(WP)HIN/ICP/HIN/6.S/OOI/HIN

Report series number: RS/200S/GE/53(PHL)

REPORT

INFORMAL CONSULTATION ON HEALTH INFORMATION SYSTEM STRATEGIC

PLAN FOR THE WESTERN PACIFIC REGION

Convened by:

WORLD HEALTH ORGANIZATION REGIONAL OFFICE FOR THE WESTERN PACIFIC

Manila, Philippines 28 -30 November 2005

Not for sale

Printed and distributed by: World Health Organization

Regional Office for the Western Pacific Manila, Philippines

January 2006

WHOIWPRO LIBRARY

English only

SUMMARY

The Informal Consultation on the Health Information System (HIS) Strategic Plan for the Western Pacific Region was held in Manila, the Philippines, from 28 to 30 November 2005 with the following objectives:

(1) to review and finalize the draft Health Information System Strategic Plan for the Western Pacific Region for 2006-2010;

(2) to prioritize strategies, develop plans and identifY forms and sources of support needed by member countries in order to scale up activities for the implementation of the Strategic Plan; and

(3) to identifY strategies for the integration of inputs, and enhance capacity for knowledge management and use of health information by member countries in the Region.

The meeting had twelve participants who were experienced HIS practitioners with different areas of expertise. A resource person from the WHO Headquarters, representing the Health Metrics Network also attended the meeting.

The presentations made during the meeting covered the proposed regional HIS strategic plan for the Western Pacific Region: 2006-2010; the Health Metrics Network (HMN framework); the Knowledge Management and Sharing (KMS) strategy; the integration of different initiatives to support decision-making at the country level; current developments in world health statistics and database development; and other issues related to HIS development, including the regional health database in the Western Pacific Region and the Ellison Institute for World Health. Those presentations, together with the output of the three group-work sessions conducted with the participants, were used as inputs in the preparation of the final draft of the Health Information System (HIS) Strategic Plan for the Western Pacific Region.

The Strategic Plan, which was endorsed by the meeting, consists of seven major strategies. These, together with the corresponding actions and initiatives are presented below:

STRATEGIES ACTIONS AND INITIATIVES

I. Advocacy 1.1 Review roles and functions of the Health StatisticslInformation Unit and its place in the Ministry of Health organizational structure

1.2 Conduct advocacy activities to create awareness, discuss issues and elicit action for the following HIS-related areas:

(a) systematic development and strengthening of the HIS of member countries (e.g., development of HIS masterplans, strategic framework, strategic plans);

(b) strengthening of the HIS workforce (review of human resource requirements, development/implementation of career development plan, etc.);

(c) formation of broad-based/multisectoral committees to provide technical support, coordinate, or manage certain aspects of the HIS;

(d) resource sharing for HIS development and maintenance among: - different programmes within the Ministry of Health; and - donor agencies;

(e) development of mechanisms for effective and efficient knowledge management; (f) integration of information systems of different vertical programmes within the

Ministry of Health: (g) more rigid implementation of existing HIS-related laws and regulations; (h) strengthening of the curriculum of medical and nursing schools in relation to the

generation and use of health information (including the use oflCD); and (i) establishment of a mechanism which ensures continuity in the assumption of

leadership/management functions for the HIS.

2. Development of 2.1 Develop policies on HIS-related issues, such as medical records (confidentiality, policies, retention, storage/release of records for medico-legal cases, etc.); release of/access to p regulations and public information; IT policv, etc. legislation on 2.2 Provide/strengthen the legal basis for different HIS-related activities, such as vitJI HIS-related registration system, reporting of notifiable diseases; data collection from the private issues health sector, use of electronic medical records, etc.

2.3 Develop, document, and disseminate operational! implemention guidelines for the HIS-related policies. regulations and legislation developed.

, Enhancement of 3.1 Develop/implement a capability-building programme for both data providers and data ~.

capacity for users. knowledge 3.2 Enhance capacity to respond to information requirements, especially those related to the management timeliness and adequacy of data. and use of health 3.3 Optimize data utilization through the application of appropriate data analysis techniques. information 3.4 Establish mechanisms to facilitate linkage of information with policy.

3.5 Participate in local and international health information networks. 3.5 Promote the sharing and application of experiential knowledge related to HIS.

4. Strengthening of 4.1 Develop/strengthen capacity to acquire and use IT. the application of 4.2 Develop policies and mechanism for the maintenance, upgrading and replacement of information and computer hardware and software. communication 4.3 Strengthen capacity to transmit, access and share health information. technology

5. Strengthening, 5.1 Integrate/unitY. the information systems of different vertical programmes. harmonization and 5.2. Conduct regular, systematic and institutionalized monitoring and review of the HIS, integration of data including collection (a) periodic review of information requirements; systems (b) continuous monitoring of the disease surveillance system; and

(c) monitoring and assessment of the efficiency of the core and support components of the HIS.

5.3 Prepare and disseminate user's manuals for the HIS and each of its sub-systems (e.g., Hospital, Public Health, Human Resource, Finance Information Systems, etc.)

5.4 Develop/enhance capacity to conduct research to complement routine data collection systems.

6. Improvement of 6.1 Develop. document and disseminate data quality standards. data quality 6.2 Develop and implement a systematic, regular and institutionalized system for the

supervision, monitoring and evaluation of data quality, covering all activities from data capture to data processing and analysis

7. System 7.1 Develop policy and implement a maintenance plan for various resources related to the maintenance HIS, including:

(a) physical resources (e.g. record storage facilities); (b) replacement and upgrading of equipment, including computer hardware and

software; (c) human resources (e.g., retention of qualified staff); and (d) data and IT standards.

On the last day of the meeting, the participants reached the following conclusions in relation to the Health Information System Strategic Plan for the Western Pacific Region for 2006-2010:

(1) The group endorsed draft 6 of the Health Information System Strategic Plan for the Western Pacific Region for 2006-20 I O.

(2) There is a need to monitor the effectiveness of the Strategic Plan. WHO should monitor its progress, using the indicators specified in the Plan.

(3) Countries should take up a number of the actions and initiatives identified in the Strategic Plan, using the support provided to them by the Health Metrics Network.

CONTENTS

1. INTRODUCTION ........................................................................................... 1

1.1 Objectives ............................................................................................... 1 1.2 Participants and resource persons .......................................................... 1 1.3 Organization ........................................................................................... 1 1.4 Opening ceremony ................................................................................. 2

2. PROCEEDINGS ............................................................................................. 2

2.1 Proposed Regional HIS Strategic Plan for the Western Pacific Region: 2006-2010 ...................................................... 2

2.2 Framework of the Health Metrics Network ........................................... 6 2.3 The Knowledge Management and Sharing strategy ............................... 6 2.4 Integration of different initiatives .......................................................... 6 2.6 Other issues ............................................................................................ 7 2.7 Group-work outputs ............................................................................... 8

3. CONCLUSIONS ........................................................................................... 15

ANNEXES:

ANNEX 1 - LIST OF TEMPORARY ADVISERS, CONSULTANT AND SECRETARlAT ............................. 17

ANNEX 2 - TIMETABLE ....................................................................... 19

ANNEX 3 - HEAL TH INFORMATION SYSTEM STRATEGIC PLAN FOR WPR: 2006-2010 ............................................. 21

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1. INTRODUCTION

The Informal Consultation on the Health Information System Strategic Plan for the Western Pacific Region was held in Manila, the Philippines, from 28 to 30 November 2005, and was the final step in the series of processes undertaken to develop the plan for 2006-2010. Since 2004, a series of workshops have been conducted in seven countries in the Region (Cambodia, China, Fiji, the Lao People's Democratic Republic, Malaysia, Papua New Guinea and the Philippines) to solicit inputs and advocate for the development of health information system (HIS) strategic plans at the country level. The strategies identified by the seven countries in the HIS strategic plans they developed during the workshops were used as inputs in the development of the first draft of the regional HIS strategic plan. The initial draft was likewise presented to several bodies, such as the WHO South-East Asia-Western Pacific Biregional Consultation on Strengthening Health Information Systems in Asia and the Pacific, held in Bangkok, Thailand, in December 2004.

1.1 Objectives

The consultative meeting had the following three specific objectives:

(I) to review and finalize the draft Health Information System Strategic Plan for the Western Pacific Region for 2006-2010;

(2) to prioritize strategies, develop plans and identifY forms and sources of support needed by member countries in order to scale up activities for the implementation of the Strategic Plan; and

(3) to identifY strategies for the integration of inputs, and enhance capacity for knowledge management and use of health information by member countries in the Region.

1.2 Participants and resource persons

The meeting had 12 participants who were experienced HIS practitioners with different areas of expertise. Eight of them were from the Ministries of Health of their countries, three from academia and one was a former WHO staff member in the area of health information. A resource person from WHO Headquarters, representing the Health Metrics Network, also attended the meeting. The list of participants is presented in Annex 1.

1.3 Organization

Three types of activity were conducted during the meeting: presentations, group work and plenary sessions. Participants were divided into two groups for each of the three group­work activities and series of guide questions and worksheets were prepared to facilitate group discussions. The plenary sessions were used for the presentation and discussion of group outputs. The programme of activities is presented in Annex 2.

The Chairperson of the meeting was Dr Stanislaw Orzeszyna, while Dr Margaret Cornelius was the Vice-Chairperson. Dr Lailanor B. Ibrahim was the Rapporteur.

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1.4 Opening ceremony

The participants were welcomed by Dr Richard Nesbit, Director, Programme Management, WHO Regional Office for the Western Pacific. He delivered a message on behalf of Dr Shigeru Omi, Regional Director, who was unable to attend the meeting.

In his message, Dr Omi mentioned that the development of an HIS strategic plan for the Region is an activity which is long overdue, since the last time a similar plan was developed for the Region was in 1999. In addition, he mentioned several developments, particularly in the last five years, which have made clear the need for timely and high quality information to help decision-makers. These developments include the emergence and continuing threat of diseases like SARS, avian influenza and HIV / AIDS; the rapid expansion of information and communication technology; and global initiatives, such as the Millennium Development Goals, the Global Fund to Fight AIDS, Tuberculosis and Malaria, and the Health Metrics Network.

Dr Omi also told the participants that, of the three objectives of the meeting, the third one was the most challenging since it involved the identification of strategies for three very difficult tasks: (1) integrating and coordinating inputs and initiatives on HIS development, especially among donor agencies; (2) enhancing the capacity of countries to share and transmit good quality information from data providers to data users in an efficient manner; and (3) translating information into action. He explained that all three tasks embedded in the third objective of the meeting would be difficult to address because they involved, not only technical factors, but also political and cultural factors.

He closed his message by expressing his confidence that, with the vast experience of the participants in the area of health information systems, a comprehensive, relevant and dynamic HIS strategic plan would be developed by the end of the meeting. Such a plan would serve as the blueprint to generate better information to be used in fonnulating better decisions that will lead to the development of better health in the Region.

2. PROCEEDINGS

2.1 Proposed Regional HIS Strategic Plan for the Western Pacific Region: 2006-2010

Dr Ophelia M. Mendoza, WHO Consultant on Health Information, presented the fifth draft of the proposed HIS Strategic Plan for the Western Pacific Region.

The basis of the framework underlying the development of the HIS Strategic Plan was the same goal as of any information system, which is the provision ofthe right information to the right persons, at the right time, for the right purposes, to get the desired results. That goal leads to four focal areas in the development of health information systems which are the: (1) generation of; (2) access to; and (3) use of health information, in order to (4) achieve the desired results.

Dr Mendoza identified several factors affecting the extent to which a country would be able to implement each of the four focal areas of its health information system as follows:

(I) Regulatory environment - This refers to the legal basis and regulatory mechanisms for data collection, sharing and use. This factor includes health legislation and policy development on HIS-related issues, as well as the placement of the Health Statistics/Information Unit within the organizational structure of the Ministry of Health.

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(2) Data source - This includes sources internal and external to the Ministry of Health. External data sources include the private health sector; other government agencies producing health-related data, like the population data produced by the National Statistics Office, nutrition-related data produced by the Ministry of Agriculture or data on accidents compiled by the police; academia, which is the usual source of research data; and nongovernmental as well as international organizations, like the United Nations Children's Fund (UNICEF), the United Nations Population Fund (UNFPA) and others.

(3) Human resources - This includes knowledge and skills, as well as the motivation of both the data providers and the data users to collect, process, analyse and utilize data.

(4) Process - This factor covers a wide range of activities related to data collection and flow - what to collect; where to record; what and how to report; to whom to submit; and what frequency of submission.

(5) Technology - This covers factors related to the use of manual and computerized systems of data processing and storage, as well as system maintenance, upgrades, updates and replacement of IT equipment.

(6) Knowledge management - This is a major factor affecting access to information. Included is the filtering/sifting of the information generated, and the storage, retrieval, marketing and sharing of information.

(7) Data quality - This is a major factor affecting the extent to which the data are utilized. This includes concerns regarding the timeliness, completeness, accuracy, reliability and adequacy of the data generated by the HIS.

(8) Organizational factors - This is another major factor affecting data utilization. It includes the mission, vision and goals of the organization in relation to generation and use of health information, the extent to which the information culture has been assimilated in decision-making and policy formulation within the Ministry of Health, the political will to develop and strengthen the HIS, as well as the role of external players like the donor agencies.

These factors are closely interrelated. Figure 1 shows the different factors affecting the generation of, access to and use of health information, and the generation of desired outcomes.

Eight major strategies were identified in the proposed strategic plan. These are outlined in Table 1, together with the actions and initiatives corresponding to each strategy.

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Table 1. Major strategies and corresponding actions and initiatives in the proposed Health Information System Strategic Plan for the Western Pacific Region

STRATEGY ACTIONS AND INITIATIVES 1. Advocacy 1.1 Systematic development of the HIS of member countries.

1.2 Resource sharing for HIS development and maintenance. 1.3 Harmonization of information systems of different programmes within

the Minist!)' of Health. 1.4 Development of mechanisms for effective and efficient knowledge

management. 1.5 Review of roles and functions of the Health Statistics Unit and its

place in the Ministry of Health organizational structure. 2. Strengthening of 2.1 Review of human resource requirements for HIS at different levels.

the HIS workforce 2.2 Development and implementation of career development plan for HIS workforce, including the provision of incentives and benefits.

2.3 Development and implementation of capability-building programmes for HIS staff.

3. Improvement of 3.1 Development, documentation and dissemination of data quality data quality standards.

4. Strengthening, 3.2 Development and implementation of a systematic, regular and harmonization, and institutionalized system for the supervision, monitoring and evaluation integration of data of data quality. collection systems 4.1 Harmonization and unification of information systems of different

programmes. 4.2 Regular, systematic and institutionalized monitoring and review of the

HIS. 4.3 Preparation and dissemination of user's manuals for the HIS and its

sub-systems. 4.4 Development and enhancement of capacity to conduct research to

complement routine data collection systems. 4.5 Strengthening of disease surveillance systems. 4.6 Provision of mechanisms for regular and effective communication

between data users and dataproviders. 5. Strengthening of the 5.1 Strengthening of capacity to use IT.

application of 5.2 Development of policies and mechanisms for the maintenance. information and u'pgrading and replacement of computer hardware and software. communication 5.3 Strengthening of the capacity to transmit, access and share health technology information.

5.4 Participation in local and international health information networks. 6. Enhancement of 6.1 Enhancement of capacity to respond to information requirements,

capacity for especially those related to timeliness and adequacy of information. knowledge 6.2 Optimal utilization of information through the application of management and appropriate data-analysis techniques. use of health 6.3 Establishment of mechanisms to facilitate linkage of information with information policy.

6.4 Promotion of the sharing and application of experiential knowledge related to the HIS.

7. System maintenance 7.1 Development of policy and implementation of a maintenance plan for various resources related to the HIS.

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REGUlATORY

ENVIRONMENT

DATA SOURCES

HUMAN RESOURCES

(Data Providers)

TECHNOlOGY [Icn

",;""",,~" .

. GENERADON O~. • _ ........ H~lTH ....•.••..•.

>INFGIiMADON'S "

KNOWlEDGE MANAGEMENT

HUMAN RESOURCES [Data Users)

ORGANIZADOW FACTORS

V>

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2.2 Framework of the Health Metrics Network

Dr Churnrurtai Kanchanachitra, Evidence and Information Policy, WHO Headquarters, presented the Health Metrics Network (HMN) framework. HMN is an international initiative to address the problems of health information systems of developing countries. It serves as a catalyst in achieving the goal of increasing the availability and use of timely and accurate health infonnation at community, national and global levels through shared agreements on HIS goals and common investment in core systems. Its framework has six main components and standards: HIS policies and resources; core health indicators; data source; information management process; data availability and quality; and dissemination and use.

HMN provides financial and technical support for low- and middle-income countries. The first phase of the project runs from 2005 to 2012. Seven Member States of the WHO Western Pacific Region (Cambodia, China, Fiji, the Lao People's Democratic Republic, Mongolia, the Philippines and Viet Nam) submitted proposals for the first phase, all of which have been approved. In all of those countries, HMN will be supporting the comprehensive assessment of the HIS, as well as the development of HIS plans. HMN will likewise support capability-building activities in Cambodia, the Lao People's Democratic Republic, Mongolia and Viet Nam.

2.3 The Knowledge Management and Sharing strategy

The Knowledge Management and Sharing (KMS) strategy was presented by Dr Y.c. Chong, Regional Adviser on Health Information, in the absence of the KMS Representative from WHO Headquarters.

The KMS vision is to attain global equity through better knowledge management and sharing. Its mission is to help bridge the "know-do gap" in global health by fostering an enabling environment and culture change. The "know-do gap" refers to the gap between what is known and what is done in practice.

Dr Chong also presented the five core functions of KMS: (1) access to health information; (2) translating knowledge into policy and action; (3) sharing experient:al knowledge; (4) leveraging e-health in countries; and (5) fostering an enabling environment. Among the strategies to be adopted to implement these functions are: knowledge mapping to understand what knowledge exists and identifY gaps; establishment of communities of practice to begin sharing and reapplying experiential knowledge; and leveraging of ICT for health. In following those strategies, KMS aims to engage partners and mobilize new resources. It will also harness the capability of regional offices and work across programmes in WHO.

2.4 Integration of different initiatives

The presentation on the integration of different initiatives to support decision­making at the country level was made by Dr Y. C. Chong, Regional Adviser on Health Information.

The integrated approach to support decision-making involves three closely related initiatives: Research to Policy (RP); Knowledge Management and Sharing (KMS); and the Health Metrics Network (HMN). All these initiatives are similar in that they support health systems development and target the same decision-makers. They also promote better use of information and knowledge in decision-making. As a result, the same experts may be involved when these initiatives are introduced at the country level.

In view of the similarities, the WHO Western Pacific Regional Office is promoting the integration of all information, research and knowledge-based initiatives at the national and sub-national levels. That involves a better understanding of how the different

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initiatives and approaches complement each other. If done successfully, it will avoid duplication and waste of resources.

Dr Chong presented the following four expected benefit of integration:

(1) a more reliable, comprehensive and useful health information system;

(2) a more systematic approach for collating, analysing, sharing and using information ( It also leads to the possibility of creating subnational, national or intercountry networks for systematic review of evidence.);

(3) a national framework for supporting health systems development by better information and knowledge sharing; and

(4) gradual improvement in capacity for evidence-based decision-making.

2.5 World health statistics and database development

Dr Michel Thieren, Team Leader, Evidence and Information Policy, WHO Headquarters, presented current developments in world health statistics and database development. He also presented examples of the current products of the system, the processes involved and the plans for the future.

Dr Thieren described the following products in the area of world health statistics: World Health Statistics 2005, both in print and on the Global Atlas, the WHO INFOBASE and the HMN Country Logbook, which are accessible on-line. While these products are similar to earlier initiatives on world health statistics in that they present indicators by country and year, major improvements have been made in the following aspects:

• For the first time, WHO is publishing, in one document, a set of data tables pertaining to the broad span of health and health care. Previously, users had to browse through several documents to get information on different types of health indicators.

• In addition to the values of the different indicators, technical information about the indicators, such as their definition, data sources, methods of estimation and the data platform, are also included.

• Also included are quality judgments on each indicator, for the guidance of the user.

Several options are being considered for future activities, including translation of the products into other languages, and application transfer from region to region, and between WHO Headquarters and the regions. In terms of content, the inclusion of more indicators and of sub national data is among the options being considered. As for the system itself, several issues are being considered for the future including: the adoption of an on-line clearinghouse process; the use of a minimum set of metadata; how to connect the various WHO databases to provide information on the minimum set of data and metadata; and the need for a common database and application system.

2.6 Other issues

The last presentation, on other issues related to HIS development, was given by Dr Y.c. Chong and was in two parts. The first part concerned the regional health database in the Western Pacific Region, while the second part was about the Ellison Institute for World Health.

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There are five key health databases in the Western Pacific Region: (I) Demographic tables; (2) Country Health Information Profiles (CHIPS); (3) Statistical annexes; (4) Health MDG indicators; and (5) programme-specific databases. Those databases can be retrieved from the website in the form of tables, maps or charts. They are also available in other formats like hard copy, CD/ROM or publications. They are updated annually and are revised every three to five years in consultation with the technical units. In producing the databases, a close link is maintained between the WHO Representatives' office and the Ministry of Health of each Member State.

Dr Chong presented six suggestions for improvement of the databases, as follows:

(I)

(2)

(3)

(4)

(5)

(6) possible.

Establish a catalogue of global core health indicators for country use.

Provide definitions of indicators to facilitate international comparison.

Resolve the issue of data accuracy, especially in the light of several conflicting values of the same indicator within a country.

Develop a core health dataset, including health MDG indicators, for long-term monitoring and evaluation.

Improve mortality reporting in the Ministry of Health, where vital registration is weak.

Use country websites for validating and updating indicators where

In the second part of his presentation, Dr Chong provided participants with background on the Ellison Institute for World Health, which was established in 2005. Its vision is to improve popUlation health and the efficiency of health system resource utilization through the regular reporting of inputs, outputs and impacts of the world's health systems and major health donors. It has 10 thematic areas under its scope of work: (I) national health accounts; (2) health interventions delivery; (3) cost-effectiveness; (4) mortality; (5) burden of disease and comparative risk assessment; (6) population health; (7) health forecasts; (8) financial risk protection; (9) health system efficiency; (10) and special evaluation studies. The Institute will go through three phases of development. For the first phase, 15-20 countries will be selected for in-depth collaboration.

2.7 Group-work outputs

The following topics were discussed during the three group-work sessions:

Group work I:

Group work 2:

Group work 3:

Review of the strategies and activities in the Health Information System Strategic Plan for the Western Pacific Region. Prioritization of strategies and identification of forms and sources of support needed for the implementation of the strategic plan. Identification of issues and development of strategies for the effective integration of HIS-related inputs at the country level.

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2.7.1 Review of strategies and activities

During the first group-work activity, the two groups were assigned to review different strategies in the proposed strategic plan. The following changes to the strategic plan were proposed:

(I) Deletion of strategy #2 (strengthening of the HIS workforce) and incorporation of the proposed actions and initiatives under this strategy to the following:

(a) Development and implementation of a career development plan for the HIS workforce, to be incorporated and reflected as a top priority issue for advocacy (strategy #2); and

(b) development and implementation of a capability-building programme for the HIS workforce, to be included among the actions and initiatives under strategy #5 (enhance capacity for KM and use of information).

(2) Inclusion of policy development among the strategies.

(3) Inclusion of the following actions and initiatives in the strategic plan:

(a) Formation of broad-based committees to coordinate HIS activities;

(b) review of the nursing and medical curricula in relation to the generation and use of health information; and

(c) ensuring continuity in HIS leadership.

(4) Reversal of the order of actions 1.1 (review roles and functions of Health Statistics Unit) and 1.2 (conduct advocacy activities).

(5) Transfer of action 5.4 (participation in health information networks) from strategy #5 (leT application) to strategy #6 (KM and use of information).

(6) Inclusion of data and IT standards among enumerated items in strategy #7 (system maintenance.

2.7.2 Prioritization of strategies

For the second group-work session, each of the two groups were asked to prioritize the seven strategies listed in the proposed strategic plan, with rank I being assigned to the strategy given the highest priority. Differences in the ranks assigned by the groups to the same strategy were discussed during the plenary. The means of the ranks assigned by the two groups to each strategy was computed to determine the final ranking of each strategy in the revised version of the strategic plan.

The two groups were unanimous in identifYing advocacy as the strategy with the highest priority. Since policy development was suggested for inclusion among the major strategies to be adopted based on the output of the first group-work session, that was given the second highest priority, since all other strategies and activities cannot proceed without corresponding policy for their implementation. The assignment of the succeeding ranks to the rest of the strategies was based on the value of their mean rank. They are shown in Table 2.

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Table 2. Prioritization of proposed strategies

Rank assigned by: Mean Priority Strategies Grp 1 Grp 2 Rank No.

1. Advocacy 1 1 1.0 1

2 Strengthening of the HIS workforce 2 5 3.5 -3. Improvement of data quality 5 6 5.5 6

4. Strengthening, harmonization and 6 4 5.0 5 integration of data collection systems

5. Strengthening of the application of 4 3 3.5 4 information and communication technology

6. Enhancement of capacity for knowledge 3 2 2.5 3 management and use of health information

7. System maintenance 7 7 7.0 7

8. Policy development - - - 2

As a result of the outputs of group-work sessions 1 and 2, the revised strategies, actions and initiatives for the Health Information System Strategic Plan for the Western Pacific Region for 2006-2010 are presented in Table 3.

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Table 3. HIS Strategic Plan for the Western Pacific Region: 2006-2010 (Draft 6)

STRATEGIES ACTIONS AND INITIATIVES

I. Advocacy l.l Review roles and functions of the Health Statistics/Information Unit and its place in the Ministry of Health organizational structure.

1.2 Conduct advocacy activities to create awareness, discuss issues and elicit action for the following HIS-related areas:

(a) systematic development and strengthening of the HIS of member countries (e.g., development of HIS master plans, strategic framework, strategic plans);

(b) strengthening of the HIS workforce (review of human resource requirements, development/implementation of career development plan, etc.);

(c) formation of broad-based/multisectoral committees to provide technical support, coordinate, or manage certain aspects of the HIS;

(d) resource sharing for HIS development and maintenance among different programmes within the Ministry of Health; and donor agencies;

(e) development of mechanisms for effective and efficient knowledge management;

(f) integration of information systems of different vertical programmes within the Ministry of Health;

(g) more rigid implementation of existing HIS-related laws and regulations;

(h) strengthening of the curriculum of medical and nursing schools in relation to the generation and use of health information (including the use of ICD); and

(i) establishment of a mechanism which ensures continuity in the assumption of leadership/management functions for the HIS.

2. Development of 2.1 Develop policies on HIS-related issues (e.g., medical records policies, (confidentiality, retention, storage/release of records for regulations and medico-legal cases, etc.); release of/access to public legislation on information; IT policy, etc.). HIS-related

2.2 Provide/strengthen the legal basis for different HIS-related Issues activities (ex., vital registration system, reporting of notifiable diseases; data collection from private health sector, use of electronic medical records, etc).

2.3 Develop, document and disseminate operationaVimplementation guidelines for HIS-related policies, regulations and legislation developed.

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STRATEGIES ACTIONS AND INITlA TIVES

3. Enhancement of 3.1 Develop/implement a capability-building programme for both capacity for data providers and data users. knowledge

3.2 Enhance capacity to respond to information requirements, management and use of health especially those related to the timeliness and adequacy of data.

information 3.3 Optimize data utilization through the application of appropriate data analysis techniques

3.4 Establish mechanisms to facilitate linkage of information with policy.

3.5 Participate in local and international health information networks .

3.6 . Promote the sharing and application of experiential knowledge related to HIS.

4. Strengthening of 4.1 Develop/strengthen capacity to acquire and use IT. the application of information 4.2 Develop policies and mechanisms for the maintenance, upgrading and and communication technology

replacement of computer hardware and software.

4.3 Strengthen capacity to transmit, access and share health information.

5. Strengthening, 5.1. integrate/unifY the information systems of different vertical harmonization programmes. and integration of data 5.2. Conduct regular, systematic and institutionalized monitoring and collection review of HIS including: systems

(a) periodic review of information requirements;

(b) continuous monitoring of the disease surveillance system; and

(c) monitoring and assessment of the efficiency of the core and s~ort com.Jlonents of the HIS.

5.3. Prepare and disseminate user's manuals for the HIS and each of its sub-systems (e.g .. Hospital, Public Health, Human Resource. Finance Information Systems, etc.).

5.4. Develop/enhance capacity to conduct research to complement routine data collection systems.

6. Improvement of 6.1 Develop, document and disseminate data quality standards. data quality

6.2 Develop and implement a systematic, regular and institutionalized system for the supervision, monitoring and evaluation of data quality, covering all activities from data capture to data processing and analysis.

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7. System maintenance

Develop policy and implement a maintenance plan for various resources related to HIS inel uding :

(a) physical resources (e.g. record storage facilities);

(b) replacement and upgrading of equipment, including computer hardware and software;

(c) human resources (e.g., retention of qualified staff); and

~dl data and IT standards

A detailed presentation of the Health Information System Strategic Plan for the Western Pacific Region for 2006-20 10 (Draft 6), including the inputs needed from countries and donor agencies as well as the performance indicators, is presented in Annex 3.

2.7.3 Best practices

For the second discussion item for group-work session 2, a modification was made. Instead of identifying types and sources of support needed for the implementation of specific strategies, the meeting participants were asked to share experiences and best practices in relation to the different strategies included in the regional plan. These are presented in Table 4.

Table 4. Experiences and best practices shared by meeting participants in relation to the different strategies included in tbe draft Strategic Plan

STRATEGYI BEST PRACTICEI ACTIONS/INITIA TIVES LESSONS LEARNT

Development/enhancement of .:. The Ministry of Health should actively capacity to conduct research to solicit the research involvement of other complement routine data institutions with research capability. collection systems

.:. Training programmes for research should be participative and interactive, and include a practicum phase, to be more effective.

Advocacy .:. Other ministries should be involved in the development of the HIS Strategic Plan to facilitate approval.

.:. The HIS Strategic Plan should be disseminated to all levels of policy-makers.

Improvement of data quality .:. All stakeholders should be involved III

designing and revising forms, including subnational-Ievel staff and NGOs.

.:. Regular spot-checking for data quality should be carried out.

Capability building for the HIS workforce

Strengthening, harmonization and integration of data collection systems

Provision of a feedback mechanism

Strengthening of ICT

Maintenance of hardware and software

Linkage of information with policy

Data utilization

- 14-

.:. There should be close interaction between the Human Resource Department and the operational bureaux in needs assessment and design of training programmes .

• :. Follow-up of training programmes are essential.

.:. Several approaches should be used in the training of data providers, including problem-solving approaches .

• :. The provincial health budget can be used for this purpose, supplemented by resources from multilaterallbilateral donors .

• :. Unifying and harmonizing the information system is a very long process, involving a lot of players.

.:. The active involvement of high-level officials in some activities conducted as part of the harmonization process is effective in relaying to the donors and other stakeholders the Ministry of Health's high level of interest in strengthening the HIS .

• :. One way of providing quick and effective feedback is the formation of committees whose membership includes different levels of data users and data providers .

• :. lCT strengthening should cover three aspects: managerial, technical and operational.

.:. The financing of computer hardware and software can be done initially by government, but the operational unit should assume responsibility later.

.:. There should also be an ICT strategic plan.

.:. Levels of responsibilities for ICT -related decisions should be clearly defined (lCT Steering Committee, Task Force, IT Division) .

• :. Who is in charge of knowledge management is important.

.:. If HIS is to be used, it cannot be isolated. HIS staff have to work with programme people .

• :. One of the difficulties is that utilization of health data is not taught in medical school.

- 15 -

2.7.4 Integration of HIS-related inputs

The two groups identified several issues related to the integration of HIS-related inputs at the country level including:

(1) a lack of health information from other programmes, projects and agencies.

(2) low requirements of decision-makers in terms of using integrated information for decision-making;

(3) ownership of information;

(4) lack ofa mechanism, system or body within the Ministry of Health to deal with the integration;

(5) a lack of coordination among donors in HIS - fragmentation of donor support;

(6) a lack/absence of policy and implementation guidelines for integration, including monitoring and evaluation;

(7) the lack of an evidence-based culture, especially among decision-makers;

(8) incompatibility of the software used by different organizations;

(9) a lack of guidance or policy on foreign funding;

(10) the emphasis of donors on surveys, to the neglect of routine data collection systems; donors likewise support the best system, rather than the existing needed system;

(II) the divergent reporting requirements imposed by donors;

(12) promotion of inappropriate advanced technologies by donors; and

(13) a weakness at the federal level in managing funds; certain areas in HIS are funded excessively.

The perceived effects of those shortcomings on the HIS are duplication and waste of resources, poorlinappropriate/delayed decisions, poor data quality, poor planning and an imbalance in HIS development. The strategies suggested to address the different issues identified include advocacy; policy development; standardization of databases, hardware, software, indicators and reporting requirements; regular donor meetings; and strengthening of the management of funds at the federal level.

3. CONCLUSIONS

On the last day of the meeting, the participants reached the following conclusions in relation to the Health Information System Strategic Plan for the Western Pacific Region for 2006-2010:

(1) The group endorsed draft 6 of the Health Information System Strategic Plan for the Western Pacific Region for 2006-2010.

(2) There is a need to monitor the effectiveness of the Strategic Plan. WHO should monitor its progress, using the indicators specified in the plan.

- 16 -

(3) Countries should take up a number of the actions and initiatives identified in the Strategic Plan, using the support provided to them by the Health Metrics Network.

- 17 -

LIST OF TEMPORARY ADVISERS, CONSULTANT AND SECRETARIAT

ANNEX I

Dr Margaret CORNELIUS, Director, Health Service Development, Dinem House, 88 Amy Street, Toorak, P.O. Box 2223, Government Buildings, Suva, Fiji, Tel. No. (679) 3306177, Fax No. (679) 3306163, Email: mcornelius@health.gov.fj

Dr York DARARITH, Department of Planning and Health Information, Ministry of Health #151-153 Kampuchea Blvd., Phnom Penh, Cambodia, Tel. No.(855) 12859134,

Email: dararith-york@yahoo.com

Dr Sereenen ENKHBOLD, Deputy Director, Information, Monitoring and Evaluation Division, Government Building VIII, Olympic Street-2, Ministry of Health, U1aanbaatar - 48, Mongolia, Tel No. (976) 11263681, Email: enkhbo1d@moh.mn

Dr Tomonori HASEGAWA, Professor and Chair, Division of Health Policy and Health Service Research, Department of Social Medicine, Toho University School of Medicine 5-21-16 Omori-Nishi, Ota-ku, Tokyo 143 8540, Japan, Tel. No.(813) 3762-4151 ext. 2413, Fax No.

(813) 5493-5417, Email tommie@rned.toho-u.ac.jp

Dr Luu Ngoc HOA T, Vice Rector, Head of Biostatistics Department, Hanoi Medical University, 01 Ton That Tung Street, Dong Da, Ha Noi, Viet Nam, Tel No. (844) 5741382, Fax No. (844) 8525115, Email: luungochoat@hn.vnn.vn

Dr Lailanor B. IBRAHIM, Deputy Director, Planning and Development Division, Ministry of Health, Level 6, Block E7, Parcel E, 62590 Putrajaya, Malaysia, Tel. No. 60-3-88833128 Fax No. 60-3-88833169, Email : 1ailanor@moh.gov.my

Dr Rohan JAY ASURIY A, Associate Professor, University of Wollongong, School of Public Health, Wollongong NSW 2500, Australia, Tel. No. 61-42-213344, Mobile 61-413-195448, Email: ajayasur@uow.edu.au

Dr Swady KINGKEO, Chief of Health Statistical Division, Ministry of Health, Vientiane, Lao People's Democratic, Republic, Tel. No. 856-20-2418363, Email: s_kingkeo@yahoo.com

Dr Stanislaw ORZESZYNA, Public Health Consultant, 408 rue de Paris, 23 residence des Fontaines, 01170 Gex, France, Email: stanis1aw_orzeszyna@yahoo.com

Dr Ferdinand S. SALCEDO, Chief, Health Research Division, Health Policy Development and Planning Bureau, Department of Health, 2nd Floor, Bldg 3, San Lazaro Compound, Rizal Avenue, Sta. Cruz, Manila, Philippines, Tel/Fax No.: (63) 2-743-83-01, Email: Csalcedo@hotrnail.com

Dr Jong-Sung SUN WOO, Manager ofInformation Management Team, Ministry of Health and Welfare, 1, Joongang-Dong, Gwacheon-si, Gyeonggi-do, Korea 427-721, Tel. No. (82) 2- 2110-6116, Fax No. (82) 2- 503-6493, Email: jssunwoo@mohw.go.kr

Ms Xiaoling WU, Director, Division of Statistics Center for Statistics Information, Ministry of Health, 1, Nanlu, Xi Zhi Men Wai, Beijing 100044, China, Tel. No. (86) 10-68792482, Fax No:(86) 10-68792478, Email: Wuxl@moh.gov.cn

Annex I - 18 -

2. CONSULTANT

Dr Ophelia MENDOZA, 47 Pook Dagohoy, U.P. Campus, Diliman, Quezon City, Philippines, Tel. No. 632-4369332, Email: opheliamendoza@yahoo.com

3. SECRETARIAT

Dr Churnrurtai KANCHANACHITRA, Health Metrics Network, WHO/EIP, Measurement and Health Information Systems, WHO Headquarters Office, Avenue Appia 20, CH-1211 Geneva 27, Switzerland, Tel No. (4122) 7913655, Email: kanchanachitrac@who.int

Dr Michel THIEREN, Team Leader, EIP/MIH, WHO Headquarters Office, Avenue Appia 20, CH-1211 Geneva 27, Switzerland, Tel. No. (4122) 7914626, Email: thierenm@who.int

Dr Y.c. CHONG (Responsible Officer), Regional Adviser in Health Information, Health Sector Development Division, WHO Western Pacific Regional Office, United Nations Avenue, Manila, Philippines, Tel. No. (632) 5289812, Fax No. (632) 5211036, Email: chongyc@wpro.who.int

Miss Hazel MACADANGDANG, Assistant, Health Information, Health Sector Development Division, WHO Western Pacific Regional Office, United Nations Avenue, Manila, Philippines Tel. No. (632) 5289838, Fax No. (632) 5211036, Email: macadangdangh@wpro.who.int

TIME

8:30 - 9:00 9:00 -10:00

10:00 - 10:30

10:30 -12:00

12:00 -1 :30

1:30 - 3:00

3:00 - 3:30

3:30-5:00

-

ACTIVITY

INFORMAL CONSULTATION ON HEALTH INFORMATION SYSTEM (HIS) STRATEGIC PLAN FOR WPR

28-30 November 2005 Manila, Philippines

TIMETABLE

I PRESENTOR ACTIVITY PRESENTOR ACTIVITY PRESENTOR

Monday, 28 November Tuesday, 29 November Wednesday, 30 November

1) Opening Ceremony 6) Group Work 2: Prioritization of Group Work 3 - Summary Group 2) HIS Strategic Plan for the Dr. O. Mendoza strategies and identification of Representatives Western Pacific Region (WPR) support needed for the 9) Recommendations for the

implementation of the HIS finalization of the HIS Strategic Plan Strategic Plan for WPR forWPR

Coffee Break

3) Health Metrics Network Dr. C. Kanchanachitra Group Work 2 - Summary Group 10) Final draft for the HIS Dr O. Mendoza Framework Representatives Strategic Plan (or WPR

4) Knowledge Management and SharinQ StrateQY

Lunch Break Lunch for all Participants Lunch Break

5) Group Work 1: Review of 7) Integration of Different Dr. Y. C. Chong 11 ) World Health Statistics and Dr. Michel Thieren the strategies, actions and Initiatives to Support Decision- Data Base Development initiatives in the proposed HIS making at the Country Level strategic plan for WPR

8) Group Work 3: Identification of issues and development of strategies for the integration of HIS-related inputs

Coffee Break

Group Work 1 - Summary Group Representatives Continuation of Group Work 3 12) Other Issues Related to HIS Dr. Y. C. Chong Development (Regional Data Base, Ellison Institute for Global Health, etc.)

13) Closing Ceremony

-

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DRAFT HEALTH INFORMATION SYSTEM STRATEGIC PLAN FOR WPR: 2006-2010

INPUTS NEEDED FROM: STRATEGY ACTIONS AND INITIATIVES COUNTRY WHO/DONOR AGENCIES

1. Advocacy 1.1. Review roles and functions of the Health Statistics/ 1. Form body to conduct review Provide technical support for the Information Unit and its place in the MOH review process organizational structure 2. Conduct the assessment and

provide recommendations

3. Implement recommendations

1.2. Conduct advocacy activities to create awareness, 1. Conduct advocacy activities like Provide financial and technical discuss issues and elicit action for the organizing meetings, seminars support for the conduct of advocacy following HIS-related areas: workshops, or working with the activities

media a. systematic development of the HIS of member Provide the lead in advocating with

countries (development of HIS masterplans; 2. Form multi-sectoral coordinating higher levels like the national strategic framework; strategic plans) body for HIS to facilitate the assembly members and other high-

mobilization of resources and ranking government officials, the b. strengthening of the HIS work force (review of other forms of support both within Minister of Health and other health

human resource requirements; developmenU and outside of the MOH policy makers, members of the implementation of career development plans; media, etc. provision of benefits and incentives, etc.)

Provide guidance and technical c. formation of broad-based/multi-sectoral support in negotiating with donor

committees to provide technical support, partners coordinate, or manage certain aspects of the HIS

Facilitate the exchange of technical d. resource sharing for HIS development and expertise through inter-country

maintenance among: agreements d1. different programmes within MOH d2. donor agencies

~. - --- --- ------~- ---- - ---- --- - - - - -- ---

PERFORMANCE INDICATOR

Roles, functions and position of Health Statistics Unit in MOH organizational structure defined

Number of meetings, seminars, and workshops and other activities conducted to advocate for different HIS-related issues

Number and type of initiatives/actions implemented as result of advocacy activities

-- -- --- -

N

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STRATEGY ACTIONS AND INITIATIVES

1. Advocacy e. development of mechanisms for effective and (con't) efficient knowledge management

f. integration of information systems of different programmes within MOH

g. more rigid implementation of existing HIS-related laws and regulations

h. strengthening of the curriculum of schools of medicine, nursing and other allied medical professions in relation to courses on the generation and use of health information (including the use of ICD)

i. establishment of a mechanism which ensures continuity in the assumption of leadership/ management functions for the HIS

2. Develop policies, 2.1 Develop HIS-related policies, regulations and regulations and legislation legislation on a. policies to guide the systematic development HIS-related and strengthening of the HIS (e.g., periodic issues development, monitoring, evaluation and

updating of the country's HIS strategic plan; integration of sub-systems within the HIS, etc.)

b. policies on HIS-related operational issues (e.g., confidentiality/retention/storage of medical records; handling of records of medico-legal cases; release of/ access to public information; IT policy, etc.)

c. Provide/strengthen the legal basis for different HIS-related activities (e.g., vital registration system, reporting of notifiable diseases, data collection from the private health sector, use of electronic medical records, etc.)

~ - ~-

INPUTS NEEDED FROM: COUNTRY WHO/DONOR AGENCIES

1. Conduct inventory of HIS-related Technical and financial support in policies, regulations and the development of HIS-related legislation already developed in policies, regulations and legislation the country and their corresponding statusllevel of implementation

2. Identify HIS-related areas for the development of policies, regulations and legislation, based on results of inventory

3. Develop HIS-related poliCies, reg! Ilatinns Find leg islation

----~ -

PERFORMANCE INDICATOR

Number of meetings, seminars, and workshops and other activities conducted to advocate for different HIS-related issues

Number and type of initiatives/actions implemented as result of advocacy activities

Number and types of HIS-related policies, regulations and legislation developed

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INPUTS NEEDED FROM: STRATEGY ACTIONS AND INITIATIVES COUNTRY WHOIDONOR AGENCIES

2. Develop policies, 2.2 Develop, document and disseminate 1. Develop operationallimplementing Technical support in the development regulations and operational/implementing guidelines for guidelines for HIS-related policies, of operational/implementing legislation on HIS-related policies, regulations and regulations, and legislation developed guidelines for HIS-related policies, HIS-related legislation developed 2. Document and disseminate HIS-related regulations and legislation developed Issues (can't) policies, regulations and legislation and

corresponding implementing guidelines Financial support for the reproduction 3. Conduct activities (e.g., seminars, media and dissemination of operational

announcements, etc.) to heighten guidelines, including the conduct of awareness on HIS-related policies, activities to increase awareness on regulations and legislation among different HIS-related policies, regulations and types and levels of stakeholders legislation

3. Enhance 3.1 Develop/implement capability building 1. Conduct training needs assessment for Technical and financial support for capacity for programme for both data providers and data providers and data users the development and conduct of knowledge data users training programmes for data users management 2. Develop and implement training and data providers and use of health programmes on data collection, research information methods, data processing, analysis and Provision of study fellowships,

utilization including exchange programmes among countries to learn from each

3. Provide opportunities and mechanisms for other staff to access/avail of Distance :earning and eHeafth

3.2 Enhance capacity to respond to 1. Provide mechanisms for constant Technical support for the training of information requirements, especially those communication between data users and data providers on data management related to the timeliness and adequacy of data providers and data sharing data

2. Train data providers on efficient ways of Financial support for the acquisition data rnanagement and sharing of communication equipment, and to

set-up technology to facilitate the 3. Acquire technology for the rapid timely transmission of data from the

transmission of data from the peripheral peripheral to the higher levels to the higher levels

L _________

PERFORMANCE INDICATOR

Number of HIS-related policies, regulations and legislation for which operational guidelines have been:

a. developed b. documented c. disseminated

Number and types of training programmes developed for:

a. data providers b. data users

Number of data providers and data users trained by type and content of training (e.g., data analysis, computer applications, etc.)

Nurnber of training activities conducted for data providers on data management and data sharing

Number of communication equipments acquired and distributed especially to far-flung areas

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INPUTS NEEDED FROM: STRATEGY ACTIONS AND INITIATIVES COUNTRY WHOIDONOR AGENCIES

3. Enhance 3.3 Optimize data utilization through the 1. Develop capability for data Financial and technical support for capacity for application of appropriate data analysis analysis training activities and fellowships knowledge techniques management 2. Provide for constant Financial support for the conduct of and use of health communication between data workshops, publication of information users and data providers, in documents and other activities (con't) relation to data utilization for which promote communication

programme planning, between data users and providers management and evaluation

3.4 Establish mechanisms to facilitate linkage 1. Review MOH organizational Technical support in the of information with policy structure in relation to the flow and development and implementation of

transmission of health information the best mechanisms to facilitate the from data providers to data users linkage between information and and policy makers policy

2. Design/develop and implement Financial and technical support for the best mechanisms (including the development and making structural changes, if implementation of training necessary) to facilitate the linkage programmes on data utilization for between information and policy programme planning, management,

monitoring and evaluation, and 3. Train staff on data utilization for policy formulation

programme planning, management, monitoring and evaluation, and policy formulation (including exposure of MOH top management to HIS)

3.5 Participate in local and international health Seek membership and participate Motivalti and provide technical information networks (e.g., HMN, RHINO, actively in local and intclI1dtional support to countries in preparing etc.) heCilth information networks documents and other requirements

lor membership, or to avail of benefits offered by international health information networks

-- --

PERFORMANCE INDICATOR

Number of training activities conducted and number of participants who attended training on data analysis and utilization

Number and type of activities conducted to promote communication between data users and data providers Mechanisms to facilitate linkage between information and policy established

Number of training activities conducted and number of participants who attended training on data utilization

Number and list of local and international health information networks where country is a member

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INPUTS NEEDED FROM: STRATEGY ACTIONS AND INITIATIVES COUNTRY WHO/DONOR AGENCIES

3. Enhance 3.6 Promote the sharing and application of 1. Document and disseminate HIS 1. Provide financial and technical capacity for experiential knowledge related to HIS lessons learned and best practices support for the documentation knowledge and dissemination of HIS best management 2. Train staff on the application of practices and use of health various methodologies for the use information of information in deCision-making 2. Provide financial and technical (con't) support for MOH staff training on

the application of methodologies for the use of information in decision-making

4. Strengthen the 4.1 Develop/Strengthen capacity to acquire 1. Acquire computer hardware and 1. Technical support for designing application of and use IT software and setting specifications for the information and appropriate leT to be applied in communication 2. Develop and disseminate User's the country technology (leT) Manuals on the use of hardware

and software 2. Technical and financial support for the provision/acquisition of

3. Train staff on the use of the computer hardware and hardware and software software

4. Expand software applications 3. Financial and technical support (e.g., GIS, global observatory, etc) for the development,

reproduction and dissemination of User's Manuals

4. Technical and financial support for staff training on leT applications

-----

PERFORMANCE INDICATOR

HIS lessons learned and best practices documented and disseminated

Number of training activities conducted on the application of various methodologies for the use of information in decision/making

Number and type of staff trained on the use of information for decision-making Number of hardware and software acquired

Number of training activities conducted and number of participants trained on the use of hardware and software

--

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INPUTS NEEDED FROM: STRATEGY ACTIONS AND INITIATIVES COUNTRY WHO/DONOR AGENCIES

4. Strengthen the 4.2 Develop policies and mechanism for the 1. Develop policy and operational Act as "brokers' in developing application of maintenance, upgrading and replacement guidelines for maintenance of financing mechanisms for the information and of computer hardware and software hardware and software acquisition and maintenance of communication computer hardware and software technology (ICT) 2. Develop 5-year sustainability plan (con't) Technical and financial support in

3. Allocate funds for maintenance the development and implementation of maintenance

4. Implement computer maintenance plans mechanism

4.3 Strengthen capacity to transmit, access 1. Use communication technology Financial support for the acquiSition and share heatth information (e.g., text and radio messaging, of communication equipment (fax

fax, email, etc.) for the rapid (machines, radios, modems, etc.) transmission of data from the peripheral to higher levels Technical and financial support for

the development of a health data 2. DocumenVconduct inventory of warehouse at national and sub-

existing and available health and national levels health-related databases

3. Establish/strengthen linkages/inter and intra-sectoral collaboration (including Research Councils}

4. Establish multi-sectoral body whose objective is to develop and implement ways to facilitate information sharing among health and health-related institutions within and outside the MOH

5. Establish a health data warehouse i1t nation;:,1 and sub-nationallflvels

----.--- -

PERFORMANCE INDICATOR

Computer maintenance programme developed and implemented

Number of computer hardware and software replaced or upgraded

Listing of existing health and health-related databases in the country prepared and disseminated

Inter and intra-sectoral collaboration for accessing and sharing information established and operational guidelines developed

Multi-sectoral body established

Health data warehouse established at national and sub-national levels

-

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INPUTS NEEDED FROM: STRATEGY ACTIONS AND INITIATIVES COUNTRY WHO/DONOR AGENCIES

5. Strengthen, 5.1. Harmonize/unify/integrate information systems of 1. Formation of multi-agency/multi- 1. Provision of technical support for harmonize and different vertical programmes. sectoral HIS Committee to lead the determination of minimum integrate data and oversee the activities related requirements for the country's collection to the harmonization of informa- HIS and the development of a systems tion systems within the MOH harmonized HIS

2. Conduct of meetings and 2. Provision of technical support for workshops to define minimum the conduct of training activities basic data sets and indicators to on the harmonized HIS be used and shared by different vertical programmes 3. Financial support for the pilot-

testing, evaluation, modification 3. Development of the information and finalization of the harmonized

system (identification of data HIS sources, development of forms, design of data flow and data processing procedures, quality control mechanisms, etc.) to generate minimum basic data requirements

4. Pilot-testing of the integrated HIS

5. Institutionalization and expansion of coverage of the integrated HIS

.- .- ---- - -

PERFORMANCE INDICATOR

Multi-agency/multi-sectoral HIS Committee formed

Number of meetings and workshops conducted to define and develop minimum basic data sets and indicators

List of minimum basic data sets and indicators prepared

Core components of the unified/integrated HIS (data elements, data collection, data flow, data processing and analysis) developed, documented and approved for implementation

Harmonized HIS piloted in selected areas

Pilot-phase of the implementation of the harmonized HIS evaluated and modifications made

Coverage of integrated HIS expanded to other areas

Harmonized HIS implemented nationwide

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INPUTS NEEDED FROM: STRATEGY ACTIONS AND INITIATIVES COUNTRY WHO/DONOR AGENCIES

5. Strengthen, 5.2. Conduct regular, systematic and institutionalized 1. Develop policies and operational Provision of technical support for harmonize and monitoring and review of HIS guidelines (what, by whom, when, policy development, and the regular integrate data how) on the regular monitoring monitoring and review of the HIS collection a. Periodic review of information requirements and review of information systems (con't) requirements

b. Continuing monitoring of disease surveillance system 2. Conduct regular, periodic

monitoring and review of HIS c. Monitoring and assessment of the efficiency

of core and support components of HIS

5.3 Prepare and disseminate User's Manuals 1. Develop User's Manuals for the Technical and financial support for for the HIS and each of its sUb-systems HI S and each of its sub-systems the development and reproduction (e.g., Hospital, Public Health, Human of Manuals Resource, Finance Information Systems, 2. Reproduce and disseminate etc.) User's Manuals

3. Train staff on the use of the User's Manuals

4. Evaluate the User's Manuals, and modify as needed

-- --

PERFORMANCE INDICATOR

Policies and operational guidelines for the regular and institutionalized monitoring and review of information requirements developed, documented, approved and disseminated

Number of activities conducted for the monitoring and review of information requirements

Results of monitoring and review are documented and disseminated, and its recommendations are discussed and implemented

Number of HIS sub-systems where User's Manuals have been developed

Number of User's Manuals reproduced and disseminated

- -

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INPUTS NEEDED FROM: STRATEGY ACTIONS AND INITIATIVES COUNTRY WHO/DONOR AGENCIES

5. Strengthen, 5.4 Develop/enhance capacity to conduct research to 1. Develop research agenda Technical and financial support for harmonize and compliment routine data collection systems the conduct of activities (workshops, integrate data 2. Capability building for research seminars, etc.) for the development collection methods and research of the country's research agenda systems management (Con't) Technical and financial support for

3. Appointment of research staff the development and implementation of training

4. Establish linkages with the programmes on research methods academe and other agencies with and research management research capability

Financial support for the conduct of research projects to complement routine data collection

5.5 Strengthen disease surveillance systems 1. Assess current status of country's 1. Technical support for capability disease surveillance system building on surveillance systems

2. Develop/enhance capacity to 2. Financial and technical support generate real-time data especially for the procurement of equipment for disease outbreaks and (e.g., radios, fax machines, etc.) investigations for the rapid transmission of

surveillance data 3. Allocate budget for various

disease surveillance activities 3. Financial and technical support to strengthen the capacity to transmiUexchange information especially on communicable diseases, within and outside of the MOH

PERFORMANCE INDICATOR

Research agenda for the country developed

Number and type of training activities conducted on research methods and research management

Number of staff trained on research methods and research management

Number of research projects I

conducted to complement routine data collection

Number and type of training activities conducted on surveillance

Number of staff trained on surveillance

Number of equipments for the rapid transmission of surveillance data procured

Number of disease outbreaks identified on time through the disease surveillance system

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STRATEGY ACTIONS AND INITIATIVES 5. Strengthen, 5.6 Develop/provide mechanisms for the regular and

harmonize and effective communication between data providers integrate data and data users (including feedback mechanism), collection invotving as many stakeholders as possible systems (Con't)

6. Improve data 6.1 Develop, document and disseminate data quality quality standards

6.2 Develop and implement a systematic, regular and institutionalized system for the supervision, monitoring and evaluation of

data quality, covering all activities from data capture to data processing and analysis

- -~

INPUTS NEEDED FROM: COUNTRY WHO/DONOR AGENCIES

1. Develop and implement plans for the regular and periodic interaction between data users and data providers

Create a technical group to develop and 1. Technical and financial support document data quality standards and in the development and docu-provide support in its dissemination mentation of data quality standards

2. Financial and technical support for the conduct of training, workshops, and publication of manuals on data quality standards

1. Develop operational guidelines for the 1. Technical support for the implementation of a systematic. development of guidelines regular and institutionalized system for the supervision, monitoring and 2. Financial and technical evaluation of data quality support for the training on the

implementation of data quality 2. Promote the joint involvement of both control mechanisms

HIS staff (data providers) and programme staff data users) in implementing data quality control

mechanisms

3. Allocate budget for activities related to the implementation of data quality control mechanisms

4. Connwt trelining on the implementation of data quality control mechanisms. including thz use uf leo

S Imr1p.ment elida qllnlity control me\~!:d~,i~lln~; ~l ~l; i~vels

._-- - --------

PERFORMANCE INDICATOR

Number and type of activities conducted aimed to provide interaction between data users and data providers

Data quality standards defined, developed and documented

Number of training activities conducted on data quality standards

Operational guidelines for HIS monitoring and supervision developed

Number of training activities on implementation of data quality wntrol mechanisms conducted

Workplan for HIS field monitoring, supervision and evaluation developed and implemented

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STRATEGY ACTIONS AND INITIATIVES

7. System Develop policy and implement a maintenance plan for

maintenance various resources related to HIS a. physical resources (e.g. record storage facilities)

b. replacement and upgrading of equipment,

including computer hardware and software

c. data and IT standards

d. human resources (e.g., retention of qualified staff)

--

INPUTS NEEDED FROM:

COUNTRY WHO/DONOR AGENCIES

1. Formulate maintenance policy. Financial support for the

2. Allocate budget replacement and upgrading of

3. Implement procedures equipment

PERFORMANCE INDICATOR

Maintenance policy developed, documented, disseminated and implemented

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