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Performance of Routine Information System Management Framework (PRISM) led by Natasha Kanagat
The PRISM framework consists of four tools to assess Routine Health Information System (RHIS) performance, identify technical, behavioral and organizational factors that affect RHIS, aid in designing priority interventions to improve performance and improve quality and use of routine health data.



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  1. 1. Data Demand & Use: PRISM Tool Webinar Series - # 7 Tuesday, February 7, 2012Presenters: Natasha Kanagat & Molly Cannon
  2. 2. Agenda• Welcome - Webinar tips• Brief overview of Data Demand and Use• Presentation of Tool – PRISM• Questions and Answers• Wrap up
  3. 3. Troubleshooting If you lose connectivity, re-enter the meeting room by clicking on the link provided If you are located in the US, you can rejoin by clicking on the link or use the conference call number provided For other troubleshooting questions right click on the host and choose “private chat” Send an email to
  4. 4. Tips for Participating in theDiscussion To comment, raise your hand by clicking on the icon with person raising hand. You can then:  Speak into your microphone. Be sure its enabled. Click on the microphone icon at the top of the screen  Type into the Q&A function. You man enter comments into the Q&A pod at any time A recording of the webinar will be made available at
  5. 5. Why improve data-informeddecision making? Pressing need to develop health policies, strategies, and interventions
  6. 6. “… without information, things are donearbitrarily and one becomes unsure ofwhether a policy or program will fail orsucceed. If we allow our policies to be guidedby empirical facts and data, there will be anoticeable change in the impact of what wedo.” National-level Policymaker, Nigeria
  7. 7. Definitions Data use – Using data in the decision making process  create or revise a program or strategic plan  develop or revise a policy  advocate for a policy or program  allocate resources  monitor a program  review must be linked to a specific decision making process Data Demand - decision makers specify what kind of information they want & seek it out
  8. 8. Data-informed Decision Making Cycle
  9. 9. Improving Data-informed Decision Making Data Users & Data ProducersTool Application Capacity Building Organizational Support Monitoring & Evaluation System Improvements
  10. 10. PRISM:Performance of Routine Information System Management
  11. 11. Rationale for strong Health Information Systems Improving health  Essential foundation of public health action and health systems strengthening  “Are we doing things right?”
  12. 12. HIS Data SourcesReference: HMN Framework and Standards for Country Health Information Systems, Second edition
  13. 13. Routine Health Information System A system that provides information at regular intervals of a year or less through mechanisms designed to meet predictable information needs. Includes paper-based or electronic health records, and facility- and district-level management information systems.
  14. 14. Routine Health Information System Performance Data Quality Continuous use of information
  15. 15. Challenges of implementing good HIS Parallel, uncoordinated systems Vertical programs Reporting requirements Resource constraints Poor data quality Lack of data use for decision making
  16. 16. The data collection forms are toocomplicated.” …“What is the use of collecting datawhen nobody uses it?” …“Upper management is notcommitted to RHIS activities.” …
  17. 17. Performance of Routine Information System Management (PRISM) Framework
  18. 18. How are PRISM assessment findings used? To identify interventions thatimprove quality of data and use of information
  19. 19. Types of Interventions Technical interventions Behavioral interventions Organizational interventions
  20. 20. Examples of technical interventions Defining a set of essential indicators Standardize a data generation architecture based on best practices Development of computerized data analysis/presentation application: DSS, Morocco
  21. 21. Examples of organizational and behavioral interventions (let us go a step further...) Create incentives for use of information (Pakistan, Uganda) Promote HMIS self-assessment (Uganda) Introduce Performance Improvement Tools focused on problem solving approach (Thailand)
  22. 22. Country Experiences Mexico & Pakistan
  23. 23. Mexico: Understanding organizational and behavioralfactors affecting DQ and Data Use
  24. 24. How Were OBAT Findings Used?• A website was created, all 33 state health departments accessed the OBAT questionnaire. The information processed by OBAT was relayed to the national level;• National authorities able to prioritize interventions and produce a plan for the incoming government to improve information use and decision making at all levels;• Measuring HMIS performance, based on funding availability, was recognized as important.
  25. 25. Pakistan: Tracking quantitative HISperformance measurements over time Improvements in Data Accuracy and Use of Information Before and After Pilot test in Pakistan, 2006 80 70 60 Percent 50 Accuracy 40 30 Use of info 20 10 0 Interventions Before After
  26. 26. How were pilot test findings used? A separate training manual developed to assess data quality and use of information Facilities and the districts implemented monthly performance reviews using DHIS information and recorded decisions on a new DHIS register A National Action Plan for DHIS, approved by the Government of Pakistan in February 2007
  27. 27. Countries where PRISM has been used
  28. 28.  The application of the PRISM framework and its tools in various countries has led to data quality improvement and increased use of information for decision making Adaptable & Flexible Can be used by a variety of stakeholders
  29. 29. PRISM Resources The PRISM framework and tools are available as free downloads from the MEASURE Evaluation website: evaluation-systems/prism
  30. 30. Questions and Answers
  31. 31. MEASURE Evaluation DDU Resources  Data Demand and Use Tool Kit  Data Demand and Use Training Resources Next webinar will be on February 14, 2012 at 9:00 am EST…Framework for Linking Data with Action To sign up for Data Use Net, send an email to Leave the subject field blank and in the body of the message type „subscribe DataUseNet‟
  32. 32. Presenter Contact Information Molly Cannon – Natasha Kanagat –
  33. 33. MEASURE Evaluation is a MEASURE project funded by theU.S. Agency for International Development and implemented bythe Carolina Population Center at the University of North Carolinaat Chapel Hill in partnership with Futures Group International,ICF Macro, John Snow, Inc., Management Sciences for Health,and Tulane University. Views expressed in this presentation do notnecessarily reflect the views of USAID or the U.S. Government.MEASURE Evaluation is the USAID Global Health Bureausprimary vehicle for supporting improvements in monitoring andevaluation in population, health and nutrition worldwide.