1. STRATEGIES FOR PERMANENT ACCESS TO
SCIENTIFIC INFORMATION IN SOUTHERN
AFRICA: FOCUS ON HEALTH AND
ENVIRONMENTAL INFORMATION FOR
SUSTAINABLE DEVELOPMENT
AN INTERNATIONAL WORKSHOP
5-7 SEPTEMBER 2005
CSIR CONVENTIONCENTRE, PRETORIA, SOUTH
AFRICA

2. UTILIZATION OF HEALTH
INFORMATION IN NAMIBIA
FOCUS ON CHALLENGES AND
OPPORTUNITIES FACED BY
HEALTH CARE DELIVERY SYSTEM
DR. L. HAOSES-GORASES
PhD, M Cur, Hon Cur, BA Cur, Adv.
Univ. Dipl. in CHN & Education

3. INTRODUCTION
• 2001 Population Census – 1.830,330
• Population 1.830,330-2001 Housing Census
• Annual growth rate 2.6%
• Surface area 824,116 km2
• Average 2 persons per km2
• People spread unevenly across the country
• Urban 33%
• Rural 67% (SSS 2004)

4. NAMIBIA BY REGION

5. BACKGROUND
 HIS under Epidemiology Division
 Collect routine data – all health facilities
(clinics, health centres & hospitals)
Aim:
 Analyze
 Documentation
 Disseminate – planning
 Direct changes in policies
 Improve monitoring performance
 Identify support needs

6. KEY PLAYERS
 MoHSS & Central Bureau of Statistics (CBS)
 Major surveys & census
 Data duplications occurring
 With new developments new programmes on
board
 Prevention of Mother to Child Transmission
(PMTCT)
 Anti Retroviral Treatment (ART)
 Voluntary Counseling & Testing (VCT)

7. CONTINUE
 Health Information System developed in
1990 after independence
 Many challenges –improvement in the
past years
 In 2004 and 2005 situation analysis and
comprehensive assessment of the
system

8. OBJECTIVES
 To improve individual and institutional
performance
 To measure quality and efficiency of the
strategies in place
 To compare performance over time in relation
to national targets
 To provide support to regions, districts &
health facilities
To monitor trends in:
 Coverage
 Quality
 Effectiveness of the services
 Guide policy-makers for resource allocation

9. RECORDING PROCEDURES
 Tally sheets
 Daily ward census
 Monthly summary forms
 E-mail
 Floppy diskettes from regional to
national level

10. CONTINUE
 Information covers indicators on:
 Human resources
 Population
 Health facilities
 Financing
 Directive in terms of MDG’s
 Information only from:
 Public and mission health facilities

11. QUALITY OF THE DATA
 Training of staff
 Computerized system
 E-mail functioning (80%)
 Floppy diskettes also introduced

12. SOURCES OF DATA
 Located in different directorates
 Directorate Planning & Human Resources
(MIS)
 Central Bureau of statistics in National
Planning Commission (Census, vital events)
 Ministry of Home Affairs (registration birth,
deaths, immigrants etc.)
 Discussions for 3rd national statistic plan

13. STRENTHENING OF HIS
 Revision in 1994
 New forms introduced in 1995
 Revised again after five years
 International standards
 ICD-10 included

14. DECENTRALIZATION/
COMPUTERIZATION
 All 13 regions
 33 districts (computerized)
 To improve channels of processing of
the data:
 Health facilities to district, regional and
national level
 Telephoning instant training
 ICD-10 for coding purposes (IP)

15. INTRODUCTION OF
STANDARD REGISTERS
 Outpatient Department (OPD)
 Inpatient Department (IPD)
 Antenatal Care (ANC)
 Expanded Programme on Immunization
(EPI)
 Legal records
 Reference manuals are available

16. INTERNATIONAL
PARTNERS ROLE
 Investing in specific programmes
 GF, USAID, FHI, CDC, PEPFAR UN
AGENCIES (Malaria, TB, HIV/AIDS)
 Reporting circles
 UN agencies support the health service
e.g. Country Response Information
System (CRIS)

17. REGULARLY & LEGAL
FRAME WORK
 Facility Act – draft
 Health Act –draft
 Consolidate information from private
health facilities & other stakeholders

18. STRATEGIES
 CBS conducts surveys & household census
 Ministry of Home Affairs generates info on
births, death and immigration
 Integrated disease surveillance system
collects info on notifiable diseases such as:
 Measles
 Neonatal Tetanus
 Polio (AFP) etc
 NDHS scheduled for 2006 (every five years)

19. INFORMATION
MANAGEMENT
Several sets:
 Health indicators used for:
Planning
Resources allocation
Monitoring & evaluation
 Compiled at district to regional and national
 Data cleaned at all levels & actions taken
 Several data bases coming up
 Development partners choice
 MOHSS is constantly updating it’s website – new
version to be release this year
 SPSS, EPI-INFO & Microsoft Access in used

20. AVAILABILITY OF SOUND
HEALTH STATISTICS
 Strength (quality) of the data assessed
 Statistical techniques examined
Major elements (domains)
 Health profile of the population
 Risk factors
 Service coverage
Factors influencing data
 Timeliness
 Representativeness
 Periocity
 Consistency
 65% info readily available

21. 2004 SENTINEL SURVEY

22. UTILIZATION
 Vital vehicle – M & E
 Reprogramming
 Planning
 Development of policies/guidelines
 Setting of priorities

23. NATIONAL HEALTH STATISTICS, 2005
Domain Indicator Score (%)
Health status Overall score (mean)
Child mortality
Maternal mortality
Adult mortality
Causes of death in children
HIV prevalence
TB incidence
Underweight in children
Obesity in adults
65
73
55
50
41
75
78
87
0

24. CONTINUE NATIONAL HEALTH
STATISTICS, 2005
Domain Indicator Score (%)
Health service
coverage
Measles coverage
Skilled birth
attendant
TB treatment DOT
Proportion of
children sleeping
under bed nets
83
70
83
50

25. CONTINUE NATIONAL HEALTH
STATISTICS, 2005
Domain Indicator Score (%)
Risk factor Smoking prevalence
Condom use at
higher risk sex
Improved water
supply
78
68
87
System Total health
expenditure (per
cap)
Health worker
density
63
76

26. CHALLENGES
 Turn-over of staff/training
 Timeliness – info – national level
 No designated staff at district level
 Computer – literacy lacking
 Info – private sector not available
 Development partners agenda
 Coordination of the systems
 Involvement of top level management

27. OPPORTUNITIES
 Strengthening/coordination of system
 Capacity development
 Completion of facility & facility & Health Act
 Capitalize on development partners’ support
to strengthen lower levels
 Regional collaboration/expertise (SADC, WHO
etc).
 Development of critical mass in the region
e.g. WHO, SADC etc.
 Availability of expertise in the SADC region

28. CONCLUSION
 Key constituencies to form coordinating
mechanism
 Designated staff at district level
 Mobilization of resources by all stakeholders
 Involve policy-makers (vital tool)
 Country needs driven system
 Indicators to match with National
Development Plan

29. CONTINUE
 Train staff on computer literacy on HIS
 Involvement of policy makers and
stakeholders for better understanding &
support
 Computer back-up system at regional level
 Facility and Health Acts be finalized and
implemented
 Sustainability of HIS address
 Horizontal learning (regional expertise)

30. NB!
 HIS is serving as a vital instrument in our
health service delivering system
 It is directing the MoHSS in identification of
shortcomings (revision of the system,
adjusting of the indicators, software etc.
 Strengthening at all levels
 Make information available in a user-friendly
manner
 Proper utilization of the system

31. CONTINUE
 HIS is reporting on diseases targeted
for eradication and elimination (e.g.
Polio (80% WHO) Measles and
Neonatal Tetanus
 HIS is in high demand by sectors –
positive move
Thank you!!!