Strengthening national health information systems for better reporting of regionalcore indicators and the Sustainable Development Goals (SDGs)

1. Strengthening national health information
systems for better reporting of regional
core indicators and the Sustainable
Development Goals (SDGs)
PRE-REGIONAL COMMITTEE TECHNICAL MEETING
63rd Session of the WHO Regional Committee for the Eastern Mediterranean
3 OCTOBER 2016, Cairo

2. Outline
• Health information systems framework
• Progress on the regional core indicators program
• Outcomes and recommendations of the rapid
assessment of country capacity on reporting on core
indicators
• The way forward
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3. Intelligence, including
research
Role of CRVS in health and health care improvement and
policy debates
Health
systems
HIS CRVS
SDGs
Communicable
diseases
NCDs and
mental health
Emergencies
RMCH, Health
promotion
3

4. Health Data Collaborative Initiative
“It was necessary to
determine how data
were generated,
analysed, reported
and disseminated for
each core indicator. “
EM/RC/61 (2014)
Dr. Ala Alwan, WHO
Regional Director
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5. SDG3 with
13 targets
26 indicators
(May 2016)
Other SDGs
health
related
indicators
Further need for
working CRVS systems
Increasing reliance
on “estimation”
processes Need for
collaboration with
non-health sectors –
within countries and
across UN agencies
Problems with certain
proposed indicators:
UHC indicators, others
More comprehensive
coverage of important
health issues (compared
with MDGs)
Focus on national,
regional and global
targets
Opportunities and threats of the SDG ‘agenda’
for health information system strengthening
5
Only ~20% of death
in the region are
medically certified

6. Effective health information systems
• Needed for sound policy development
– Rational use of resources
– Monitoring and evaluation of implementation and
outcomes.
• There is increasing demand in light of SDGs and
due to equity concerns
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7. The regional core indicators program
• Strong political mandate through the Regional
Committee
• A limited number of “core” indicators
– 68 indicators
– Other global or regional frameworks require a far
larger number of indicators
• It has been followed with a coherent plan of
action between the WHO and Member States
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8. Endorsed in the 61th
Session of the Regional
Committee
8
68 indicators
In 3 categories

9. Availability of reported core indicators- 2014-2016
9
0 5 10 15 20 25 30 35 40 45 50 55 60 65 70
group3
group2
group1
Sudan
Pakistan
Afghanistan
Yemen
Djibouti
Somalia
Iran
Egypt
Morocco
Iraq
Tunisia
Lebanon
Palestine
Syria
Jordan
Libya
Oman
Qatar
United Arab Emirates
Saudi Arabia
Kuwait
Bahrain
2014 2016

10. Available core indicators by country
Countries Total numbers of indicators available
2014 2015 2016
Afghanistan 46 55 54
Bahrain 39 46 46
Djibouti 37 45 44
Egypt 54 57 58
Iran 54 56 57
Iraq 52 53 54
Jordan 45 50 51
Kuwait 43 53 54
Lebanon 49 49 51
Libya 41 41 43
Morocco 53 56 51
Oman 54 55 55
Pakistan 50 56 56
Palestine 48 49 53
Qatar 50 49 51
Saudi Arabia 44 51 52
Somalia 34 39 38
Sudan 52 54 56
Syria 46 50 47
Tunisia 51 55 55
United Arab Emirates 44 47 47
Yemen 42 50 50
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11. Main observations
• Improvements observed throughout the region
2014-2016
– In all but one country
• Countries with better HIS infrastructures have
more reporting capacity regardless of income-
level
• Countries are concerned, in occasions, about
– Quality of data
– Estimated indicators
– Reporting mechanisms, within countries and to WHO
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12. National health information system
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Data
management
and standards
Effective
National Health
Information
System
Quality
assurance
Governance
framework
Infrastructure
and support
Dissemination
and data use
For: Routine sources of data (patient and
management records), population surveys and
other (non-health sector) sources of data

13. Rapid assessment of countries capacity in reporting on
the 68 Core Indicators
For each core indicator, the following key questions were asked
1. Is it currently collected?
2. Responsible agency for reporting
3. Data sources
4. Frequency of reporting
5. Level of reporting (national, subnational)
6. Use standardized WHO indicator definition
7. Indicator measurement methods
8. Electronic or paper reporting/data collection
9. If not reported, feasibility of reporting in future
10. Main barriers to reporting
19 countries participated in the assessment – August 2016
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14. Selected assessment outcomes
• None of the countries are able to produce all 68 core
indicators in a timely basis
• Most HIS systems lack adequate connectivity with
relevant stakeholders
• Population surveys do not follow a long term plan
– Most group 2 and 3 countries rely on donor support for surveys
• Data quality assessments are inadequate
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15. Selected assessment outcomes
• 8 countries know about the global estimation
processes and methodologies
• 15 countries publish annual statistical reports
• 12 countries use ICD 10 coding system for cause
specific mortality
• Half of core indicators are reported for all countries
– Many based on estimates
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16. Actions that are following the assessment
• Developing a recommended list of population
surveys for different groups of countries
• Conducting comprehensive health information
system assessments for interested countries
– The first country in October 2016
• Expanding capacity building activities
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17. The way forward
• 19 countries completed the assessments
– Follow up with the remaining three countries to complete
by the end of October 2016
• As gaps in the plans and indicators are identified:
• We will discuss further with countries about how we
can help in
– improving health information systems, and
– capacity to develop and use the key indicators
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18. Thank you