Gaps, priorities and challengesGaps, priorities and ... · Gaps, priorities and challengesGaps,...

Gaps, priorities and challengesGaps, priorities and challenges in health information systems research

Carla AbouZahrCoordinator Statistics Monitoring and Anal sisCoordinator, Statistics, Monitoring and AnalysisDepartment of Health Statistics and Informatics

26 May 2008

1Health Statistics & Informatics

Health information systems

• Key component of health systems, one of the building blocks

• Also a cross cutting component eachAlso a cross cutting component, each building block requires sound informationinformation

• Dual role, multiple responsibilities on health information systems


Health system responsiveness, fairness

What data should the health information system

MortalityMorbidity,

fairness health information system generate?

Use of services

Wellbeing

Health system outputs & service availability

Service accessibility, safety, quality, efficiency

Health system inputs &

availability

Governance, human resources, medical products, information

q y, y

Determinants of ill health

processes


ill-health

Which data

Health research

sources are used?

Resource, admin records

Service recordsFacility surveys ServiceService--basedbased

Individual records

Household surveys:

PopulationPopulation--basedbased

Censuses

Civil or sample registration, DSS

PopulationPopulation basedbased


Censuses

Global monitoring

Research

Global monitoring and reporting

What are Analysis of health situation and

d

ResearchWhat are the data needed for? trends

Programme planning

needed for?

planning, management & evaluation

Patient

Facility management

Support health d k

Patient management


decision-making

l b l

From data production ………………………..to data useFrom data production ………………………..to data use

Health research Research

Global monitoring and reportingHealth system

responsiveness, fairness

Resource, admin records

Analysis of health situation and

d

Research

Use of servicesMortalityMorbidity,

fairness

Service records Facility surveys

trends

Programme planning Use of services

Use of servicesy,Wellbeing

Individual records

planning, management & evaluationHealth system

outputs & service availability

Household surveys:

Patient

Facility managementHealth system

inputs &

availability

Censuses

Civil or sample registration, DSS

Support health d k

Patient management

Determinants of ill health

processes


Censuses decision-makingill-health

R h d h lth i f tiResearch and health information systems: a multifaceted relationship

• Research is one of the sources of data the health information uses

• Contributing to research is one of theContributing to research is one of the functions of the health information systemsystem

• The health information itself deserves to be an object of research


Health information systems today:

Never mind the quality, feel the width


Demand-supply imbalancesDemand-supply imbalances

D d f h lth t ti ti i• Demand for health statistics growing • Supply fragmented by disease-specific data

collectioncollection • Health workers overburdened by reporting

requirementsrequirements • Data collected but not analysed and used • Disease-specific data collection poorly integratedDisease specific data collection poorly integrated

into national health information systems • Coordination difficult; financial, administrative ; ,

constraints. • Need R&D on new tools and methods


Why the neglect?Why the neglect?

• Underinvestment in health information systems. • Systematic data collection recent phenomenon

i d l d t ieven in developed countries. • Lack of standardization in terminology,

methodologies presentationmethodologies, presentation.• Need for human and financial resources,

organizational, analytical and statistical skillsorganizational, analytical and statistical skills• Information not seen as outcome but as by-product

of activities to improve health. p• Few incentives to focus on underlying statistics:

instrumental to M&E; demonstrating impact


Range of research needs

Type of research neededConceptual Methodological Field work;Conceptual

developmentMethodological

tools development and

testing

Field work; implementation

researchtesting

Systems building for health

Some work required

Some work required

Major efforts neededo ea t

informationq q

Enhancing demand for data

Some work required

Some work required

Moderate effort required

St th i S k M j ff t M j ff tStrengthening specific data sources

Some work required

Major effort needed

Major efforts needed

Strengthening data analysis, and use

Some work required

Moderate effort needed

Major efforts needed


use

Health information systemsHealth information systems

• Assessing cost and economic value of better health statistics E i ith l i t ti b t• Experiences with closer integration between ministries of health and national statistics officesoffices

• Documentation of policy, legislative and regulatory strategies need to overcome g y gfragmentation

• Documentation of costs, benefits and risks of i t d i ICTintroducing ICT


Specific data sources:Specific data sources:tools and methods

• Statistical techniques for adjusting incomplete and biased data such as hospital records, incomplete civil registration records, etc.

• Innovative approaches to estimate numbers, age-distribution and causes of deaths in settingsdistribution and causes of deaths in settings without death registration and medical certification

• Validating sentinel methods of vital-events• Validating sentinel methods of vital-events monitoring and cause-of-death attribution.

• Validating verbal-autopsy tools g p y• Sampling techniques to permit generation of

population-based data at district level.


Specific data sources:Specific data sources:Implementation researchp

• Cost-effective ways of enhancing monitoring of vital events including training inof vital events, including training in certification and coding causes of death.

• Best practices in ensuring the integration of• Best practices in ensuring the integration of data from the private health care sector into the health information systemthe health information system.

• Documentation of experiences in the use of field-appropriate and cost-effective diagnosticfield appropriate and cost effective diagnostic technologies to obtain biomarkers in household surveys.


y

Data analysis and useData analysis and use

I i d t lit b h i h lth• Improving data quality by enhancing health personnel skills to generate, interpret, disseminate, use and value health informationuse and value health information.

• Effectiveness of interventions (training, supervision, feedback and incentives) for improving data quality.) p g q y

• Effectiveness of dissemination methods for different audiences (health managers, policy

k it )makers, community groups) • Sociocultural factors and constraints affecting

information useinformation use• Measuring the health impact of sharing information

with citizens15Health Statistics & Informatics

with citizens

Redressing the neglect

• Increase funding Sti l t th i t t f h• Stimulate the interest of researchers

• Increase demand for evidence-based h t h lth i f ti tapproaches to health information system

strengthening by policy-makers, development agencies and donorsagencies and donors

• Embed research as integral part of health systems research not assumed to be confinedsystems research, not assumed to be confined to the monitoring and evaluation component.

•17Health Statistics & Informatics

•

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