What is health information system?
In concept, health information system (HIS) is a system for the collection/processing of data from various sources, and using the information for policy making and management of health services. It could be paper-based or electronic. To apply this to a nation, a country HIS integrates data from civil/vital registration, censuses, population surveys, facility surveys, individual records, service records and resource records for policy making and efficient management of health services. There is general agreement among all that a strong HIS is a key component of any health system. However, currently the data sources are often incomplete and fragmented. The challenge is to bring together or integrate all these diverse data sources into one seamless system.
Drivers for change
The recognition that the health information system in most of the developing countries is very weak is not new. Over the years, many countries did not make it a priority. Donors worked around it by relying mostly on ad-hoc national surveys and other estimates that satisfied the global community but was not very useful at sub-national levels. The last several years have introduced decentralization, performance-based resource allocation, as well as an unprecedented demand for MDG-related health information. Reporting requirements have been stepped up. With the advent of decentralization, management decisions are now made at lower and lower government administration levels. Frequent reporting of short term program output has become a requirement. Surveys will always be needed but their frequency/cost cannot meet the new requirement and at sub-national levels, survey estimates are unreliable. Denominators needed for outcome measures must come from a very recent census or vital registration. Routine data ranging from individual records to service and resource records come from administrative sources.
Approaches to HIS strengthening
There are several approaches to HIS strengthening. The ultimate goal is to produce quality and timely information for evidenced-based decisions and interventions. A widely practiced approach is the Health Metrics Network’s (HMN) framework and standards for health information systems. It focuses on core requirements of health system strengthening in low and low-middle income countries. Key among these requirements is the need to enhance the entire health information and statistical system rather than focus on specific disease lines. This means strengthening the human resources, integration of potential data sources as well as use of the data within the country.
As was mentioned above, a country’s HIS is made up of several data sources. Key among them is vital records garnered from a nation’s civil registration system. In many ways, this source can be seen as the foundation of any complete health information systems. Although vital records serve a broader legal purpose, its application in HIS is mostly statistical. A key strength of vital record statistics is that it is a census rather than a survey. Yet it is timelier than a census because it is updated on a regular basis as opposed to censuses which occur every ten years or more. When functional, civil registration records every vital event occurring in the country. Consequently, good information can be produced from the smallest geographic areas of a country using accurate denominators. There is much more on vital registration in another sub-directory including information on joining a community of practice (COP).
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