1. The role of routine health information systems in the post 2015 development agenda1 |
The role of Routine Health Information
Systems
in the post-2015 development agenda
Vancouver. November 2016

2. The role of routine health information systems in the post 2015 development agenda2 |
New information demands on the post 2015 agenda
Only in 2016, 18 countries of the WHO AFRO
region were developing the M&E plan of the
national health strategy

3. The role of routine health information systems in the post 2015 development agenda3 |
Why is facility data important in the post 2015
context ?
 Continuous; only source
 Subnational; Important equity dimension;
 Multiple uses – Programme management,
performance monitoring, quality of care,
disease surveillance, health system
performance assessment
Examples of facility-based indicators
Availability of essential medicines,
commodities; & stock outs;
Service availability & readiness
(interventions offered, & adherence to
standards of care)
TB treatment success rate, ART
retention; Client satisfaction
Coverage : FP use, antenatal care,
PMTCT, postnatal care, delivery,
immunization, vitamin A, ART
Leading OPD diagnosis, malaria case
rates (lab confirmation); TB
notification;
Hospital mortality and causes of death
For 8 out of 26 of the indicators of the SDG-3,
the preferred source of data is facility level
data

4. The role of routine health information systems in the post 2015 development agenda4 |
Sustainable development goals 3: HEALTH CRVS Survey Facility Other
Maternal mortality ratio X X (X) Sampling,
sentinel sites
Skilled birth attendants X X
Under-5 mortality rate X X
Neonatal mortality rate X X
Number of new HIV infections per 1,000 X surveillance Spectrum
TB incidence per 1,000 population X surveillance
Malaria incidence per 1,000 surveillance
Hepatitis B incidence per 100,000 population X
Number of people requiring specific interventions against NTDs estimation
Mortality rate from cardiovascular
diseases, cancer, diabetes or chronic respiratory diseases
X X
Suicide mortality rate X special studies
Treatment coverage for substance abuse disorders
Alcohol per capita consumption X administrative
Death rate due to traffic road accidents X
Family planning coverage rate X X
Adolescent birth rate per 1,000 women X X
Coverage of essential health services X X
Number of people covered by a health insurance or public health system per 1,000
population
Mortality rate attributed to household and ambient air pollution X
Mortality rate attributed to unsafe water, unsafe sanitation and lack of hygiene X
Mortality rate attributed to unintentional poisoning X
Prevalence of tobacco use 15 years + X
Access to affordable medicines and vaccines on a sustainable basis X facility surveys
Total net ODA to medical research and basic health sectors
Health worker density and distribution Health worker
registry
IHR capacity and health emergency preparedness Key informants

5. UHC tracer indicators Surveys Facility Others
1. RMNCH
1. Family planning coverage X X
2. ANC4 X X
3. Immunization coverage X X
4. Care seeking for pneumonia X
2. Infectious disease control
1. TB cases detected and treated X surveillance
2. HIV receiving ART X
3. Insecticide treated bed nets X
4. Improved sanitation X
3. Noncommunicable diseases
1. (Non)-Elevated blood pressure in adults X (X)
2. (Non)-Elevated blood glucose in adults X (X)
3. Cervical cancer screening X X
4. Non-use of tobacco X
4. Service capacity and access
1. Inpatient admissions rate X
2. Health professionals per capita X
3. Availability of essential medicines X (HFAs)
4. IHR core capacity index Key
informants
NOTE: blood
pressure and
blood glucose
likely will
change to
treatment of
BP and
diabetes

6. The role of routine health information systems in the post 2015 development agenda6 |
What are the major challenges /gaps?
 Data quality inadequate
 Private sector often not captured
 Key data gaps/challenges
 Hospital reporting of deaths,
causes
 quality of care
 Community service delivery
 Poor analytical capacity and use
 DISAGGREGATION AND EQUITY
 Parallel vertical systems
 Separate, single-topic facility
surveys
 Fragmented, unconnected,
unsustainable systems
 Mushrooming of indicators; Heavy
burden on health workers
 Duplication & inefficient
investments

7. The role of routine health information systems in the post 2015 development agenda7 |
In Cambodia, the Time and Motion study identified 20 monthly forms out of 44
reporting forms are in use and require a total of 45 hours per month to complete -
the HC Monthly requires 21 hours on its own

8. The role of routine health information systems in the post 2015 development agenda8 |
In Sierra Leone, there are >15 information systems collecting information routinely
from facility and community level. Systems are not interoperable nor integrated
currently.
Source: Sierra Leone Health Information Systems Interoperability Meeting 24 August 2016 | Bintumani Hotel

9. The role of routine health information systems in the post 2015 development agenda9 |
What are the opportunities & innovations?
 Growing demand for
accountability & better
results
 Major growth in
innovations in ICTS
 Advances in data
standards & methods,
survey tools
Web-based facility systems- (e.g DHIS 2.0)
Electronic health records - (e.g. ART, TB patient
monitoring)
Mobile devices to manage stock outs of
medicines (e.g Rapid SMS); notification of
events
Automated systems for coding of cause of
death (e. IRIS, CODEIT)
Visualization tools & analytics, scorecards,
dashboards, observatories
Rapid tools for assessing service delivery &
quality eg SARA, SDI SPA)

10. The role of routine health information systems in the post 2015 development agenda10 |
The Heath Data Collaborative
January 2015 June 2015 September 2015 January 2016 March 2016
Draft roadmap
for measuring
health SDGs
M4Health
Summit:
5 point call to
action
Global Health
Agency Leaders
meeting
Calls for
agencies to
develop joint
plan to support
countries
HDC operational
work-plan scope
and key
deliverables
agreed
HDC launch at
UN Statistical
Commission
with over 32
partner
commitments

11. 11
The approach: to enhance efficiency of current investments in
health information systems
CHANGING THE WAY WE WORK TOGETHER

12. Measurement and accountability for health:
The role of health facility information systems in the post 2015 development agenda12 |
Country & regional platforms
Existing collaborative platforms
HDC Working Groups
Operating through thematic technical Working Groups

13. 13
1. Review, harmonize & disseminate standards for improved facility and
community based reporting
2. Identify ways in which investments in HMIS can be better aligned to ensure
scale-able integrated, sustainable systems
3. Identify & agree on protocols and standards for integrating disease surveillance
into routine HMIS
4. Catalyse joint support to countries to scale up and strengthen integrated facility
systems, based on international standards and good governance
5. Joint support for analysis and use of facility data for action
Global deliverables
•Package of data standards & tools -
indicators, metadata, data quality, ICD
coding, master facility lists, analytical
outputs, template forms, open access
•Standards & protocols for integrating
disease surveillance into routine HMIS
•A joint investment plan for DHIS 2.0
development, implementation and
maintenance
Country deliverables
•Aligned support to scale up and strengthen
integrated facility based health information
systems, including IDSR, based on
international standards
•Documented country best practices &
guidance for sound governance
Technical working group on routine health information systems
Scope of work

14. Measurement and accountability for health:
The role of health facility information systems in the post 2015 development agenda14 |
 Significant uptake by
countries for monitoring
national health sector
performance
 Aligned with health SDGs
monitoring agenda, UHC
2030, Global Strategy for
Women, Adolescents &
Children, NCD
monitoring..
 2016 update due by end
of year
Global Reference List of 100 Core Health Indicators

15. Measurement and accountability for health:
The role of health facility information systems in the post 2015 development agenda15 |
Progress:
 More and more programmes
& countries moving towards
DHIS 2 platform
 Partners begin working on
joint investment & core
functional requirements
But .. much more required :
− to establish sound
governance at country level
− To integrate public heath
surveillance into RHIS
− To build adequate capacity in
analysis and use
From vertical reporting systems
… towards a common data platform

16. Measurement and accountability for health:
The role of health facility information systems in the post 2015 development agenda16 |
“Monitoring the Global Strategy requires substantial
investments in data collection, compilation, analysis,
communication and use in countries. The Health Data
Collaborative and others must play a critical role to:
•Advocate for and invest in strengthening CRVS
systems through the CRVS window of the Global
Financing Facility;
•Ensure every country has a regular programme of
health surveys;
•Focus on disaggregated data to address equity and
human rights considerations so that no one is left
behind:
•Improve monitoring of health system resources such
as financing, workforce and access to medicines”
Progress:
 Joint curriculum developed with
other tools including data quality
review, analyses, best practices for
governance
 Combining efforts to build regional
networks in data analysis & use
But :
− Much more needed to avoid
development of separate tools &
guidance & capacity building
programmes
Joint curriculum on data analysis & use
Working together to build institutional capacity

17. Measurement and accountability for health:
The role of health facility information systems in the post 2015 development agenda17 |
……… ON-SITE DATA VERIFICATION
(OSDV) ……….
From multiple disease-specific data quality tools
… to a harmonized approach

18. Measurement and accountability for health:
The role of health facility information systems in the post 2015 development agenda18 |
ALL STAKEHOLDERS SUPPORTING
KENYA’S M&E PRIORITIES
•Data analytics capacity
•Quality of Care
•Kenya Health Observatory
•CRVS
•Mid-term review
“WE NOW EXPECT ALL HEALTH
DATA COLLABORATIVE PARTNERS
TO PULL IN THE SAME
DIRECTION.”
Dr Nicholas Muraguri, Principal
Secretary, Kenya MOH
Kenya Health Data Collaborative
(launched May 2016)

19. Measurement and accountability for health:
The role of health facility information systems in the post 2015 development agenda19 |
Role of regional networks
 Promote peer learning and review
 Promoting a culture of data use in countries
 Roll-out public goods to country level- need of
strong global and regional networks
What is next ?
Some Health Data Collaborative progress
• Inter country conference on measurement. AeHIN
(Bangladesh, April 2016)
• African Regional Health and Accountability Dialogue
(Lagos, 2016)
• BIG (Better use, Improved action, Good data) campaign
• West and Central Africa work on DHIS2

20. CONCLUSION: Something
needs to change…

21. Thank you
WHO. Global Platform for Measurement and
Accountability
Kathy O’Neill- Unit coordinator oneillk@who.int
Eduardo Celades- Technical officer celadese@who.int
Maki Kitamura- Communications officer kitamuram@who.int