This document summarizes presentations from a MEASURE Evaluation event on making health information available to improve health. It discusses MEASURE Evaluation's work strengthening health information systems and monitoring and evaluation systems in various countries. A key presentation summarized MEASURE Evaluation's guide for monitoring and evaluating health systems strengthening initiatives. Another presentation discussed MEASURE Evaluation's initiative to strengthen health information systems in Latin America and the Caribbean through regional coordination, country-led processes, and knowledge sharing between countries.

1. Making Information Available
to Improve Health
MEASURE Evaluation
End-of-Phase-III Event, May 22,
2014

2. Outline
 Overview of M&E Systems
 Highlighted presentations
 “Monitoring and Evaluating Health Systems
Strengthening : A Practitioner’s Guide” by David
Hotchkiss
 “StrengtheningHealthInformationSystems
inLatinAmerica&Caribbean”byBeatrizPlaza
 Wrap Up

3. M&E Systems Strengthening

4. Health System Strengthening

5. MEASURE Evaluation Contributions
 Technicalleadership to expand the knowledge-
base for HSS
 Relationship between “building blocks”
and HSS
 Measurement of specific HSS interventions
 Implementation of sustainableapproaches for
improving RHIS and M&E systems

6. Technical Leadership

7. RHIS and M&E Systems
 Improved 20 HIS and M&E Systems in 9 countries
 Various systems including:
 Routine HIV/AIDS Information
 Routine Community Health Information
 Malaria Information
 Health, Population, and Development
 Community Based Organizations
 Civil Registration and Vital Events
 Regional Initiative Health Information System Strengthening in
Latin American and the Caribbean (2005-2010

8. Monitoring and Evaluating Health
Systems Strengthening:
A Practitioner’s Guide
David Hotchkiss, PhD
MEASURE Evaluation
End-of-Phase-III Event, May 22, 2014

9. Roadmap
 Importance of M&E of HSS
 Purpose of guide and intended
audience
 Qualitative needs assessment
 Overview and structure of guide

10. Significance
 Health systems strengthening
continues to receive considerable
attention
 Increased focus on Universal Health
Coverage
 Measuring HSS progress requires
careful planning and sound metrics

11. Available Resources for M&E of HSS

12. Purpose of Guide
 To provide practical guidance to
prospectively monitor and evaluate
health systems strengthening projects
and initiatives
 Intended audience: USAID mission
staff; M&E staff working for HSS
projects and government offices

13. Qualitative Needs Assessment
 Purpose: to better understand the
needs of USAID mission staff and
partner organizations
 Survey participants:
 HSS and M&E staff from eight USAID
missions
 M&E staff from HSS projects
 M&E staff from GFATM, WHO,
World Bank, GAVI

14. Key Challenges Identified
 Complex nature of HSS
 Indicators
 Institutional capacity
 Data availability and quality
 Funding and resources

15. Overview of Guide
 Introduction, definitions
 HSS M&E framework, challenges
 Overview of HSS indicators
 Step by step guidance on
developing a M&E plan for HSS

16. Definitions: Health System
 All people, institutions, resources,
and activities whose primary
purpose is to promote, restore,
and/or maintain health
 Includes private and public sector
actors
 Includes actors at national, state,
district, and community levels

17. Definitions: Health Systems
Strengthening
 Strategies, responses, and activities
designedto sustainably improve health
system performance
 Good health systems performance is
achievingsustained health improvements
by providing:
 Financial risk protection
 Essential services and equitable population
coverage
 Responsiveness to people’s expectations

18. IHP+ Framework for Monitoring
and Evaluating HSS
Inputs and Processes Outputs Outcomes Impacts
Governance
Financing
• Infrastructure
• Workforce
• Commodities
• Information
Systems
• Service
Readiness
• Access
• Quality of
Care
• Health
• Financial risk
protection
• Responsive-
ness
• Coverage
• Prevalence
of risk factors
Adapted from: Monitoring the building blocks of
the health system. WHO Report. October 2010.

19. Steps for Developing an M&E plan
1. Defining the HSS intervention, project
2. Developingan M&E framework
3. Identifying key indicators, sources of data
4. Establishing a research design for impact
evaluation
5. Collecting additionaldata
6. Analyzing and interpretingdata
7. Disseminatingresults

20. Next Steps
 Guide expectedto be finalizednext month
 Expectedto help improve M&E capacityby:
 Synthesizing currently available guides and
tools on M&E HSS
 Preparing readers to identify appropriateHSS
indicators and impact evaluation designs most
appropriatefor their projects and settings

21. Strengthening Health Information
Systems in Latin America
& Caribbean
Beatriz Plaza
MEASURE Evaluation
End-of-Project Meeting, May 22, 2014
Washington, D.C.

22.  Paris 21
 RHINO
 Health Metrics Network
 USAID/LAC/Pan American Health
Organization/Regional Strategy
for Strengthening Health
Information Systems
Justification

23. `
 Use of international standarized
frameworks and tools.
 Establish a baseline for monitoring
improvements and eventual evaluation.
 Define strategies and action plans at the
local, national, and regional level for
improving health information systems.
USAID LAC Bureau Centerpiece
for Regional Strategy

24.  Poordataquality&weakinformationuse.
 Parallelinformationsystems.
 Lackofinformationstandardarization.
 Limitedtechnicalcapacityatalllevels.
Common Problems
(as evidenced by the tool applications):

25.  Strengthen regional strategic
coordination.
 Facilitate country-led processes.
 Promote sustainability.
Our Role?

26. Learnwhatworksinaparticularcountry
and sharethatinformation
withinthecountry
and acrosscountries.
Our Focus?
South-to-South

27. Our Strategic Partners

28. Solutions/Products
www.relacsis.org

29. 1. Develop practical best practices.
2. Identify those that ensure sustainability
over time.
3. Strengthen south-to-south exchange
between countries.
RELACSIS

30. Solutions/Products

31. Second Global Symposium on Health System Research
Beijing, People´s Republic of China, 31 October ‒ 3 November 2012
“Health Information Systems network for research education and
capacity building in Latin America and the Caribbean”
Leonel Gonzalez-Gonzalez, Lina Sofía Palacio-Mejia, Juan Eugenio Hernandez-Avila,
Beatriz Plaza, Alejandro Giusti
“Assessing the process of
designing and implementing
electronic health records in a
statewide public health system:
the case of Colima, Mexico”
J Am Med Inform Assoc.,
published online September 27, 2012

33.  Training of Trainers (25 instructors)
course in Ecuador 2011 (Bolivia,
Paraguay & Peru)
 Training of Trainers (25 coders) course in
Central America 2012 (Honduras,
Nicaragua / El Salvador, Guatemala)
Capacity Building

34.  Virtual on-line training for ICD-10
 Virtual on-line course for doctors on correct entry of
cause of death
South-to-South Solutions
Products (2012-2013)

35.  On-line course for effective
communication strategies for producers
of information
Products (continued)

36. Online Course for Assisted and Automated
Coding for ICD-10 Cause of Death

37.  Pros & Cons of Electronic Health Records
in the Americas
 Measurements of Inequality in Health
Two Online Forums

38. Regional Initiative Health InformationSystems
Strengthening: LatinAmerica andCaribbean: 2005-2010
http://www.measureevaluation.org/publications/tr-12-85

39. www.relacsis.org
www.measureevaluation.org/eop

40. Q&A
1. What are the opportunities to expand our
knowledge about M&E and HSS system
strengthening?
2. How can we continue to promote the
strengthening of sustainable M&E systems?

41. Wrap-Up
 There is a need to further understand how
various HSS interventions contribute to
improved health systems and improved health
outcomes
 Strong approaches for strengthening M&E
systems address the information needs
required for improving health

42. www.measureevaluation.org/eop