Facilitybased MIS Planning, Assessment, Design and Implementation

1
Facility-based MIS Planning, Assessment, Design
and Implementation

• Field Officer Orientation - August 2004

2
Why Plan and Assess?

• HIV/AIDS care must be integrated into the health
  care system
• Important links to VCT, prenatal care, PMTCT, TB,
  Malaria, care and support services, opportunistic
  infections, STDs
• Plan for local USE of information

3
The Goal

• Appropriate use of information at each level

4
The Process

• Planning
• MIS Development Team
• Assessment
• Design
• Short- and Long-term
• Implementation

5
Planning Phase

• Initial discussions and consensus-building should
  involve
• HIV/AIDS, Reproductive and Child Health program
  managers,
• the US Government Agencies
• NAC, MOH,
• other government departments,
• private sector providers,
• and non-governmental organizations

6
Establish a multidisciplinary MIS development
team

• Combination of in-country and expatriate
  expertise
• Cover skill areas such as systems analysis,
  epidemiology, policy analysis, computer
  programming, user assistance/training

7
Find leadership Senior government official who

• (i) is committed to the reform
• (ii) will take the necessary risks
• (iii) has the right political connections and
• (iv) can access local resources

8
Time and Resources

• Ensure availability of the required time and
  resources to design and implement the MIS
  (eventually including contributions from other
  partners)

9
Goal is to prepare MIS development plan as part
of the country plan

• Initially, design options for various components
• Base development plan on assessment of existing
  HIS
• Involve principal stakeholders previously
  identified to choose between options
• Set priorities for investments in HIS

10
Assessment Phase

• Undertake an assessment study of existing MIS
• Make use of external technical assistance
• Assessment protocol and forms available

11
Use a health system approach

• What information do you need?

12
Assess the Process

• data collection gt aggregation gt processing gt
  analysis gtpresentation
• Address how management structures impact
  information resources and procedures
• Identify all stakeholders and describe their
  roles/impact on information systems
• Use existing tools (e.g. political mapping tool)

13
Assessment of MIS Status

• Status of
• National HIS
• MIS for Emergency Plan interventions
• Computerization of data entry and processing
• Communication technology
• Human resources
• Standardized procedures
• Ability to Use Data

14
Scoring of Capability

• Score coverage, availability, functioning
• A High
• B Medium
• C Low

15
MIS Design Phase
16
Software That Lasts 2000 Years

• Infrastructure Software

17
Short- and long-term recommendations and options

• Short-term, we refer to the reporting
  requirements of the Emergency Plan
• (first six-monthly report).
• Long-term, information systems developed to
  monitor and evaluate HIV/AIDS care should be well
  integrated into the overall facility-based MIS
• sustainable integrated management information
  systems

18
Identification of information needs

• Short Term
• Use standard list of Emergency Plan indicators
• Identify Emergency Plan information needs for
  patient/client and facility management based on
  consensus of in-country managers

19
Identification of information needs

• Long Term
• Seek international and national consensus on
  Emergency Plan indicators
• Identify Emergency Plan, and broader HIV/AIDS
  information needs for patient/client and facility
  management based on consensus between in-country
  managers
• Examine the link between Emergency Plan and
  broader HIV/AIDS information needs and
  information needs of related programmatic
  interventions such as prenatal and obstetrical
  care, family planning, and child health.

20
Data collection

• Short Term
• Where MIS are well established (3AB), use
  existing data collection forms and add quick
  fixes to complete missing data
• In countries with no standardized MIS (3C),
  develop and pre-test separate forms
• Long Term
• For 3BC countries, add required Emergency Plan
  data to existing MCH and other forms
• For 6A countries, pilot test electronic patient
  record system

21
Data aggregation

• Short Term
• In 3C and 4C countries, use extra person-power on
  a temporary basis to aggregate facility data
• Long Term
• Examine both data aggregation options based on
  cumulative or an individual data
• For 6AB countries, pilot test innovative
  technologies for data entry and aggregation

22
Data reporting and transmission

• Short Term
• In 3C countries, develop and pre-test standard
  report formats
• In 4BC countries, use health facility surveys or
  perhaps extra person-power on a temporary basis
  to ensure reporting from facilities to national
  level
• Develop or adapt software or system tools for
  reporting

23
Data reporting and transmission

• Long Term
• In 4BC countries, establish reporting channels
  along hierarchical lines (facility-district-interm
  ediate-national)
• In 6C countries, develop integrated software for
  the Emergency Plan and other data entry at
  district level
• In 6B countries, integrate Emergency Plan
  information in existing software for
  facility-based MIS
• In 6AB countries, pilot test data reporting from
  handheld devices via cell phones

24
Data processing and analysis

• Short Term
• Develop or adapt software or system tools and use
  at most convenient level for data processing and
  analysis
• Long Term
• In 6BC countries, develop integrated software for
  Emergency Plan and other data processing and
  analysis at district and higher level

25
Data presentation and use

• Short Term
• Initial focus on use of core indicators at all
  levels facility, district, national, and
  international levels
• Long Term
• Design action-oriented data collection and
  referral forms
• Develop skills for using data at facility level
  for service management and quality assessment
• In 6BC countries develop decision-support
  computerized applications geared to the district
  level and below

26
MIS Implementation Phase

• Individual and institutional capacity-building
• Mobilization of the required resources
• Development of standard procedures and
• Monitoring and evaluation.

27
MIS capacity building

• Short Term
• Training care providers and managers to ensure
  Emergency Plan data and report generation
  according to the Plans requirements
• Follow-up of trainees via supportive supervision

28
MIS Capacity Building - Long Term

• Involvement of future users at all levels in the
  MIS design effort
• Training care providers and managers in data
  collection and use
• Training MIS staff in data processing and
  analysis
• Training staff at various levels in commercial
  and customized software applications
• Training national and sub-national managers in
  use of information for program planning
• Follow-up of trainees via supportive supervision

29
Institutional capacity building

• Organizational development (revised job
  descriptions, lines of communication, etc.)
• Computer maintenance and trouble shooting

30
MIS resources

• Short Term
• Provide the necessary equipment and supplies for
  initial MIS functioning
• Long Term
• Joint planning of required MIS resources
  (including recurrent costs) with government and
  other donors, taking into account the country
  resource context
• For 5BC and 6BC countries, investment in various
  computer and communications equipment

31
MIS procedures

• Short Term
• Develop procedures manuals for Emergency Plan
  data collection and reporting
• Long Term
• Develop procedures manuals with clear indicator
  definitions, instructions on all steps in the
  information generating process, and proposed use
  of indicators for program management

32
MIS monitoring and evaluation

• Short Term
• Develop and implement ME plan for short-term MIS
  design and implementation
• Long Term
• Develop and implement ME plan for long-term MIS
  design and implementation

33
Be Prepared

• Dont end up as roadkill on the information
  highway!