The document discusses measuring and improving the performance of routine health information systems (RHIS) to support district health planning and management. It presents the PRISM framework, which views RHIS performance as determined by technical, behavioral, and organizational factors. The framework guides assessment of RHIS using various tools, analysis of findings to prioritize issues, and development of action plans to implement technical and non-technical interventions to strengthen RHIS. Examples of past RHIS reform efforts are also provided.