Presented at the 2012 Global Symposium on Health Systems Research.

1. Using PRISM Tools to Assess the Scale-Up of
Health Management Information Systems
— Evidence from Ethiopia —
Background methodology
Since 2009, the U.S. Agency for International De- All 3 zonal and 19 district health offices, and a
velopment (USAID) and USAID’s MEASURE Eval- random sample of 31 health centers (HCs) and
uation project have supported the government 36 health posts (HPs), were selected in Cluster 1
of Ethiopia’s reform and scale-up of it’s health using Lot Quality Assurance Sampling method.
management information system (HMIS) in 4,195 Similarly in Cluster 2, all 6 zonal health offices and
health facilities of the 22 zones in the Southern random sample of 19 district offices, 19 HCs and
Nations, Nationalities and Peoples Region. Dur- 19 HPs were assessed using PRISM tools. Overall,
ing 2011and 2012, Performance of Routine In- 367 health staff from the selected zonal and dis-
formation Systems Management (PRISM) assess- trict offices, HCs and HPs were interviewed us-
ments were done in two clusters consisting of ing the Organizational Behavior Assessment Tool
nine zones with the objective of generating ev- questionnaire. The PRISM tools were adapted to
idence for behavioral and organizational inter- the local context, and a Microsoft Excel spread-
ventions for improving HMIS performance. sheet was prepared for data entry and analysis.
results conclusion
The findings of Cluster 1 were used as a bench- Contextualized to the local situation, PRISM as-
mark for comparing the HMIS performance of sessment was helpful in establishing HMIS per-
Cluster 2. Overall, Cluster 2 was comparable with formance benchmarks and deciding the focus
Cluster 1. The data quality was checked by their of interventions. For better understanding of
supervisors in 55–65% of health facilities; how- performance determinants, in-depth interviews
ever, the data accuracy was 32–67% depend- were needed which revealed that data quality
ing on the data element and type of the facil- was affected by complexity of the data defini-
ity. All facilities had performance review teams; tion and the HMIS forms.
50% of them reviewed HMIS in the past quarter
and evidence of HMIS-based decision-making
was found in 25–45% of facilities. HMIS task con- MEASURE Evaluation is funded by the U.S. Agency
fidence among staff was over 80% compared to for International Development (USAID) under terms of
Cooperative Agreement GHA-A-00-08-00003-00. The
views expressed in this poster do not necessarily reflect the
50% skill level. views of USAID or the United States government.
Tariq Azim Hiwot Belay Hailemariam Kassahun Firew Solomon
Resident Advisor M&E/HIS Advisor HIS Advisor Head of Planning and M&E Process
MEASURE Evaluation John Snow, Inc MEASURE Evaluation Regional Health Bureau
Ethiopia Washington, D.C., USA Ethiopia Southern Nations, Nationalities and Peoples Region
syedtariqazim@gmail.com hiwot_belay@jsi.com hailekw2@yahoo.com firew_solomon@yahoo.com