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Health Management Information System in Ethiopia
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Health Management Information System in Ethiopia


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Health Management Information System in Ethiopia Presentation Transcript

  • 1. Health Management Information System in Ethiopia Ownership Starts on Day One
  • 2. Health Management Information System (HMIS)
    • The purpose of HMIS is to routinely generate quality health information that provides specific information support to the decision-making process at each level of the health system for improving the performance of health system and thereby the health status of the population
  • 3. HMIS in Ethiopia
    • Pivotal role for HMIS within Health Sector’s M&E system
    • FMOH adopted “One Plan, One Report & One Budget” policy
      • HMIS providing the core indicators
    • HMIS reform high in Health Sector Development Program (HSDP) agenda
    • Reformed HMIS designed & pilot tested in 2006-2007, with technical assistance by JSI
  • 4. The USAID-funded HMIS scale-up project
    • In 2009, FMOH invited John Snow Inc. (JSI) to scale-up HMIS in the Southern region (SNNPR)
      • SNNPR: population of 16M
    • Funding by USAID through MEASURE Evaluation
    • Scaling up in other regions with assistance of other development partners
  • 5. This presentation is on HMIS scale-up in Southern Nations, Nationalities and Peoples Region (SNNPR)
    • Administrative structure
      • 15 zones
      • 4 special woredas
      • 156 woredas
      • 22 Town Admin.s
      • 3602 rural kebeles
      • 324 urban kebeles
    • Health facilities (public)
      • 23 Hospitals
      • 591 Health centers
      • 3340 Health posts
  • 6. Ownership matters
    • Regional Ownership is essential for
      • Full implementation of HMIS in the region
      • Sustainability of HMIS in the region
  • 7. The vision: Sustaining HMIS in SNNPR
    • We can say that HMIS is sustainable in SNNPR when the Regional Health Bureau (RHB):
      • Values HMIS & demonstrates desire to have HMIS for health system management
      • Drives the system to get the desired benefits from it; i.e.
        • SNNP RHB maintains production of quality HMIS information to meet the current information needs of the region
        • There is continued use of HMIS information for decision making at all tiers of health system
      • Takes responsibility for its successes and failures
      • Manages & continues to have the capacity to manage the HMIS resources & controls financial decisions for HMIS implementation
  • 8. The Challenge
    • Balancing Regional Ownership and Technical Assistance for implementing HMIS
  • 9. The Strategy: Balanced sharing of responsibility & promoting Regional Ownership from Day One RHB JSI/MEASURE Evaluation Mentoring IT development Level of Responsibility Time Training HMIS data collection, reporting Data Quality Assurance Use of HMIS data for decisions eHMIS use
  • 10. Project’s approach to promoting region’s ownership
    • Advocating regional ownership with RHB in the driving seat
    • Building capacity
    • Encouraging broad-based partnership
    • Enhancing IT support
    • System’s approach: introducing HMIS zone by zone
    • Technical support to address changing priorities
  • 11. … .Advocating region’s ownership
    • Sensitization of Regional Health Bureau
      • RHB Head & senior staff
      • Zonal & District Health Offices heads & HMIS Focal Persons
    • Collaboration and participation
      • All communications for training, supervisory visits, reporting are sent out by the RHB
      • Training activities by facilitators from RHB & ZHDs
      • Joint supervisory visits & review meetings
      • RHB in charge of supply of printed supplies from FMOH
    • Capacity building
      • Facilitation & coaching skills
      • Role modeling use of HMIS information
  • 12. The Approach: Advocating regional ownership with RHB at the driving seat Sensitization of RHB senior management and development partners in SNNPR
  • 13. … .Building capacity
    • Training on HMIS skills
      • Training of Health Managers and staff of Health Centers and Hospitals
      • Training focuses on building skills for
        • Record keeping & reporting using HMIS Instruments
        • Data quality assurance
        • HMIS information use
    • Training on eHMIS
      • RHB IT staff trained on eHMIS application
    • Supportive supervision
  • 14. … .Building capacity - participatory training model On-site training Master Trainers from RHB, ZHD & WorHO 5 Trainers from each WorHO Master Trainers from Hospital 50 Coordinators & technical staff from Hospital 5 Case Team staff from every HC All remaining staff All remaining HC staff 5 days TOT 4 days training 4 days training Supervisory visits by ZHD, WorHO and Project Staff
  • 15. Participatory training on HMIS – Facilitators from Zonal Health Departments conducting training
  • 16. Supervisory Visit by HMIS Technical Working Group HMIS Instruments in use Client bringing back his Service ID card
  • 17. … .TA to address emerging priorities & information needs (typical in long-lasting HMIS scaling up process)
      • New priority : Implementation of Family Folder designed as family-centered information tool for integrated health service delivery by Health Extension Workers
      • Needed operational guidelines for implementation
    • Project provided TA on:
      • Developing operational guidelines & pilot testing of various implementation options
      • Testing procedures for assuring continuity of care for significant health episodes through defaulter tracing
      • Promoting community participation
  • 18. HEW Training Involving district administration Mobilizing volunteers HH Numbering Record keeping at Health Post Family Folder FF Filing system HH List Implementing Community-based HMIS
  • 19. Every HH has a unique number and a Family Folder
  • 20. Family Folder has complete list of every HH member and contains service cards for each member
  • 21. Profile of a kebele served by a Health Post: Data collected during HH registration
  • 22. … .Enhancing IT support – the eHMIS
    • eHMIS features
      • Health System Reference Database (HSRD): provides
        • Population denominators for HMIS indicators – by region, zone, district, sub-district
        • Listing of health admin units and facilities with ID numbers
        • Human resource and assets information
      • Data entry module - manual & using scanning technology
      • Data aggregation module
      • Decision Support System
        • Automated generation of graphs, charts, tables and maps
        • Historic HMIS data migrated to new eHMIS thus ensuring continuity
        • Mobile Executive DSS
  • 23. Hands-on Training on eHMIS – RHB, ZHD, WorHO
  • 24.
  • 25.
  • 26.
  • 27.
  • 28. The Strategy paid off…..
    • Within 1½ years
      • Over 5,200 health managers and staff trained
      • TOT completed for all 615 Health centers & 23 Hospitals in the region
      • 9 / 22 zones implementing reformed HMIS, 6 zones started regular reporting
      • 1737 (44%) Health Posts implementing community HMIS
      • eHMIS installed and functional at RHB
        • Electronic Health Institutions data for all health institutions
        • 6 Zonal Health Departments have eHMIS to access aggregate data and Decision Support System via internet
  • 29. ....strategy paid off
    • RHB is in the lead role and owns the process
      • RHB Planning unit in charge of managing the scale-up
      • RHB IT staff carrying out electronic data entry & quality checks
      • Trained HMIS facilitators from among the staff in every zone, woreda & health facility
        • Anecdote: In one hospital 12 staff replaced by new staff. The hospital authority immediately arranged training of these new staff using the trained facilitators from within the hospital
  • 30. … .RHB in the lead
      • RHB mobilizing other implementing partners to assist in HMIS scale-up and sustainability
        • Mobilized resources for printing, furniture, computers for HMIS
      • RHB organizing regular meetings to review scale-up progress & address bottlenecks
  • 31. Lessons learned
    • Strong visionary leadership & commitment of the region (country) essential for scale-up and sustainability of HMIS
    • Developing government ownership starts on Day One and continues throughout the implementation process
    • Harmonized teaming up of development partners with the government can bring the desired results
  • 32.
    • MEASURE Evaluation is funded by the U.S. Agency for
    • International Development and is 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. The views
    • expressed in this presentation do not necessarily reflect
    • the views of USAID or the United States Government.
    Thank You!