Making Information Available to Improve Health


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Presented by Shannon Salentine, David Hotchkiss and Beatriz Plaza at the MEASURE Evaluation End-of-Phase-III Event.

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Making Information Available to Improve Health

  1. 1. Making Information Available to Improve Health MEASURE Evaluation End-of-Phase-III Event, May 22, 2014
  2. 2. Outline  Overview of M&E Systems  Highlighted presentations  “Monitoring and Evaluating Health Systems Strengthening : A Practitioner’s Guide” by David Hotchkiss  “StrengtheningHealthInformationSystems inLatinAmerica&Caribbean”byBeatrizPlaza  Wrap Up
  3. 3. M&E Systems Strengthening
  4. 4. Health System Strengthening
  5. 5. MEASURE Evaluation Contributions  Technicalleadership to expand the knowledge- base for HSS  Relationship between “building blocks” and HSS  Measurement of specific HSS interventions  Implementation of sustainableapproaches for improving RHIS and M&E systems
  6. 6. Technical Leadership
  7. 7. RHIS and M&E Systems  Improved 20 HIS and M&E Systems in 9 countries  Various systems including:  Routine HIV/AIDS Information  Routine Community Health Information  Malaria Information  Health, Population, and Development  Community Based Organizations  Civil Registration and Vital Events  Regional Initiative Health Information System Strengthening in Latin American and the Caribbean (2005-2010
  8. 8. Monitoring and Evaluating Health Systems Strengthening: A Practitioner’s Guide David Hotchkiss, PhD MEASURE Evaluation End-of-Phase-III Event, May 22, 2014
  9. 9. Roadmap  Importance of M&E of HSS  Purpose of guide and intended audience  Qualitative needs assessment  Overview and structure of guide
  10. 10. Significance  Health systems strengthening continues to receive considerable attention  Increased focus on Universal Health Coverage  Measuring HSS progress requires careful planning and sound metrics
  11. 11. Available Resources for M&E of HSS
  12. 12. Purpose of Guide  To provide practical guidance to prospectively monitor and evaluate health systems strengthening projects and initiatives  Intended audience: USAID mission staff; M&E staff working for HSS projects and government offices
  13. 13. Qualitative Needs Assessment  Purpose: to better understand the needs of USAID mission staff and partner organizations  Survey participants:  HSS and M&E staff from eight USAID missions  M&E staff from HSS projects  M&E staff from GFATM, WHO, World Bank, GAVI
  14. 14. Key Challenges Identified  Complex nature of HSS  Indicators  Institutional capacity  Data availability and quality  Funding and resources
  15. 15. Overview of Guide  Introduction, definitions  HSS M&E framework, challenges  Overview of HSS indicators  Step by step guidance on developing a M&E plan for HSS
  16. 16. Definitions: Health System  All people, institutions, resources, and activities whose primary purpose is to promote, restore, and/or maintain health  Includes private and public sector actors  Includes actors at national, state, district, and community levels
  17. 17. Definitions: Health Systems Strengthening  Strategies, responses, and activities designedto sustainably improve health system performance  Good health systems performance is achievingsustained health improvements by providing:  Financial risk protection  Essential services and equitable population coverage  Responsiveness to people’s expectations
  18. 18. IHP+ Framework for Monitoring and Evaluating HSS Inputs and Processes Outputs Outcomes Impacts Governance Financing • Infrastructure • Workforce • Commodities • Information Systems • Service Readiness • Access • Quality of Care • Health • Financial risk protection • Responsive- ness • Coverage • Prevalence of risk factors Adapted from: Monitoring the building blocks of the health system. WHO Report. October 2010.
  19. 19. Steps for Developing an M&E plan 1. Defining the HSS intervention, project 2. Developingan M&E framework 3. Identifying key indicators, sources of data 4. Establishing a research design for impact evaluation 5. Collecting additionaldata 6. Analyzing and interpretingdata 7. Disseminatingresults
  20. 20. Next Steps  Guide expectedto be finalizednext month  Expectedto help improve M&E capacityby:  Synthesizing currently available guides and tools on M&E HSS  Preparing readers to identify appropriateHSS indicators and impact evaluation designs most appropriatefor their projects and settings
  21. 21. Strengthening Health Information Systems in Latin America & Caribbean Beatriz Plaza MEASURE Evaluation End-of-Project Meeting, May 22, 2014 Washington, D.C.
  22. 22.  Paris 21  RHINO  Health Metrics Network  USAID/LAC/Pan American Health Organization/Regional Strategy for Strengthening Health Information Systems Justification
  23. 23. `  Use of international standarized frameworks and tools.  Establish a baseline for monitoring improvements and eventual evaluation.  Define strategies and action plans at the local, national, and regional level for improving health information systems. USAID LAC Bureau Centerpiece for Regional Strategy
  24. 24.  Poordataquality&weakinformationuse.  Parallelinformationsystems.  Lackofinformationstandardarization.  Limitedtechnicalcapacityatalllevels. Common Problems (as evidenced by the tool applications):
  25. 25.  Strengthen regional strategic coordination.  Facilitate country-led processes.  Promote sustainability. Our Role?
  26. 26. Learnwhatworksinaparticularcountry and sharethatinformation withinthecountry and acrosscountries. Our Focus? South-to-South
  27. 27. Our Strategic Partners
  28. 28. Solutions/Products
  29. 29. 1. Develop practical best practices. 2. Identify those that ensure sustainability over time. 3. Strengthen south-to-south exchange between countries. RELACSIS
  30. 30. Solutions/Products
  31. 31. Second Global Symposium on Health System Research Beijing, People´s Republic of China, 31 October ‒ 3 November 2012 “Health Information Systems network for research education and capacity building in Latin America and the Caribbean” Leonel Gonzalez-Gonzalez, Lina Sofía Palacio-Mejia, Juan Eugenio Hernandez-Avila, Beatriz Plaza, Alejandro Giusti “Assessing the process of designing and implementing electronic health records in a statewide public health system: the case of Colima, Mexico” J Am Med Inform Assoc., published online September 27, 2012
  32. 32.  Training of Trainers (25 instructors) course in Ecuador 2011 (Bolivia, Paraguay & Peru)  Training of Trainers (25 coders) course in Central America 2012 (Honduras, Nicaragua / El Salvador, Guatemala) Capacity Building
  33. 33.  Virtual on-line training for ICD-10  Virtual on-line course for doctors on correct entry of cause of death South-to-South Solutions Products (2012-2013)
  34. 34.  On-line course for effective communication strategies for producers of information Products (continued)
  35. 35. Online Course for Assisted and Automated Coding for ICD-10 Cause of Death
  36. 36.  Pros & Cons of Electronic Health Records in the Americas  Measurements of Inequality in Health Two Online Forums
  37. 37. Regional Initiative Health InformationSystems Strengthening: LatinAmerica andCaribbean: 2005-2010
  38. 38.
  39. 39. Q&A 1. What are the opportunities to expand our knowledge about M&E and HSS system strengthening? 2. How can we continue to promote the strengthening of sustainable M&E systems?
  40. 40. Wrap-Up  There is a need to further understand how various HSS interventions contribute to improved health systems and improved health outcomes  Strong approaches for strengthening M&E systems address the information needs required for improving health
  41. 41.