This document discusses strengthening routine health information systems in Africa through regional collaboration. It reviews where sub-Saharan Africa is currently in terms of health information system development and global trends. It explores existing networks like the African Centre for eHealth Excellence and the HISP network that can be leveraged. Finally, it proposes next steps like consolidating the efforts of these networks to implement a 5-point call to action and developing a monitoring and evaluation framework for peer review across countries.

1. Strengthening RHIS in Africa
Improving Regional Collaborations
• Vincent Shaw: Executive Director
14 November 2016

2. 2
Aim of the Presentation
• Take stock of where we are as a sub-
region in terms of Routine Health
Information Systems Development
(RHISD)
• Review global trends in RHISD,
especially implications of the MA4H
5-Point Call to Action
• Explore existing networks
• Present an approach for RHISD
activities in Sub-Saharan Africa and
Southern Africa

3. Where are we in terms of HISD
3
• Roadmap for Health Measurement and
Accountability
• DHIS platform provides a robust base for
measurement of health services
• However, challenges remain around:
– Data quality
– Fragmented interventions across donors, and
implementing partners
• Realisation that in many countries, we still cannot
report accurately on key indicators such as the
SDG’s, and key systems such as surveillance systems
are fragile
• Despite these challenges, the expansion of the
internet, and technological developments are
pushing us toward new frontiers, including patient-
based data collection

4. 1. Increase level and efficiency of investments by Government and Development
Partners to strengthen Country IS
– By 2020 DP investments are fully aligned in single country platform
2. Strengthen country institutional capacity to manage and use data at all levels
– By 2020 countries have annual transparent reviews of health progress and system
performance
3. Well functioning sources for Population data (CRVS), census and health surveys
– By 2025 regular comprehensive program of surveys
– 2020 round of census completed
4. Maximise opportunities provided by the data revolution, based on open standards, to
improve health facility and community information systems incl. disease surveillance,
financial, and health workforce accounts to empower decision makers at all levels
– By 2020 countries are IHR compliant and have effective real-time surveillance systems in place
– By 2025, 80% of facilities report health statistics using real-time electronic systems
5. Regular transparent reviews of progress and performance at all levels of the health
system
– By 2016 a global co-ordination and accountability mechanism is functioning producing regular
reports and holding reviews regular comprehensive program of surveys
– By 2017, countries have established mechanisms to make health data available to users
through electronic dissemination and easy access to a central data repository.
– By 2020, civil society organizations in countries are actively and meaningfully participating in
country reviews of progress and performance at all levels 4
5-Point Call to Action for the post 2015 era

5. How to achieve this?
1
2
3

6. How to Address the 5-Point Call for Action
• Strong country leadership
• eHealth and mHealth Strategies clearly defined,
costed, and co-ordinated
• Key stakeholders agree to buy-in to the strategies
• National Indicator Datasets defined
• Improve data use amongst program managers
• Improve data quality
• Population data available
• Overall HIS architecture defined and costed
• Interoperability strategy defined
• Master Facility Lists
• Surveillance systems strengthened
• M&E Framework defined, adopted, and reported
against

7. Network Opportunities: African Centre for eHealth
Excellence (Acfee)
Organisation:
• An international network of eHealth professionals
established in 2012
• Develop leadership and capacity to advance eHealth
in African countries
• NPO registered in South Africa.
• Its board is made up of African public health and
eHealth professionals
Acfee Activities:
• eHealth Alive Conference – SA Aug 2016
• eHealth Forum (followed the conference)
– attended by the Permanent Secretaries (or their
representatives) from Namibia, Uganda, Mali, South
Africa, East African Community.
– HISP participated in this event, and provided an
overview and discussion on the GHS agenda, and the
role of the HISP PO in strengthening health information
systems in Africa.
Planned Activities:
• eHealth Alive Conferences in East and West Africa
• eHealth Forum Annually
• eHealth Forum Report Annually
https://acfee.org/
http://ehealthalive.co.za/

8. Network Opportunities: HISP Network
• HISP Teams are active in many of the
countries across SSA
• Teams are composed of local staff, who
understand the context, and are rooted
to the community through many
networks
• The teams tend to endure beyond
project duration as they are
“committed to the cause” in their
country
• However, HISP teams are not strong
organisationally
• There is a need to develop standards
and SOP’s for database management
and data quality control
• How do we transition local HISP
entities to be:
– “strong local hubs of health
information systems (HIS)
practitioners,
– capable of providing effective,
high quality support for routine
health information systems
development (RHISD), especially,
but not necessarily exclusively,
around the use of the DHIS”

9. Key focus areas of HISP Partnership Organisation:
• Supporting organisational
development and management of
HISP entities
• Collaboration and sharing of
resources
• Create a formal mechanism
whereby the strategy for RHIS
development can be discussed and
articulated and shaped;
• Setting of standards for the
provision of RHIS services to
stakeholders;
Member 5Member 3
Board of
Directors
Member2
Member
4
Member 1
Member 4 Member n

10. HISP entities
HISP activities
Why drive this through the HISP
Network?
• DHIS2 used almost throughout the region
• The DHIS data can be used as a vehicle to drive
RHIS agendas, such as:
– Use of population data within the DHIS
– Development of Technical Standards to
improve data quality:
• Indicator to data element ratios
– National Indicator Data Sets
• Data completeness
• Data timeliness
• Standardised naming convention in DHIS of:
– DE
– Indicators
– Organisational Units
– Provision of technical solutions using the DHIS:
• Master Facility Lists and “National Data
Dictionaries”
– Needed to address fragmentation of systems
– Essential for interoperability and data exchange
• Surveillance systems templates
• TB patient management

11. Strengths of each Network
Acfee HISP Partnerships
Organisation
Governance issues  
Technical support for RHISD  
Capacity Building Activities  
Peer review and progress monitoring  
Representation from International Organisations Aims to No
Representation from MoH Yes No
Representation from Universities Yes No

12. Next Steps
• Each of these vehicles is already
moving
• Consolidate on their efforts, and
move along with them to activate
the 5-Point call for Action
• RHINO can play a role in the
development of an appropriate
M&E framework, and its
application across countries, so as
to serve as a formal “Peer Review”
mechanism

13. Thank you….
Dr Vincent Shaw
vshaw@hisp.org
Mobile: +27 82 576 8246