This document summarizes the development of a standardized Routine Health Information System (RHIS) curriculum. It describes the need to strengthen RHIS in low and middle-income countries. A consultative meeting in 2015 defined RHIS core competencies and developed a core RHIS course. This was then pilot tested in India in 2016. The finalized curriculum covers 10 modules on topics like data collection, management, analysis and use. Next steps include disseminating the curriculum through training workshops to strengthen RHIS globally.

1. RHIS Curriculum:
Standardizing Core
Competencies and
Training Materials
Presenter: Theo Lippeveld, MD, MPH
MEASURE Evaluation
tlippeveld@jsi.com
BBL Presentation at USAID/DC
January 10, 2017

2. Overview
 Need for strengthening routine health
information systems (RHIS) in low- and
middle-income countries (LMICs)
 RHIS Curriculum Consultative Meeting, in
April 2015
 Definition of RHIS core competencies
 Development of RHIS core course
 Pilot-test of draft RHIS core course
 Next steps/way forward

3. Health Information System: A Pillar
of a Strong Health System
FUNCTIONS (6 Building Blocks) GOALS / OUTCOMES OF THE
SYSTEM
Stewardship
Commodities
Infrastructure
Service delivery
Financing
I
N
P
U
T
S
Health
Responsiveness
(the way people are
treated and the
environment)
Fairness in
financial
contribution
Quality
Coverage
Efficiency
Source: WHO, 2000.
WHO Annual Report, 2000
Human resources
Information
Safety

5. Administrative
records systems
(NHA, etc.)
Services
records
systems
Individual
records
systems
Population-based
surveys
Vital
registration
Census
Population-based
data sources
Health institution-based
data sources (AKA RHIS)
Health Information System: Data
Sources

6. The Role and Importance of a Decentralized
Routine Health Information System
 Facility-based and ideally also community-based
 Main (and often only) source of information for (daily)
planning and management of quality health services at
the district level and below
• Coverage and quality of health interventions
• Disease surveillance
• Commodity security
• Human resource management
• Financial information systems
 Also feeding information into national and global levels
(for example, monitoring of SDGs)
 Ideal support to integrated management of
health interventions

7. But We All Know
RHIS in most
LMICs are
woefully
inadequate
to provide the
needed
information
support ...

8. What Is Wrong with Existing Routine
Health Information Systems?
 Plethora, irrelevance, and poor quality of the data
collected
 Centralization of information management
without feedback to district and service- delivery
levels
 Fragmentation into “program-oriented”
information systems: duplication and waste
 Poor and inadequately used HIS resources and
infrastructure (including ICT)
AS A RESULT
Poor use of information by users at all levels

9. RHIS in the Spotlight:
M&A for Results in Health Summit in June 2015
Call for Action (Action Point 4)
Maximize effective use of the data revolution,
based on open standards, to rapidly improve
health facility and community health information
systems, including well-functioning disease and risk
surveillance systems, and financial and health
workforce accounts

10. We Have All the Evidence-Based Interventions
Needed to Improve RHIS Performance
Technical interventions
 Establish a set of essential indicators
 Redesign RHIS architecture
 Ensure interoperability of RHIS subsystems
Organizational interventions
 Create an information culture with
incentives for use of information
Behavioral interventions
 Capacity building at all levels

11. First Priority
 Capacity-building in health managers and
care providers in RHIS performance and
management
 Standardization of RHIS core competencies
at all levels of the
health system

12. RHIS Curriculum Consultative Meeting
Chapel Hill, April 27-28, 2015
Objective
 To convene an advisory committee to plan, guide,
and oversee the development of a standardized
RHIS curriculum
Participating Partners
 MEASURE Evaluation, WHO/Geneva (Health
Statistics and Information Systems Division), AEDES,
Oslo University, INSP/Mexico, PHFI/India
Proceedings
 Review of existing RHIS curricula
 Definition of RHIS core competencies
 Scope and focus of a core RHIS curriculum
• Should address basic core competencies at all levels
 Terms of reference advisory committee

13. RHIS Core Competencies*
Eight Main Categories
 Data collection and reporting
 Data management
 Data analysis, interpretation,
and communication
 Data use and demand
 RHIS design, improvement,
and implementation
 RHIS assessment and monitoring
 RHIS governance and management
 Use of ICT for RHIS
* For a detailed listing, see RHIS Course Syllabus, Appendix 1

14. RHIS Course Development
Process
 Development of outline (June–July 2015)
 Development of modules (August 2015 –
February 2016)
Overview And Technical Committees
 RHIS Course Advisory Committee
 RHIS Course Technical Working Group (TWG)
 RHIS Course Module Working Groups

15. RHIS Course Advisory Committee:
Purpose and Responsibilities of Membership
Purpose
 Planning, guidance, and validation of the RHIS
curriculum process
Role And Responsibilities
 Validate the RHIS core competencies
 Guide and monitor the process for development,
delivery, and management of the RHIS curricula,
starting with the core curriculum
 Convene the RHIS Technical Working Group (TWG)
 Review and validate the output of the RHIS TWG
 Coordinate the inputs of various partners

16. RHIS Course Advisory Committee
Membership
Representatives of:
 MEASURE Evaluation (Co-Chair)
 WHO/Geneva (Co-Chair)
 WHO/SEARO
 Universities of Oslo, of Queensland, of Brussels, of
South Africa (UNISA), and the University of North
Carolina at Chapel Hill (UNC-CH)
 Instituto Nacional de Salud Pública (INSP), Mexico
 Public Health Foundation of India (PHFI)
 Health Information Systems Program (HISP),
South Africa
 Agence Européenne pour le Développement
et la Santé (AEDES)

17. RHIS Course Technical Working Group:
Purpose and Role(s)
Purpose
 To coordinate development of the core curriculum, including
reviewing and revising existing course materials
Role and Responsibilities
 Finalize the list of core and specialized competencies
 Map existing course materials and identify gaps
 Develop outline for the core curriculum
 Identify technical leads and contributors for each
core module
 Establish a mechanism for communication/coordination
for sharing resource materials and guide curriculum development
Membership
 Technical experts of same partners as advisory committee

18. RHIS Course Module Groups:
Role(s) and Responsibilities
 Identify and share existing materials (i.e., existing curricula,
reading materials, etc.) that can contribute to their
module
 Develop session plans, including details on learning
objectives, teaching activities, and timing
 Develop and/or gather session materials (i.e., slide decks,
lecture notes, readings, case studies, exercises, etc.)
 Module group membership
• Coordinator: coordinates with RHIS/TWG
• Technical experts of MEASURE Evaluation and partners

19. Syllabus
 Summary of the course,
including references
 Serves as a participants’
manual
Facilitators’ Manual
 Includes contextualization
guidelines
Other Training Materials
 PowerPoint presentations
 Case studies
 Exercises
 Handouts
Core RHIS Course Products

20. Course Title
 Routine Health Information System: A Curriculum on Basic
Concepts and Practice
Course Performance Objective
 At the end of this course, the participants will have
acquired the RHIS core competencies as listed in the
learning objectives of the course modules
Course Audience
 Targeted to the health workforce at large:
1. Policymakers and health managers
2. Care providers and health technicians
3. Students in health sciences
Core RHIS Course Syllabus

21. Draft Core RHIS Course Syllabus (2)
Course Content
 Builds on basic core RHIS competencies among health
workforce to enhance their work performance
 Modular organization of training materials (ten modules)
Course Duration
 60 hours: equivalent to two weeks of course work
Course Teaching Methods
 Blended learning methods directed toward
experiential learning (participatory, with lots of case studies)
Course Prerequisites
 No prerequisites, but strongly advised to have taken basic
M&E course

22. RHIS COURSE MODULES (1 session = 3h)
Introduction
Module 1: Health systems and health information systems (1 session)
RHIS Data Generation
Module 2: Indicators and Data Collection and Reporting (2 sessions)
Module 3: RHIS Data Management Standards (1 session)
Module 4: RHIS Data Quality (1 session)
Module 5: RHIS Data Analysis (3 sessions)
Module 6: RHIS Data Demand and Use (3 sessions)
RHIS Management
Module 7: RHIS Governance and Management of Resources
(2 sessions)
Module 8: Information and Communication Technology for RHIS
(2 sessions)
RHIS Strengthening and Reform
Module 9: RHIS Performance and Assessment (2 sessions)
Module 10: RHIS Design and Reform (3 sessions)

23. RHIS Course Pilot-Testing in New Delhi Jun
6-17, 2016

24. RHIS Course Pilot Test
 Teaching Staff
• 3 MEASURE Evaluation experts
• 5 Public Health Foundation of India (PHFI) faculty members
 Participants
• 13 participants: from India (3), Bangladesh (4), Nepal (2), Myanmar
(3), and Ghana (1)
 Location
• PHFI training facilities in Gurgaon (suburb of New Delhi)
 Funding
• USAID and SEARO
 Results
• Feedback by teaching staff and participants on technical
content, as well as teaching method (detailed
report available)

25. Final RHIS Course
 Feedback from New
Delhi pilot test was
incorporated in the
draft RHIS curriculum
and materials
 Final version was ready
on September 30, 2016
 Currently, further
editing and formatting
are ongoing by the
MEASURE Evaluation
KM team

26. Next Steps/Way Forward
 Dissemination and Contextualization of RHIS Basic Course
• Contextualization guidelines (RHIS Facilitators’ Manual, Appendix)
• Translation into French (GF) and Spanish (PAHO) — other languages
on demand
• Organization of Training of Trainers workshops
 Development of Other RHIS Courses
• Development of RHIS in-depth modules (e.g., data analysis
and ICT)
• Development of RHIS courses for particular audiences (such
as community-based RHIS, online course, etc.)
• Development of RHIS subsystem courses, such as LMIS, HRIS, etc.

27. How to Disseminate the RHIS Course?
 Via teaching institutions (universities and
other health sciences schools)
 Via downloads from the websites of WHO,
USAID, MEASURE Evaluation, and other
partners such as GF
 Via regional RHIS strengthening networks
(RELACSIS, AeHIN, WAHO, and others)
 Via the USAID missions in priority countries

28. Recent and Planned Events in 2017 on
RHIS Course Dissemination
 RHINO satellite session at the HSR symposium on
November 14th in Vancouver, Canada
 Presentation of RHIS course at GEMNet-Health
meeting, February 25, 2017 in Cuernavaca,
Mexico
 Integration of RHIS course in newly designed
MPH program at PHF/India in 2016-2018
 Presentation of RHIS course at the AeHIN General
Meeting in Myanmar, March 6-10, 2017
 Training of Trainers for RHIS course at Ghana
University, in June 2017

29. Thank You and Questions
For further information on the RHIS course:
 Hemali Kulatilaka,
hkulatil@email.unc.edu
 Tariq Azim tariq_azim@jsi.com
 Alimou Barry alimou_barry@jsi.com
 Theo Lippeveld, tlippeveld@jsi.com

30. Routine Health Information Systems: A Curriculum on
Basic Concepts and Practice – Syllabus
http://www.measureevaluation.org/resources/publi
cations/sr-16-135a
Routine Health Information Systems: A Curriculum on
Basic Concepts and Practice – Facilitators’ Guide
http://www.measureevaluation.org/resources/publi
cations/sr-16-135b
Available for Download on the
MEASURE Evaluation Website

31. This presentation was produced with the support of the
United States Agency for International Development
(USAID) under the terms of MEASURE Evaluation
cooperative agreement AID-OAA-L-14-00004. MEASURE
Evaluation is implemented by the Carolina Population
Center, University of North Carolina at Chapel Hill in
partnership with ICF International; John Snow, Inc.;
Management Sciences for Health; Palladium; and Tulane
University. Views expressed are not necessarily those of
USAID or the United States government.
www.measureevaluation.org