Data Management and HMIS Facilitator Dr Lucie Blok

Data Management and HMIS Facilitator: Dr. Lucie Blok Delhi, 31 st Jan 2006

The Issue is not that we need more data…. . . but better use of data

HMIS: Definition A HMIS is a system of record-keeping, reporting, processing, analysis, interpretation, use, and feedback of information.

HMIS: Functions - Provides different levels of beneficiaries (clients, community, service providers, managers, planners and policy makers) with timely and relevant information - Used to formulate policy, to plan, implement, monitor, supervise and evaluate health-related activities (adapted from Campbell, 1997)

HMIS provides information on: – Health status (through surveillance, surveys) – Health-related interventions and services (activities, progress, quality) (through surveillance, program monitoring and evaluation)

Purposes of HMIS: Evidence-Based Decision Making - Monitoring and evaluation of control programs - Plan actions, programs, and resources - To prioritize the allocation of health resources - To provide the basis for epidemiological research - Accountability

Management cycle Where are we now? Situation Analysis Where did we reach? Evaluation Is everything going according to plan? Monitoring Identifying constraints Taking action Where do we want to go? HMIS Objectives Which route shall we take? Strategy How shall we travel there? Plan of Activities

M&E Framework in TBCP Context: • • Input Political commitment Access and utilisation of services Socioeconomic conditions Epidemiological context (HIV, nutrition) Process Output Source: WHO: (2004); Compendium of indicators for monitoring and evaluating national tuberculosis programs, Outcome Impact

Problems in HMIS 1: Design 1. Top-down control, leaving out lower level 2. Unclear objectives and targets 3. Too much working time spent on HMIS 4. No guidelines 5. Not enough skills 6. Not enough staff 7. Fragmentation in services

Problems in HMIS 2: Collection Too many records Too late Poor quality Poor lay-out, confusing terminology Incomplete Potential exclusion of private and hospitalized patients Inflexible data collection Resistance to change

Problems in HMIS 3: (Self-) Assessment Data not analysed to produce information, but just forwarded upward No indicators to assess progress Presentation not clear, out of date Management culture does not value information (decision-making on intuitive or political basis only) Political use (coverage = 1 microscope per dist)

Problems in HMIS 4: Use Inadequate training for managers Data not available for the right persons at the right time No feedback to lower levels, no pressure to use data Data not used for supervision Rigid criteria (success rate in the era of HIV)

A good HMIS system: Provides all information required Is easy to implement Requires minimal staff time Is consistent with other management and recording systems in place Is useful for all stakeholders and is used

Group work HMIS - challenges Question 1 a: What are the main challenges in your country regarding design of the HMIS? Question 1 b: What solutions do you suggest?

Group work HMIS - challenges Question 2 a: What are the main challenges in your country regarding the collection and quality of data that you receive? Question 2 b: What solutions do you suggest?

Group work HMIS - challenges Question 3 a: What are the main challenges in your country regarding the use of data collected on TB management? Question 1 b: What solutions do you suggest?