Design of HMIS – Challenges•Group 1:

–Design of data-collection tools – operational level not involved–Late submission and inconsistencies in data–Lack of human resources, staff turnover–Workload–Incomplete data–Lack of standardized reporting from private sector

Design of HMIS – Challenges

• Group 2– Not enough staff involved in design; too much data is being

collected– Myriad of reporting formats, according to type of services

(NGOs, FBOs), periodicity (inconsistent)

Design of HMIS – Solutions•Group 1

–Consult lower levels and other stakeholders in design of tools, and include more tool pre-testing at this level–Increased, proper training on M&E and reporting, software to ease data entry and compilation. Increase awareness of the need for timely reporting. Make sure staff understand why data are needed and how data are used. –Advocacy and increased political commitment and collaboration with NGOs to assist. Include training to address human-resource challenges.–Simplify data-collection tools–Create new posts (funded!)–Increase private-sector training. Create awareness of NTP policies, supervision of the private sector, and restrict license renewal pending reformed data collection. Use “sticks and carrots” to enforce reporting by the private sector.

Design of HMIS – Solutions

• Group 2:– Involve operational-level staff in the design of

forms– Integrate the various existing reporting forms

with one national format

Data collection - Challenges

•Group 2:–Staff turnover, especially in high-HIV prevalence areas, staff need a lot of training–Incompleteness in recording and poor attitudes towards recording–Lots of inconsistency; cases show up in one register but not the other–Triangulation is not done–Delay in submission

Data collection - Solutions

•Group 2:–Training as continuing CMEs, create awareness about the need for data.–Quarterly progress-review meetings, including quality of data as a topic to be covered.–Strengthen supportive supervision

Self assessment – Challenges

•Group 2:–Reports are only forwarded up to next level, no self assessment.

Self assessment - Solutions

•Group 2:–Encourage use of the indicators at facility level as a management tool.

Use of Data - Challenges

•Group 1–Data are not used by decision-makers.

•Group 2:

–Not a lot of training, beyond international courses such as Arusha.–Rigidity in targets–Lack of feedback

Use of Data: Solutions

•Group 1:–Involve these stakeholders in the design of systems to ensure they use them and perform cost-benefit analysis to show policymakers the importance of data use.

•Group 2:–Mid-level managers should have better training. They also need to develop a curriculum and build capacity at district level.–Reinforce need for feedback in support and supervision visits.–Localize needs for use of information, put the data in context, indicator based.