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The Role of Routine Health Information Systems in the Post-2015 Development Agenda

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The Role of Routine Health Information Systems in the Post-2015 Development Agenda

  1. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 11 The approach: to enhance efficiency of current investments in health information systems CHANGING THE WAY WE WORK TOGETHER
  12. 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. 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. 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. 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. 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. 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. 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. 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. 20. CONCLUSION: Something needs to change…
  21. 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

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