Country Profiles

Countries

Afghanistan  |  Bangladesh  |  Botswana  |  Burundi  |  Cameroon  |  Côte d’Ivoire  |  Dominican Republic  |  The Democratic Republic of the Congo  |  Ethiopia  |  Ghana  |  Guatemala  |  Guinea  |  Guyana  |  Haiti  |  India  |  Indonesia  |  Kenya  |  Lesotho  |  Liberia  |  Madagascar  |  Malawi  |  Mali  |  Mozambique  |   Myanmar/Burma   |   Namibia  |  Nepal  |  Nigeria  |  Pakistan (Balochistan)  |  Pakistan (Khyber Pakhtunkhwa)  |  Pakistan (Punjab)  |  Pakistan (Sindh)  |  Rwanda  |  Senegal  |  South Africa  |  South Sudan  |  Swaziland  |  Tanzania  |  Uganda  |  Ukraine  |  Yemen  |  Zambia  |  Zanzibar  |  Zimbabwe

As part of the Health Information System Strengthening Resource Center, we have created health information system (HIS) country profiles to:

  • show the status of HIS in select United States Agency for International Development (USAID) priority countries using a number of indicators

  • create a baseline of HIS indicators for the selected countries to measure changes in these indicators over time

  • facilitate participating countries to share and learn from one another

We originally selected 21 HIS indicators to collect online or through in-country contacts. This list has expanded to 30 HIS indicators. The first step was to search for documents online, either through government websites or online searches. Once this method was exhausted, we contacted professionals who work in the selected countries to populate the remaining indicators. MEASURE Evaluation will document progress on additional indicators and data collection methods in this Resource Center over time.

Indicators selected

The indicators selected represent various areas of the HIS Strengthening Model. The indicators and brief descriptions are presented below:

HISS component

Indicators

 Description

HIS governance & leadership

1. Country has a national health strategy (year)

A national health strategy is a document that outlines a country's vision, priorities, budgetary decisions, and course of action for improving and maintaining the health of its people. Such documents provide direction for improving health and are used for planning purposes. Ideally, any activities for strengthening health information systems (HIS) are mentioned in a country’s national health strategy.

HIS governance & leadership

2. Country has a health sector monitoring and evaluation plan (M&E)

Once a country has a national health strategy, it should have an accompanying monitoring and evaluation (M&E) plan. The primary aim of an M&E plan for the health sector is to have a strong M&E and review system in place for the national health strategic plan that comprises all major disease programs and health systems. The need to improve health information system (HIS) is often driven by national M&E needs.

HIS governance & leadership

3. Country has Health Information System policy (year)

Policies that govern national health information systems (HIS) are one indicator of the strength of a country’s HIS. HIS policies outline a deliberate system of principles to guide decisions and achieve HIS outcomes.

HIS governance & leadership

4. Country has an HIS strategic plan (year)

Strategic plans for health information systems (HIS) are country plans that are based on HIS assessments, such as those that were developed based on the Health Metrics Network (HMN) Framework. An HIS strategic plan outlines the country’s strategy for HIS strengthening based on the results of their assessment, and typically outlines costed interventions to achieve results.

HIS governance & leadership

5. Country has set of core health indicators (year updated)

This is a list of core health indicators that track health progress. Availability of indicators and information on definitions, data sources, and data collection methods are indicative of the HIS performance and organization. Data should be comprehensive and cover all categories of health indicators: determinants, inputs, outputs, outcomes, and health status. Should include key health indicators. Core list of indicators can be part of the health sector M&E plan.

HIS management

6. National HIS coordinating body/committee

An interagency body or steering committee to oversee the implementation of the national HIS strategy. This body should include representatives from the ministry of health, national statistics office, academia, telecommunications, local government, and the private healthcare sector. This committee can provide a technical advisory role for health and social welfare data management in close collaboration with other strategic partners.

HIS governance & leadership

7. Country has master facility list (year updated)

A master facility list (MFL) is a complete listing of health facilities in a country (both public and private) and is comprised of a set of administrative information and information that identifies each facility (unique ID). This list needs to have a schedule for updating. An MFL is important in monitoring the health infrastructure and the services provided to the population, and it assists in calculating the percentage of facilities that are included in routine health data collection.

HIS management

8. Conducted Health Metrics Network (HMN) assessment (year)

This is a self-assessment conducted to identify strengths and weaknesses of the national HIS, identify priorities for improvement, establish baseline to monitor progress, and provide basis for strategic planning.

Data sources

9. Population census (within the last 10 years)

A population census collects data on the size, distribution, and composition of population as well as social and economic information about the population. It provides sampling frames for household and other surveys, and the population projections are used to calculate health indicators.

Data sources

10. Availability of national health surveys

This is a national survey that includes data collection about health related behaviors and bio-clinical measurements, e.g., Demographic Health Survey (DHS), Multiple Indicator Cluster Surveys (MICS), and living standards measurement survey.

Data sources

11. Completeness of vital registration (births and deaths)

Vital registration systems record the occurrence and characteristics of vital events pertaining to the population and serve as a main source of vital statistics. Countries with complete (at least 90% coverage) vital statistics registries may have more accurate and timely demographic indicators.

Data management

12. Country has electronic system for aggregating routine facility and/or community service data

Many countries are transitioning from paper-based systems of aggregating routine facility and/or community service data to electronic systems to collect data to help facilitate transmission, quality, and aggregation. This can be DHIS2 or another system.

Data management

13. Country has national statistics office

Designated and functioning institutional mechanism charged with analysis of health statistics, synthesis of data from different sources, and validation of data from population-based and facility-based sources.

Info products and dissemination

14. National health statistics report (annual)

This is a report that summarizes the status of key health indicators. It is produced annually and should provide information on health statistics nationally and by region. This can include service delivery statistics as well as specific health outcomes. It can be called various names—including the annual health management and information system (HMIS) report, annual performance report, health and health-related indicators report, etc.

Info products and dissemination

15. Country’s ministry of health has an updated website

This involves having an updated website with the most recent health data and having various reports covering different program areas available. This can have links to other federal departments as well as subnational websites.

Data management

16. Data quality assessment (DQA) conducted on prioritized indicators aligned with most recent health sector strategy (year of most recent)

Data quality assessments are important in assessing the overall quality of routine data. DQAs are conducted at the facility level because of the heavy dependence on these data for monitoring interventions to address specific health areas such as HIV, tuberculosis, and malaria. DQAs are not conducted on annual basis, a DQA conducted within the current health sector strategy cycle.

HIS management

17. PRISM assessment conducted in any regions/districts

This is an assessment of the performance of routine health information system (RHIS) or HMIS. The framework consists of tools to assess RHIS performance; identify technical, behavioral, and organizational factors that affect RHIS; aid in designing priority interventions to improve performance; and improve quality and use of routine health data.

Data quality

18. Percentage of facilities represented in HMIS information

Countries should define core data series that are reported by all facilities at various times throughout the year (monthly, quarterly, six months, annual). The percentage of facilities reporting should be reported in HMIS reports. Numerator: Number of health facilities that report data into HMIS annually. Denominator: Total health facilities. 

Data use

19. Proportion (facility, district, national)  offices using data for setting targets and monitoring

Use of routine and non-routine data for setting annual targets and monitoring key indicators is critical for evidence-based decision making. This information may be available from country reports, meeting minutes, or through special studies.

HIS performance

20. Measles coverage reported to World Health Organization (WHO)/UNICEF

The ability to report the proportion/percentage of children aged one who received one dose of measles vaccine is a measure of HIS performance. The WHO site that is the data source for this indicator presents information from both the United Nations/WHO estimates and official government figures which allows the comparison of the two.

HIS performance

21. Number of institutional deliveries available by district and published within 12 months of preceding year

Deliveries in institutions such as hospitals and health clinics are attended by skilled health staff who are trained to give the necessary supervision, care, and advice to women during pregnancy, labor, and the postpartum period. The number of institutional deliveries is the numerator in determining the coverage.

HIS governance & leadership

22. Existence of policies, laws, and regulations mandating public and private health facilities/ providers to report indicators determined by the national HIS

 Countries should have a regulatory framework for the generation and use of health information. This enables the mechanisms to ensure data availability of public and private providers. This may include specific laws but, in some cases, it may be written in to other policies or regulations.

HIS management 23. Availability of standards/guidelines for RHIS data collection, reporting, and analysis

In order to ensure uniformity and standardization in the collection of RHIS data, countries need to have standards/guidelines that lay out how data should be collected, reported, and analyzed. This information is used for training purposes and should be available as reference documents to staff.

Data management 24. Presence of procedures to verify the quality of data (accuracy, completeness, timeliness) reported.

As part of the effort to assure data being generated by the HIS is of high quality, countries need to have procedures to assess data quality. This can include data accuracy checklists prior to report acceptance, internal data quality audit visits, and written feedback forms.

HIS governance & leadership 25. RHIS data collection forms allow for disaggregation by gender

As part of the process of ensuring gender equity in health, countries need to collect and analyze data by gender. Data collection forms have to be designed to allow for data collection. This indicator focuses on gender disaggregation in RHIS.

Data sources 26. At least one national health account completed in last 5 years

The National Health Accounts is a process through which countries monitor the flow of money in their health sector. This information is needed to determine the level of financing being provided to HIS.

Data sources 27. National database with health workers by district and main cadres updated within last 2 years

This database comprises data from multiple sources, including census, labor force surveys, professional registers, training institutions, and facility assessments. This information is needed to estimate the current staffing level and plan for future staffing needs.

Data sources 28. Annual data on availability of tracer medicines and commodities in public and private health facilities

This indicator measures the availability of data to measure the use of medicines and health commodities. This is used to measure both service provision and to monitor availability of the medicines and commodities to ensure there are no stock outs and that medicines/commodities are available in facilities.

HIS governance & leadership 29. eHealth strategy

With the introduction of ICT in healthcare, countries should be strategic and set forth a strategy of how eHealth will be organized and used in their country. This strategy should be current with the national health planning cycle.

Data quality 30. Completeness of disease surveillance reporting

Percentage of disease surveillance reports received at the national level from districts compared to the number of reports expected. Indicate whether such data are available, and note the most recent compilations (by year or month).

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