Strengthening Health Information Systems in Low- and Middle-Income Countries—A Model to Frame What We Know and What We Need to Learn


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Author(s): MEASURE Evaluation

Year: 2017

Strengthening Health Information Systems in Low- and Middle-Income Countries—A Model to Frame What We Know and What We Need to Learn Abstract:

Health information is one of six core functions of the health system (USAID, 2015). Health information, generated by health information systems (HIS), supports data-informed decision making at each level of a health system. An HIS encompasses all health data sources required by a country to plan and implement its national health strategy.

Examples of these data sources are electronic health records for patient care, health facility data, surveillance data, census data, population surveys, vital event records, human resource records, financial data, infrastructure data, and logistics and supply data. Health information can inform the planning and targeting of national and subnational health programs to support the achievement of health equity and universal health coverage. In addition, HIS supports a country’s ability to report on progress in meeting the ambitious goals of global initiatives: the Sustainable Development Goals, an AIDS-free generation, ending preventable child and maternal deaths, and the prevention and treatment of malaria.

HIS strengthening is the implementation of one or more interventions targeting one or more components of the HIS to improve the quality and use of data for decision making at all of the health system’s levels. HIS strengthening consists of a range of technical, behavioral, and organizational interventions. The output of a strengthened HIS is the improved availability of high-quality data that are used on a continuous basis for decision making at all levels of the health system.

MEASURE Evaluation has developed a model for strengthening HIS in low- and middle-income countries. The HIS strengthening model (HISSM) is a starting point for framing what we know now and the opportunities we have to learn more about strengthening the HIS. Using the Health Metrics Network (HMN) Framework as a foundation (HMN, 2008), we worked with experts around the globe to develop a model to address four key objectives:

  1. Promote HIS as an essential function of a health system
  2. Define HIS strengthening
  3. Measure HIS performance
  4. Monitor and evaluate HIS interventions

The HISSM is intended for use by HIS managers, MEASURE Evaluation staff, and other project staff implementing HIS interventions. It also supports country-specific and global stakeholders as they assess, plan, design, implement, and monitor and evaluate their HIS interventions. This model will expand and evolve as our working context changes, and as we learn and understand new developments and approaches in strengthening HIS. The dynamic nature of HIS strengthening demands that we regularly review and update the model through the feedback of experts and practitioners. Feedback on the HIS strengthening model will be gathered on an ongoing basis through targeted solicitation and ad hoc contributions and shared through the MEASURE Evaluation HIS strengthening resource center: https://www.measureevaluation.org/his-strengthening-resource-center.

Within this document, in addition to describing the HIS strengthening model, we describe the HIS strengthening process and discuss the HIS as a function that supports the entire health system. We also discuss the importance of the human element in HIS strengthening and the selection of interventions to strengthen HIS, based on appropriate assessment methods, HIS sustainability, and describe the need to measure HIS performance and monitor and evaluate specific HIS interventions.

This document is not available in print from MEASURE Evaluation.

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