Health information system
A key component of any health system is health information. This is essential to inform policies and the planning process.
To be useful, data need to be:
easy to collect—rather than require too much time from health providers,
reliable, to be provided in a timely manner across the system,
transformed into information for use for decision-making, and
fed back in a user-friendly format—preferring maps and graphs rather than tables whenever possible—to those who collected it, for use also at their level.
Monitoring the quality of data collected and providing immediate feedback, e.g. during supervisory visits or programme mangers annual meetings, is also an important aspect of data management. Experience suggests that the process of feedback is critical to improve reliability of data recording and reporting.
Unfortunately, health information systems (HIS) often suffer from many weaknesses. Furthermore, vertical programmes may often develop their own recording forms and reporting systems to monitor programme performance more closely and in detail. This unfortunately also translates into overburdening an already malfunctioning information health system.
At the end of the line, there is always one health provider who is supposed to take care of everything: this reality should guide decisions, even if that means foregoing ambitious systems. It is then important to find the right balance.
When introducing IMCI (Integrated Management of Child Health), many countries in the Region have felt the need to collect information to monitor implementation and performance of intermediate outcome indicators. One of the challenges has been to make the IMCI action-oriented classifications at primary health care level compatible with the disease-oriented HIS classifications.
Usually, countries have introduced in health facilities the IMCI clinical recording forms used during IMCI training courses, as health providers have been trained in their use and find them a useful guide to the clinical management of a child.
Based on those forms, some countries (e.g. Egypt, Djibouti, Sudan, Syrian Arab Republic, Tunisia) have introduced or modified registers for under-5 children, with information due to be summarized and reported to the higher level monthly.
In some cases (e.g. Egypt, Djibouti, Syrian Arab Republic) HIS classifications have been modified to include the IMCI classifications, simplifying the recording and reporting job at primary health care level. These approaches need to be evaluated.