Title: The Health Metrics Network, and the case of Health Information Strengthening in Sierra Leone
1The Health Metrics Network, and the case of
Health Information Strengthening in Sierra Leone
- WITFOR, August 26 2009,Hanoi
- Johan Ivar Saebo
2HMN A global partnership focused on
strengthening country health information systems
- Country support and tools for
- HIS assessment
- HIS strategic planning
- HIS implementation in a few selected countries
(to learn from the field) - Framework and guidelines for HIS implementation
- The HMN Framework
- HIS implementation guidelines
- Buyer's guide to HIS software and services
- Guidelines for ICT procurement policies/resolution
s - Guidelines for establishing an ICT infrastructure
for HIS - Communicate tools, activities and results
- www.healthmetricsnetwork.org
- HMN newsletter
- Hosted by WHO
3(No Transcript)
4HMN and Sierra Leone
5Challenges of Sierra Leone Degradation of the
health system
- 10 years of civil war 1991 to 2001
- Loss of half of health facilities
- Death or emigration of half of health workers
- Weakening of the culture of information use
- De-motivated ME staff at district and national
levels - Almost no data reported by hospitals
- No annual statistical report for more than 15
years - National "Annual Review" is used for planning but
hardly used for discussion of results
6A vicious cycle, how to break it?
Decisions not evidence-based
Donors get their own
Data not trusted
Weak demand
Using evidence not perceived as a winning strategy
Poor data quality
Limited investment in HIS
Weak HIS
Fragmentation
limited capacity to manage or analyse data
7Sierra Leone projectSome challenges towards
sustainable HIS
- Thinking about IT to counter
- Poor electricity supply, and lots of virus
- Fragmentation of HIS, and little awareness among
the fragmented actors on the scale and
implications of this - Poor data quality, and hence lack of interest in
HIS investment - Little information transparency, and poor culture
of analysis, feedback, and accountability - Poor sense of what information is important, and
how to analyse it, how to present it, interpret
it, and act upon it
8Trying new solutions
9Integration Data entered in one form...
10show up in other forms. Used to highlight
duplication
11Improving quality
12Transparency Accountability and peer pressure
13Seeing is believing
People living closer to Freetown have greater
access to clinical workers
14What has this led to?
- District managers are competing to have the best
scores! - Western Area District Medical Officer placed ad
in newspaper reminding about free maternal health
services, since he was very upset about the low
institutional delivery rates ("We want to be
best") - Donors are impressed with data quality and
completeness, and request their data now from the
integrated data repository (UNICEF, DFID, IRC,
WHO, etc) - Revision of forms, from more than 10 to 4. No
overlap between data entry forms. A simpler, more
streamlined system of collection.
15Challenges still to be addressed
- Capacity building, capacity building, and more
capacity building! At all levels, for IT, health
information management, information use. - Expanding the scope No hospital data in the
system. - Link with Financial IS, Humar Resource IS, Drug
logistics IS etc - MoH is broke. There is no exit-strategy when it
comes to funding. - Scores of people "living off the land", working
for free but selling "free" commodities to make a
living. Ghost workers system and other types of
corruption thrive on lack of information.
16Thank you!
- Health Metrics Network
- www.healthmetricsnetwork.org
- The Global Health Information Network
- www.tghin.org