strengthening his in lac global health council meeting may30 2007
DESCRIPTION
PAHO and Measure Evaluation Project collaborative work to strengthing Health Information System (HIS) inTRANSCRIPT
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Partnerships for Strengthening Health Information Systems in
Latin America and Caribbean
Presenter: Beatriz Plaza, MEASURE Evaluation
Co-authors: Anwer Aqil, MEASURE EvaluationRamon Martinez, PAHO
Global Health CouncilMay 31, 2007
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Learning Objectives• List strategies for partnerships and/or
collaborations.
• Articulate the different methodologies for planning and prioritizing investments to strengthen health information systems.
• Identify factors contributing to better performing information systems.
• List achievements, outcomes of partnerships
• Lessons learned
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Background
Why did we do this?
• Poor performance of Health Information Systems (HIS) in America region
• Inadequate coordination and collaboration among donor agencies to strengthen HIS in America region
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Justification
• USAID/LAC Regional Strategy for Strengthening Health Information Systems
• Strengthening of health information systems (HIS) is one of the priority areas for the Pan American Health Organization’s Strategic Plan 2003-2007.
• World Health Organization (WHO) and Health Metrics Network (HMN) working agenda is to promote efficient health information systems.
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Partnership Model
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Strategies for Partnership
• Agree on the mission, goals, measurable outcomes, roles and responsibilities
• Mutual trust, respect, commitment and accountability
• Build upon identified strengths and assets that each bring
• Create a balance of power (technical &managerial) and resources (financial)
• Clear, open and accessible communication• Share credit of accomplishments
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RESULTS
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Health Information Systems Project
• Objectives:– Assure availability of standardized frameworks,
methods and tools in order to successfully monitor Health Information Systems performance
– Identify, document and disseminate successful experiences, key processes and lessons learned in two national HIS: Brazil and Mexico.
– Implement the HIS performance monitoring process, that will facilitate the orientation of interventions more objectively.
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Partners’ Contribution in meeting objectives
• USAID, through MEASURE Evaluation and PAHO, provided financial assistance on conducting two case studies in Brazil and Mexico for best practices
• PAHO and MEASURE Evaluation provided technical assistance on use of Health Metrics Network (HMN) framework and tools
• MEASURE Evaluation provided technical support on use of PRISM framework and tools
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Partners’ Contribution
• Brazil and Mexico conducted case-studies
(Rationale to choose these countries was to provide lessons from these mid-income countries with well-established information to other countries in the region)
• Mexico used HMN framework as well as PRISM organizational and behavioral assessment tool (OBAT).
• Paraguay and Honduras used HMN framework and PRISM OBAT tools
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Major Obstacles to HIS Performance• Less emphasis on improving data quality and continuous
use of information – inadequate use of performance improvement tools
• More stress on use of information technology for improving performance rather than looking at why staff could not retain the skills learned or motivation
• Less importance on empowerment and decision-making
• Inadequate promotion of culture of information by senior management, lack of dissemination of success stories on use of information by senior management or staff, lack of role model/champions
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Planning for HIS Performance Improvement
• Convert problems into opportunities
• Provide technical and financial recourses for implementing new interventions such as– Use of performance improvement tools– Empowerment for decision making, learning advocacy
skill– Learning problem solving skills– Self-assessment to reduce performance gaps and
close supervision– Promote dissemination of success stories for use of
information by senior management and staff
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Framework and Assessment Tools
HMN Framework HMN Framework HMN Situation Analysis and
Monitoring Tool (SAMT)
HMN Situation Analysis and Monitoring Tool (SAMT)
PRISM Conceptual frameworkMonitoring process
PRISM Conceptual frameworkMonitoring process
Successful experiences
Key processes & Lesson learned
Identification of determinants of
positive HIS performance
Successful experiences
Key processes & Lesson learned
Identification of determinants of
positive HIS performance
Diagnostic ToolDiagnostic Tool
Quality of DataQuality of Data Use of InformationUse of Information
HIS OverviewHealth Facility Check List
HIS OverviewHealth Facility Check List
HIS ManagementAssessment Tool
HIS ManagementAssessment Tool
Organizational &Behavioral Assessment Tool (OBAT)
Organizational &Behavioral Assessment Tool (OBAT)
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Process for Improving Health Information Systems
3. Planning Phase
4. Action Phase
5. Evaluation Phase
2. Assessment Phase
Successful experiences, Key Processes, andLessons Learned
1. Preparation
Phase
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Major Achievements
Mexico and Brazil HIS experiences are documented and disseminated, as case studies for best practices, lessons learned and success stories.
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Regional workshop to disseminate HIS Experiences
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Virtual Collaboration & Sharing Tools
HIS SharePoint Sites
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Open Web Site for Disseminating Results
http://www.lachealthsys.org
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Other Outcomes of Partnership
• Partnerships renewed interest in HIS strengthening
• The first Spanish language regional course on Performance of Routine Health Information System Management (PRISM) was carried out in September, 2006 at INSP in Mexico.
• The INSP of Mexico developed a software program for PRISM assessment tools which provides an added value for integrated analysis of four tools.
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Other Outcomes (2)
• The project has also fostered South-to-South technical assistance between: Mexico to Honduras and Brazil to Paraguay.
• PAHO and MEASURE Evaluation have also assisted Honduras and Paraguay in formulating Strategic Plans and Action Plans.
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Lessons Learned
• Partnerships help in building consensus among donors and Governments for use of standardized tools, assisting in better country and regional comparisons
• Partnerships must share a common vision and shared goals
• Partnerships must have passionate and committed champions
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Lessons Learned (con’t)
• Partnerships must learn to manage hidden agendas
• Partnerships must maintain a local focus, no one-size-fits-all approach will work
• Partnerships work better with shared monitoring of processes, outputs and outcomes
• Successful partnerships have to use the dissemination of information about the performance of HIS as an inducement to change!