Improving health information systems for decision making across five sub-Saharan African countries: Implementation strategies from the African Health Initiative View Full Text


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Article Info

DATE

2013-05

AUTHORS

Wilbroad Mutale, Namwinga Chintu, Cheryl Amoroso, Koku Awoonor-Williams, James Phillips, Colin Baynes, Cathy Michel, Angela Taylor, Kenneth Sherr, with input from the Population Health Implementation and Training – Africa Health Initiative Data Collaborative

ABSTRACT

BACKGROUND: Weak health information systems (HIS) are a critical challenge to reaching the health-related Millennium Development Goals because health systems performance cannot be adequately assessed or monitored where HIS data are incomplete, inaccurate, or untimely. The Population Health Implementation and Training (PHIT) Partnerships were established in five sub-Saharan African countries (Ghana, Mozambique, Rwanda, Tanzania, and Zambia) to catalyze advances in strengthening district health systems. Interventions were tailored to the setting in which activities were planned. COMPARISONS ACROSS STRATEGIES: All five PHIT Partnerships share a common feature in their goal of enhancing HIS and linking data with improved decision-making, specific strategies varied. Mozambique, Ghana, and Tanzania all focus on improving the quality and use of the existing Ministry of Health HIS, while the Zambia and Rwanda partnerships have introduced new information and communication technology systems or tools. All partnerships have adopted a flexible, iterative approach in designing and refining the development of new tools and approaches for HIS enhancement (such as routine data quality audits and automated troubleshooting), as well as improving decision making through timely feedback on health system performance (such as through summary data dashboards or routine data review meetings). The most striking differences between partnership approaches can be found in the level of emphasis of data collection (patient versus health facility), and consequently the level of decision making enhancement (community, facility, district, or provincial leadership). DISCUSSION: Design differences across PHIT Partnerships reflect differing theories of change, particularly regarding what information is needed, who will use the information to affect change, and how this change is expected to manifest. The iterative process of data use to monitor and assess the health system has been heavily communication dependent, with challenges due to poor feedback loops. Implementation to date has highlighted the importance of engaging frontline staff and managers in improving data collection and its use for informing system improvement. Through rigorous process and impact evaluation, the experience of the PHIT teams hope to contribute to the evidence base in the areas of HIS strengthening, linking HIS with decision making, and its impact on measures of health system outputs and impact. More... »

PAGES

s9

References to SciGraph publications

  • 2013-05. A common evaluation framework for the African Health Initiative in BMC HEALTH SERVICES RESEARCH
  • 2004-12. Analysing the quality of routine malaria data in Mozambique in MALARIA JOURNAL
  • 2009-04. Evidence-Based Knowledge Management: an approach to effectively promote good health-care decision-making in the Information Era in INTERNAL AND EMERGENCY MEDICINE
  • 2011-12. An assessment of routine primary care health information system data quality in Sofala Province, Mozambique in POPULATION HEALTH METRICS
  • 2013-05. The Tanzania Connect Project: a cluster-randomized trial of the child survival impact of adding paid community health workers to an existing facility-focused health system in BMC HEALTH SERVICES RESEARCH
  • 2013-05. Protocol-driven primary care and community linkages to improve population health in rural Zambia: the Better Health Outcomes through Mentoring and Assessment (BHOMA) project in BMC HEALTH SERVICES RESEARCH
  • 2013-05. Strengthening integrated primary health care in Sofala, Mozambique in BMC HEALTH SERVICES RESEARCH
  • 2013-05. Comprehensive and integrated district health systems strengthening: the Rwanda Population Health Implementation and Training (PHIT) Partnership in BMC HEALTH SERVICES RESEARCH
  • 2013-05. From the ground up: strengthening health systems at district level in BMC HEALTH SERVICES RESEARCH
  • 2013-05. The Ghana essential health interventions program: a plausibility trial of the impact of health systems strengthening on maternal & child survival in BMC HEALTH SERVICES RESEARCH
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    http://scigraph.springernature.com/pub.10.1186/1472-6963-13-s2-s9

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    DIMENSIONS

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    PUBMED

    https://www.ncbi.nlm.nih.gov/pubmed/23819699


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