How Electronic Health Records Strengthen the Health Systems of Low- and Middle-Income Countries: Learning from Eswatini and Mexico


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Author(s): Eva Silvestre

Year: 2018


Silvestre, E. (2018) How Electronic Health Records Strengthen the Health Systems of Low- and Middle-Income Countries: Learning from Eswatini and Mexico. Chapel Hill, NC: MEASURE Evaluation, University of North Carolina.
How Electronic Health Records Strengthen the Health Systems of Low- and Middle-Income Countries: Learning from Eswatini and Mexico Abstract:

Managing patient records is a challenge in any country and for all diseases, especially those that require continuity of care (COC). COC helps HIV-positive people stay in treatment, contributing to the 90-90-90 goals described by the Joint United Nations Programme on HIV/AIDS (UNAIDS), and other health areas, such as maternal care and childhood immunizations. One key intervention for COC is electronic health records (EHRs), which have been implemented worldwide to improve patient management and reporting. The EHR (a term used henceforth both for a single record and the system of health records) is a tool for improving the quality, safety, and efficiency of health services. It also provides data and information for assessing health system performance and the health status of the population. According to the 2015 global survey on eHealth of the World Health Organization (WHO), 57 of 125 countries (46%) reported having some sort of national EHR system ((World Health Organization, 2016). But these interventions are part of the much larger health information system (HIS). There is also great variation in the scope and scale of EHR systems used.

Two examples of large-scale EHR rollout that MEASURE Evaluation—funded by the United States Agency for International Development—has studied are the client management information system (CMIS) in Eswatini (previously called Swaziland), in Phase IV of the project, and the Sistema Administrativo del Expediente Clinico de Colima (SAECCOL, or Management of the Electronic Health Record in Colima, Mexico), in Phase III. This report discusses the role of such EHRs as the SAECCOL and the CMIS in overall health system strengthening. More specifically, it views HIS strengthening through the lens of MEASURE Evaluation’s Learning Agenda—the formal approach that the project has been using to document what we are learning about HIS strengthening. This report also highlights key points to consider when developing an EHR for use on a large scale.

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