1. Health Management Information System (HMIS) in
Ethiopia
Who Owns the
HMIS

2. Health Management Information
System (HMIS)
 The purpose of HMIS is to:
 routinely generate quality health information
 that provides specific information support to:
 the decision-making process at each level of the
health system for
 improving the performance of health system and
thereby the health status of the population
2

3. HMIS in Ethiopia
 Pivotal role for HMIS within Health Sector’s M&E
system
 FMOH adopted “One Plan, One Report & One
Budget” policy
 HMIS providing the core indicators
 HMIS reform high in Health Sector Development
Program (HSDP) agenda
3

4. Various HMIS functions carried
out by different institutions
 HEW
 Generates the data
 Submits the reports
 Uses for managing her activities
 HEW Supervisor
 Compiles the data
 Conducts data quality checks
 Submits reports to woreda
 Uses for managing performance of the unit
4

5. Various HMIS functions carried
out by different institutions
 Woreda Health Office
 Aggregate, archive reports
 Analyze and review,
 Decide, plan, implement or give feedback
 Provide HR, equipment, funds
 Regional Health Bureau
 Aggregate, archive reports
 Analyze and review,
 Decide, plan, implement or give feedback
 Provide HR, equipment, funds
5

6. Various HMIS functions carried
out by different institutions
 Federal Ministry of Health
 Make policy decisions
 Aggregate, archive reports
 Analyze and review,
 Decide, plan, implement or give feedback
 Provide HR, equipment, materials, funds
 Implementing Partners/Development Partners
 Build capacity on HMIS tasks
 Provide funds, equipment, HR, materials
6

7. So, who own the HMIS
7

8. When can I say that I own a
system?
 I have legal rights on it
 I enjoy its benefits
 I value the system
 I drive the system to get the desired benefits from it
 I take the responsibility to manage/maintain it (using
my own resources/expertise or mobilizing others)
 I take credit of its successes
 I take the responsibility of its failures
8

9. Who owns HMIS?
 Who is the beneficiary of HMIS?
 Who is responsible for maintaining/managing it?
 Who gets the credit if HMIS is successful?
 Who should take care of HMIS if it is not
functioning as desired?
9

10. Who owns HMIS?
 HEWs?
 WorHO?
 RHB?
 FMOH?
 Partners??
10

11. Why Regional Ownership matters
 Regional Ownership is essential for
 Full implementation of HMIS in the
region
 Sustainability of HMIS in the region
11

12. SNNPR’s vision: Sustainable HMIS
 HMIS is sustainable in SNNPR when the Regional Health Bureau
(RHB):
 Values HMIS & demonstrates desire to have HMIS for health
system management
 Drives the system to get the desired benefits from it; i.e.
 SNNP RHB maintains production of quality HMIS information to
meet the current information needs of the region
 There is continued use of HMIS information for decision making at
all tiers of health system
 Takes responsibility for its successes and failures
 Manages & continues to have the capacity to manage the HMIS
resources & controls financial decisions for HMIS
implementation
12

13. The Challenge
 Balancing Regional Ownership and Technical
Assistance for implementing HMIS
13

14. The Strategy:
Balanced sharing of responsibility &
promoting Regional Ownership from Day One
RHB
JSI/MEASURE
Evaluation
Mentoring
IT development
LevelofResponsibility
Time
Training HMIS data collection, reporting
Data Quality Assurance
Use of HMIS data for decisions
eHMIS use
14

15. The Strategy paid off…..
 Within 2 years
 Over 5,200 health managers and staff trained
 TOT completed for all 615 Health centers & 23 Hospitals in the
region
 9 / 22 zones implementing reformed HMIS and started regular
reporting
 1737 (44%) Health Posts implementing community HMIS
 eHMIS installed and functional at RHB
 Electronic Health Institutions data for all health institutions
 6 Zonal Health Departments have eHMIS to access aggregate data
and Decision Support System via internet
 eHMIS expanded to all WorHOs
15

16. ....strategy paid off
 RHB is in the lead role and owns the process
 RHB Planning unit in charge of managing the scale-
up
 RHB IT staff carrying out electronic data entry &
quality checks
 Trained HMIS facilitators from among the staff in
every zone, woreda & health facility
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17. ….RHB in the lead
 RHB mobilizing other implementing partners to
assist in HMIS scale-up and sustainability
 Mobilized resources for printing, furniture,
computers for HMIS
 RHB organizing regular meetings to review scale-
up progress & address bottlenecks
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18. Lessons learned
 Strong visionary leadership & commitment of the
region (country) essential for scale-up and
sustainability of HMIS
 Developing government ownership starts on Day
One and continues throughout the
implementation process
 Harmonized teaming up of development partners
with the government can bring the desired results
18

19. Thank You!
MEASURE Evaluation is funded by the U.S. Agency for
International Development and is implemented by the
Carolina Population Center at the University of North
Carolina at Chapel Hill in partnership with Futures Group
International, ICF Macro, John Snow, Inc., Management
Sciences for Health, and Tulane University. The views
expressed in this presentation do not necessarily reflect
the views of USAID or the United States Government.
19

20. The research presented here has been supported by the
President’s Emergency Plan for AIDS Relief (PEPFAR)
through the United States Agency for International
Development (USAID) under the terms of MEASURE
Evaluation cooperative agreement GHA-A-00-08-00003-
00. Views expressed are not necessarily those of
PEPFAR, USAID or the United States government.
MEASURE Evaluation is implemented by the Carolina
Population Center at the University of North Carolina at
Chapel Hill in partnership with Futures Group, ICF
International, John Snow, Inc., Management Sciences for
Health, and Tulane University.

21. www.measureevaluation.org