Integrating Routine Health Information Systems: How much is too much? - July 2002

RHINO Forum in July 2012 on integrating information systems

Moderated By: Dai Hozumi, JSI MEASURE Evaluation

July 15-31, 2002


In order to support the decision-making process at different levels in the health system, the structure of a health information system must reflect the structure of the health services delivery system. The history of evolution of health information systems in developing seems to endorse this statement. At the early stage of international health cooperation, disease- or activity-specific vertical programs were implemented in many developing countries. The small pox eradication program and the Growth Monitoring Program are some examples. These vertical programs established program specific information systems, mainly to provide data for top managers and external experts.

Following the Alma Ata in 1978, however, attention was shifted toward horizontal integration of various health care activities. This was reflected in the field of health information systems as the introduction of community information systems in limited scale. After the decade of integrated primary health care in the 1980s, many donor organizations and policy makers became impatient and started to promote vertical approaches. The emergence and re-emergence of diseases enforced this trend. Many vertical programs survived and new programs were introduced while efforts continued to implement integrated PHC. The current state of health information systems seems to reflect the chaotic state of the health systems in developing countries; efforts continue to integrate information systems while new vertical information systems are introduced and old vertical information systems resisted. If this is the case, then, will we be unable to integrate health information systems until health service systems have been integrated?


  1. What should be integrated? Can we have a single comprehensive information system for each country?
  2. What are the advantages and disadvantages of integrated information systems?
  3. Can the initiative to integrate health information systems be a driving force for health system reform?
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