Day 3: What have we learned so far?
Cotonou, December 18 2015
Local health system: the dominant view
Central level
Local government
Actors of other sectors
Civil Society Group
District office
Hospital
Health Centre
Private providers
Community Health Workers
Verification agent
Households
What it is actually Central
level
Local government
Actors of other sectors
Civil Society Group
District office
Hospital
Health Centre
Private providers
Community Health
Workers
Verification agent
Households Community groups
Collectively intelligent local health system
Central level
Local government
Actors of other sectors
Civil Society Group
District office
Hospital
Health Centre
Private providers
Community Health
Workers
Verification agent
Households Community groups
The solutions reviewed on days 1 & 2
Central level
Local government
Actors of other sectors
Civil Society Group
District office
Hospital
Health Centre
Private providers
Community Health Workers
Verification agent
Households
DHIS2
The solutions reviewed on days 1 & 2
Central level
Local government
Actors of other sectors
Civil Society Group
District office
Hospital
Health Centre
Private providers
Community Health
Workers
Verification agent
Households Community groups
Open RBF
Central level
Local government
Actors of other sectors
Civil Society Group
District office
Hospital
Health Centre
Private providers
Community Health Workers
Verification agent
Households
Open ClinicTelemedicine
The solutions reviewed on days 1 & 2
Central level
Local government
Actors of other sectors
Civil Society Group
District office
Hospital
Health Centre
Private providers
Community Health Workers
Verification agent
Households
DataSanté
The solutions reviewed on days 1 & 2
Central level
Local governmentActors of other
sectors Civil Society Group
District officeHospital
Health Centre
Private providersCommunity Health
Workers
Verification agent
Households
Djantoli
The solutions reviewed on days 1 & 2
Central level
Local governmentActors of other
sectors Civil Society Group
District officeHospital
Health Centre
Private providersCommunity Health
Workers
Verification agent
Households
mHealth India
The solutions reviewed on days 1 & 2
Central level
Local governmentActors of other
sectors Civil Society Group
District officeHospital
Health Centre
Private providersCommunity Health
Workers
Verification agent
Households
mHealth India
The solutions reviewed on days 1 & 2
Collectively intelligent LHS: 3 principles?
1. Information and processes should empower LHS actors in their specific role
2. Information and processes enhances connections between actors, both within the LHS and with key actors outside the LHS
3. Information and processes empower actors in charge of the coordination of the LHS (including in the management of tensions and conflicts)
Weak points
Central level
Local governmentActors of other
sectors Civil Society Group
District officeHospital
Health Centre
Private providersCommunity Health
Workers
Verification agent
Households Community groups
The empty hamburger
A lot of attention at the top
Growing attention at the bottom
Not enough attention to the middle and the many ingredients that make the system effective!
Two emerging observations on ICT solutions
1. Solutions going to scale are those developed first for the needs of the central level. Main limit: They are not inclusive enough for LHS actors.
2. Solutions empowering health providers are those first developed for their specific needs. Main limit: none has scaled up (not inclusive enough of the central and district levels?). Yet, some are growing by horizontal diffusion (ex. Open Clinic).
An observation on actors
• Those in local coordination position (mainly DMT, local governments) are under-using data.– Too many district teams are still under-achieving
their 1987 mission (coordinate public & assimilated health facilities).
– Even fewer are using data to steer other providers (2013 pluralistic vision).
– Local governments are out-of-the info loop.
Key questions
• How to involve DMT (dashboards and beyond) and increase connections between LHS actors?
• How to accelerate the diffusion / the scale up of solutions for: health providers (‘point of care’) and users.
An effective information solution – an emerging framework
• Context
• Health System• People
Design, collect…
Organize, analyse…
Decide, act…Share,
observe, improve…
Technology