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Strengthening Health Information Systems

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The Importance of Health Information Systems

Sound and reliable information is the foundation of decision-making across the health system.

The Importance of Health Information Systems

The UN Sustainable Development Goals set an ambitious agenda for a healthier world. It’s clear that achieving the goals will require reliable data, in order to properly understand the scale of the work to be done, and to make good decisions about how to allocate resources for the most efficient and effective results.
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Attaining these goals will require investments in robust health information and statistical systems.

In many countries, the quality of data gathered at health facilities and capacity to analyse and use this data remains inadequate to support decision-making that will accelerate Universal Health Coverage.

WHO health system strengthening stresses the need to support countries to strengthen their Health Information Systems (HIS), which provide reliable information on which to base programme decisions, to support the development of solid national health policies, strategies and plans; and contribute to reliable procurement and supply of health products through accurate data on needs and usage.

UNDP has worked over a number of years to strengthen the Health Information System in Zimbabwe.

UNDP worked with the Ministry of Health and Child Care (MOHCC) to implement a District Health Information System (DHIS) to replace the mainly paper-based, multiple reporting systems previously in use at health facilities.
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The DHIS-2 package, implemented in partnership with PEPFAR and RTI, provided a dramatic improvement in data management and analysis for health programme monitoring and evaluation, leading to more informed decision making.

Its utility is diverse – ranging from processing facility registers and service availability mapping to logistics management and mobile tracking of pregnant mothers in rural communities. Efforts are underway, with technical support from the University of Oslo, to provide the platform for the integration of electronic Patient Management Systems (ePMS) and other programme electronic systems into the DHIS-2.

In addition, a Weekly Disease Surveillance System (WDSS), incorporating innovative inbuilt Frontline SMS messaging into mobile phone-based reporting of weekly data, has been supported ensuring timely transmission of surveillance data.

  • Significant and on-going investments in the DHIS-2 and the WDSS have strengthened the national Health Information System (HIS).
  • The result is more timely and reliable health information enabling improved analysis, more informed decision-making and quality national forecasting and planning.
  • Improved responsiveness of the services for patients.
  • The completeness of the monthly reports has increased from around 50% to over 98% and the weekly reports from about 45% to 90%.
  • The reporting burden for health workers has been significantly lessened through the integration of different reporting systems into the DHIS-2, enabling them to spend more time with patients.

Definition of Health Information System

A Health Information System is broadly defined to encompass all health data sources, including health facility and community data, electronic health records for patient care; population-based data; human resources information; financial information; supply chain information; and surveillance information; along with the use and communication of this information.

Why is a well-functioning Health Information System important?

Understanding the progress of the health of populations and the performance and quality of health care systems requires the ability to monitor individuals over time, as they experience health care events, receive treatments, and experience improvements or deteriorations in their health.
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Good governance of a health system requires reliable, timely information. Decision-makers need to know, for example, whether or not people are getting the services they need and where resources are going.

Information is used in a wide range of situations: when developing national strategies and plans; when monitoring progress against national priorities; or when ensuring accountability for results.

Information is essential for health system policy development and implementation, governance and regulation, health research, human resources development, health education and training, service delivery and financing.

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Developing Resilient and Sustainable Health Systems

Strengthening health information systems is critical to establishing a more resilient and sustainable health system. Having quality data, in a timely manner, is necessary for countries to respond quickly to public health crises.
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The strength of the health information system ensures that when an emergency health situation arises, such as Ebola, health leaders are aware of it early and can divert necessary resources to prevent epidemics.

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Data to support Key Populations

An effective health information system also ensures that information is available on vulnerable groups and key populations most affected by health issues, to ensure that services include activities tailored to the specific needs of those communities.
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Data on age and gender and non-discriminatory accessibility and quality of services can be particularly critical in HIV prevention and care, since population groups most vulnerable to infection continue to face legal and cultural barriers in accessing health care. In many countries it can be challenging collecting data on most-at-risk populations due to the profound stigma and discrimination directed towards these key populations. It may be important to carry out qualitative behavioural studies and operations research to complement data collection, analysis and synthesis.

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Health Information Systems & Monitoring and Evaluation

In addition to being essential for monitoring and evaluation, the information system also serves broader objectives, such as providing an alert and early warning capability, supporting patient and health facility management, enabling planning, stimulating research, permitting health situation and trends analyses, and reinforcing communication of health challenges to different groups.
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Information is of little value if it is not available in formats that meet the needs of these different groups, i.e. policy-makers, planners, managers, health-care providers, communities and individuals. Dissemination and communication are therefore essential attributes of the health information system.

The Health Information System supports strategic and management decisions for the entire health sector and so is the responsibility of multiple stakeholders (e.g.: Ministries of Health as well as National Statistics Offices).

The national M&E system needs to contribute to and draw on existing data from the HIS. As such, the performance of the M&E system is directly linked to the capacity of the HIS. For example, health workers who report and manage HIV-specific data are often also responsible for collecting and managing data about other health services.

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The Global Fund recognises that health information systems are critical as part of a resilient and sustainable system for health. Its funding mechanism aims to support countries to move beyond reporting to active use of data in real time at all levels, to manage and evaluate programmes and formulate budgets; integrating multiple data collection systems into one national integrated health information system.
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It has developed guidelines on what activities countries should prioritise for strengthening data systems when applying for funding.

Applicants should include investments to scale up capacities and establish sustainable systems at country level in their funding request. The Global Fund recommends that grants allocate 5-10% of the total budget to M&E. Examples of activities that can be included in applications to the Global Fund to strengthen country health information systems include the following:

  • Routine information systems: the establishment, maintenance and strengthening of national HMIS, district health information systems, mobile platforms for community level data collection and reporting, and support for human resources for data systems.
  • Programme and data quality: activities related to assessments of programme and/or data quality, as well as monitoring of quality improvement activities.
  • Evaluations, reviews, data analysis and its use.
  • Surveys and studies.
  • Administration and financing of data systems.
  • Civil registration and vital statistics (CRVS) systems.
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Guidance & Tools