacity Practices Dissemination Integration Data collection methods Population surveys Census Vital statistics Services data (health facilities) Surveillance (acute & chronic) System (administrative, financial) Assessment of Data Sources & Data Collection Methods – HMN tool HMN tool uses series of criteria to score the strength of each data source

  17. Simplified method based on Simplified method to rate functioning of key data sources according to specific benchmarks

  18. Health Information System score -Data collection score (% of maximum)Selected countries, 2000-2005 46% 42% 36% 32% 25% 13%

  19. Potential for use of HMN tool to monitor HIS • Strengths: • Easy to produce a score on a regular basis • Promotes the use of specific benchmarks for HIS data sources • Can be done objectively at international level • Specifies different components • Limitations • Data refer to five year period preceding assessment, change may be slow • Standards or benchmarks used to score subject to discussion and inter-country variation

  20. www.healthmetricsnetwork.org

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