Health Management Information Systems

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DFID Health Resource Centre

Eldis Health Key Issues

Health management information systems
Health management information incorporates all the data needed by policy makers, clinicians and health service users to improve and protect population health. Few countries in the world today have effective and comprehensive systems in place to gather this data. Yet there has never been a greater need for robust health information. As the world community has turned its attention to meeting Millennium Development Goal targets, and ever increasing resources are going towards preventing and treating high burden diseases such as HIV and AIDS, tuberculosis and malaria, decision-makers need to be able to measure whether policies and programmes are working, and whether progress is being made towards the goals that have been set. Donors are also placing more emphasis on performance, linking the release of funds to performance based measures. See: Structuring information and incentives to improve health The World Health Organization (WHO) argues that investment in health management information systems (HMIS) now could reap multiple benefits, including: • • • • helping decision makers to detect and control emerging and endemic health problems, monitor progress towards health goals, and promote equity; empowering individuals and communities with timely and understandable health-related information, and drive improvements in quality of services; strengthening the evidence base for effective health policies, permitting evaluation of scale-up efforts, and enabling innovation through research; improving governance, mobilising new resources, and ensuring accountability in the way they are used.

This key issues guide examines some of the strategic and operational challenges involved in implementing HMIS; considers the evidence from some case studies; and asks what lessons have been learned to date.

The online version of this guide is available at: www.eldis.org/healthsystems/hmis/index.htm This guide was written by Cindy Carlson for the DFID Health Resource Centre (www.dfidhealthrc.org/)

Contents:
Strategic and operational issues ………………………………………………...…………...……….2 Strategic challenges ……………………………………………………………………………..2 Putting a working HMIS in place ………………………………………………………………..3 Operational constraints ………………………………………………………………………….4 Case studies ………………………………………………………………………………………………6 National case studies ……………………………………………………………………………6 District health information case studies ………………………………………………………..6 Lessons learned ………………………………………………………………………………………….7 References and summaries …………………………………………………………………………….8

Strategic and operational issues
The data needed in a comprehensive health management information system ranges from birth, morbidity and mortality data, to type and location of health personnel, to type and quality of clinical services provided at national and sub-national level and finally to population indicators, such as demographics and socio-economic status. This information can be divided into five different domains, as shown in the figure below: health determinants, health system inputs, health system outputs, health system outcomes, and health status.

Health information domains

Source: World Health Organization, 2005

There are a number of strategic and operational challenges involved in building such a system. This page looks at these issues and also provides information on some of the tools that have been developed to help countries build better HMIS in practice.

Strategic challenges
As noted in the introduction, a great deal of momentum has been built up over the last few years to improve HMIS, which has included setting up the Health Metrics Network to harness and channel this energy. But many challenges remain at international, national and sub-national levels for developing effective strategies for improving HMIS and then for implementing these strategies.

Health Metrics Network The Health Metrics...
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