Swaziland is the last absolute monarchy in Africa - a small country of 1.4 million people with big health issues to combat. It has the fifth-highest infant mortality rate at 55 per 1,000 live births and a maternal death rate of 590 per 100,000 live births. It has the highest prevalence of HIV in the world, with more than 25 percent of the adult population and an estimated 40 percent of pregnant women infected, and AIDS is the leading cause of death for children under age five. Swaziland faces dual epidemics of tuberculosis (TB) and HIV, in which more than 80 percent of TB patients are HIV positive.
With these health challenges, and in the face of scarce resources, health managers and providers have to rely on information from routine data collection systems in order to select the most optimal solutions for defined problems. This, however, is only possible if data from the system is of good quality. USAID/Swaziland recognizes a need for a strong health information system (HIS) characterized by quality data and has called upon MEASURE Evaluation to collaborate with the Ministry of Health (MOH) and a local USAID implementing partner, the Institute for Health Measurement/Southern Africa (IHM), to strengthen collection, analysis, and use of routine health data and to improve country-level capacity to manage health information systems, resources, and staff.
Already, the Strategic Information Department HMIS Unit (SID/HMIS) in the Swaziland MOH, with technical assistance (TA) from IHM, has been working on streamlining the routine data collection system in public health facilities. However, a number of key HIS activities are in their early stages or have not yet begun, offering a unique opportunity to develop new and/or adapt existing tools to provide information needed by the MOH and partners to plan strategically for approaches to improve HIS performance, and to tailor TA and resources to their needs. Additionally, MEASURE Evaluation also is to conduct organizational development for IHM.
MEASURE Evaluation focuses on:
- Developing a consolidated patient file recording all service-specific information, thereby tracking patient/provider interactions across all health facilities. This work will also institute a unique patient identifier (UPID) tracking mechanism.
- Offering training and mentoring to meet the needs of the MOH Strategic Information Department and partners to improve data analysis, synthesis, communication, and use for decision making, with a focus on building capacity in data visualization tools.
- Developing internal policies and procedures for IHM and a TA strategy that includes leadership training and review of audit results that will prepare IHM to receive direct awards from USAID.
- Developing a consistent level of capacity in the use of geographic information systems (GIS) and a community of practice around GIS for public health. PEPFAR/Swaziland has identified increased capacity to use GIS as a priority both for its own team, as well as for its partners.