Reliable and timely health information is an essential foundation of public health actions and health systems strengthening. Information is needed to track how health systems respond to increased inputs and improved processes, and the impact they have on improved health indicators. In Pakistan, health information and disease surveillance activities are through several vertical health information and disease surveillance systems, which include DHIS/HMIS, Vertical Health Programs (LHWs, MNCH, HIV/AIDS, TB, EPI, Dengue and Malaria), Service Statistics, Logistics, Financial & Human Resource MISs, DEWS and several surveillance databases/dashboards operating according to their specific needs and respective capacities across all provinces and at the federal level. The current information system is truly public sector focused and fails to capture the larger private sector.
The Ministry of National Health Services Regulations & Coordination (MoNHSR&C) has the constitutional mandate to perform and deliver on the assigned role of coordination, policy guidance derived from analysis of routine reporting systems (DHIS, Vertical Programs, Surveillance Dashboards etc.), as well as periodic Surveys (PDHS, PSLM, MICS, Economic Survey etc.) and Assessments undertaken in Health Sector (Reports of Health Development Partners). In this context, a technical unit namely Health Planning, System Strengthening & Information Analysis Unit (HPSIU) has been established at the MoNHSR&C and revitalizing the National Health Information and Resource Centre (NHIRC) is in process. The NHIRC, which is housed within the HPSIU, has been mandated the key functions of:
Pakistan Health Information System and analysis: To provide stewardship for building a well-functioning integrated health information system ensuring the production, analysis, dissemination and use of reliable quality and timely information on health determinants, health performance and health status. The unit has developed the PHIS dashboard linked with provincial/regional DHIS units and dashboard for data sharing on 78 key indicators. Support capacity building of technical HR at provincial/regional level.
Provincial Support and Linkages: The unit would actively support and liaise with provincial/regional Health System Reforms Units/planning and policy unit focusing on the system issues in the development of Provincial Health Plans/reforms agenda b setting up and Inter-Provincial Health System Strengthening Task Force. Liaison with line ministries and partners on issues related to health systems, planning and analysis.
Strategic Policy Framework: To generate evidence for planning and reform process, ensuring that strategic policy framework, appropriate regulations accountability system are in place at federal level.
National Health Report: Development of the annual National Director General Health report as well as regular reporting on SDG 3 to Planning commission & at International Levels
DHIS
The Ministry and Provincial / Regional governments have recognized the challenges of fragmentation and are keen to implement measures aimed at unifying the various HIS & preparing the country to report on the development indicators at the provincial, national, and international levels. A District Health Information System (DHIS) is one of the mainframe health recording and reporting system that was adopted and implemented across the four provinces of Pakistan since 2007/08. The DHIS system in the four provinces has been subsequently digitized during the last two years, with development of management dashboards to facilitate the data flow mechanisms and promote evidence based decision making. A National PHIS Dashboard (1st Phase) has been developed and housed at HPSIU
WHO support
A WHO scoping mission to Pakistan was conducted in December 2016 at the request of MoNHSR&C. The scoping team identified a number of key strategic areas to establish/strengthen and move towards a unified system, strengthen coordination among various systems and stakeholders, along with strengthening the capacity of staff in data collection, analysis, information transmission, use and dissemination
The follow up HIS review mission visited in July 2017, it aimed at supporting Pakistan’s efforts to monitor its health development agenda as well as enhance its reporting capacity on the 100 core health indicators, the 68 regional core indicators, and the health-related SDGs. The mission had consultative meetings with HPSIU technical experts and carried out field visits to provinces/ regions for consultations, the field visit was followed up by a 2 days National Consultative workshop