routine data systems
DESCRIPTION
Routine Data Systems. Data Use for Program Monitoring. Learning Objectives. Differentiate between routine and non-routine data Understand parameters and influences of HIS via the PRISM framework Recognize & use tools available to improve RHIS function. Session Overview. - PowerPoint PPT PresentationTRANSCRIPT
Routine Data Systems
Data Use for Program Monitoring
Learning Objectives
Differentiate between routine and non-routine data
Understand parameters and influences of HIS via the PRISM framework
Recognize & use tools available to improve RHIS function
Session Overview
General concepts of an RHIS Health information systems PRISM framework for understanding factors that
influence RHIS PRISM Toolset for RHIS1
RHIS Performance Diagnostic Tool RHIS Overview & Facility/Office Checklist Organizational & Behavioral Questionnaire RHIS Management Assessment Tool
Activity – Applying the PRISM Tools
1MEASURE Evaluation, Data demand and information use in the health sector: strategies and tools
Definitions
Health information system
A system providing specific information support to decision-making process at each level of an organization1
Health system
All resources—people, institutions & other—arranged according to established policies to protect, promote and improve the health of the served population2
1Hurtubise R (1984). Managing Information Systems. Kumarian Press, West Hartford.
2 WHO, http://www.euro.who.int/observatory/Glossary/TopPage?phrase=H
Definitions: Routine vs. Non-routine Data
Routine data Are collected continuously at various times
periods (daily, patient by patient, monthly etc.) Come from the HIS and its subsystems that are
collected as part of an ongoing system
Non-routine data Are collected at certain periods of time, or over a
specific period of time Come from special studies or surveys carried out
for specific purposes
Are we talking about this?
Or this?
Or do we mean this?
All of these, but this is where we really want to get
Why do programs need information?
Programs Need Information to
Understand entire context of program status
Enhance program performance through evidence-based decision making
All major functions
service delivery, resource mobilization, financing, stewardship
All levels
Community to national level
Health Information Systems (HIS)
HIS is an integral part of the health system
Just like a health system, an HIS is not static
Health systems in continuous process of change due to pressure from both outside and within the system
HIS must amend itself to these changes
HIS Sub-systems: Frequency of Data Collection Routine or continuous data collection
Health facility-based (pt. info. & service stats) Community based (service statistics) Vital registration Sentinel reporting Program reporting systems
Non-routine or periodic data collection Household or facility-based surveys Population census Rapid assessment procedures (RAP) Research
HIS and HIV Programs
A subset of the comprehensive health system
Data sources can be routine or non-routine
Contribute to data collection of various HIS subsystems
Need harmonization and integration in data collection & utilization within context of national HIS (the Third One)
PRISM* Framework for HIS Performance1
TechnicalDeterminants• system design • data collection forms• Skills/knowledge of personnel
Systemic/Environmental Determinants: leadership, structure, culture, roles/responsibilities, resources
Behavioral determinantsAttitudes, motivation, values
Inputsinformation systemassessment, strategies & interventions
Improved Health Status
Improved Health System
Performance
Desired Outcomes= information system performance• good quality information• appropriate use of information
*Performance of Routine Information System Management1MEASURE Evaluation. 2006. Data demand and information use in the health sector: Strategies and Tools
RHIS Performance Diagnostic Tool
HIS Quality & Use Influences
Standard indicators
Data collection forms
Appropriate IT
Data presentation
Trained people
TechnicalDeterminants
RHIS Overview & Facility/Office Checklist
Technical
Determinants
HIS Quality & Use Influences
Motivation
Attitudes & values
Confidence
Sense of responsibility
Behavioral Determinants
Organizational and Behavioral Questionnaire
Behavioral
Determinants
HIS Quality & Use Influences
Resources
Health sys. structure
Roles & responsibilities
Organizational culture
System &EnvironmentDeterminants
RHIS Management Assessment Tool
System &
Environmental
Determinants
PRISM Tools - Rationale
RHIS often not produce good information for health sector decision-making Data quality may low No processes in place for using data Managers/staff not understand importance of role in
information process & have little incentive
Traditional Assessments of RHIS narrow in focus Answer only part of why RHIS not high quality Typical focus is on data collection or information
technology alone
PRISM Tools - Rationale
Well designed interventions to improve RHIS should address these questions Is the organization committed to information-using
culture? Do people responsible for data collection have
necessary skills? Do they understand & care about importance of
their work? Do managers support them with training,
supervision & needed resources?
Description of PRISM Tools
Systematically provide answers, using an ordered process of gathering information about RHIS
Objectively measure performance & identify factors hindering performance Assess performance of RHIS Identify technical, behavioral & organizational factors affect
RHIS performance Aid in designing/prioritizing interventions to improve
performance Support ongoing efforts for M&E of data quality & use in
decision-making.
PRISM Tools - Implementation
Apply all four Tools for systematic assessment
Implement Tools in this order:
RHIS Performance Diagnostic Tool
RHIS Overview & Facility/Office Checklist
Organizational & Behavioral Questionnaire
RHIS Management Assessment Tool
PRISM Tools:RHIS Performance Diagnostic Tool
Primary component in the set
Determines overall RHIS performance (like MESS for whole M&E system)
Examines data quality & information use to identify gaps
Identifies overall strengths and weaknesses
PRISM Tools:RHIS Overview & Facility/Office Checklist Addresses technical determinants of RHIS such
as
Structure & design of existing information systems
Information flows
Interaction between different information systems
Use to understand availability & status of RHIS resources & practices
PRISM Tools:Organizational & Behavioral Questionnaire Addresses behavioral and organizational
determinants to RHIS, examines
Staff capacity
Knowledge, skills, confidence and motivation
Organizational culture
Promote value of information quality & use?
Compares these factors with RHIS performance to identify related gaps
PRISM Tools:RHIS Management Assessment Tool
Allows a rapid assessment of management and supportive RHIS practices
Results in recommendations for stronger RHIS management
PRISM Tools – Guiding Principles
Holistic approach that recognizes RHIS performance depends on combination of
technical, organizational & behavioral factors
Each of these components contributes to whole system, whole is more than the sum of its parts
Causal influence of all determinants in 3 areas must be understood to improve performance
PRISM Tools Guiding Principles
When data collectors understand importance of their contributions, they will be more committed
When decision-makers believe they have high quality data, more likely to use it for evidence-based decisions
When people empowered to make decisions, become champions for accountability and transparency
PRISM Tools
Tools are administered, based on
Observations, document review, information technology review
Triangulation of multiple data sources increases validity of findings
Self-assessment aspect creates sense of ownership for results & atmosphere of collaboration
Steps to use PRISM Tools Identify a potential opportunity
Determine how Tools would be used for the presenting need
Perform pre-assessment planning Determine organization’s readiness to improve RHIS Assemble core team stakeholders Identify key informants to interview Modify Tool to fit application
Assess & analyze current RHIS performance Use the Tools in order (Diagnostic, overview,
organizational/behavioral, management assessment)
Define plan for reaching desired level of RHIS performance Implement plan and monitor progress
Goal of RHIS Produce meaningful insights about performance of
health system
Is our HIV program working?
Increasing people willing to be counseled & tested
Decreasing HIV incidence
Reaching more pregnant, HIV + women
More effective information systems lead to better health status for more of the population
MEASURE Evaluation is a MEASURE project funded by the
U.S. Agency for International Development and implemented by
the Carolina Population Center at the University of North Carolina
at Chapel Hill in partnership with Futures Group International,
ICF Macro, John Snow, Inc., Management Sciences for Health,
and Tulane University. Views expressed in this presentation do not
necessarily reflect the views of USAID or the U.S. Government.
MEASURE Evaluation is the USAID Global Health Bureau's
primary vehicle for supporting improvements in monitoring and
evaluation in population, health and nutrition worldwide.