A health information system is only as good as the data entered into it.

Health Information System Data

Health planners and decision-makers need different kinds of information including:

  • Health determinants (socioeconomic, environmental, behavioural and genetic factors) and the contextual environments within which the health system operates).
  • Inputs to the health system and related processes (health infrastructure, facilities and equipment, human and financial resources).
  • The performance or outputs of the health system (availability, accessibility, quality of health information and services, responsiveness of the system to user needs).
  • Health outcomes (mortality, morbidity, disease outbreaks, health status, disability and wellbeing).
  • Health inequalities (sex, socioeconomic status, ethnic group and geographical location).

Uses of data

Data entered into a health information system needs to be organised for multiple uses, as different users have different needs.
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Clinicians use the information from the health information system to manage patients’ care and coordinate integrated services.

Hospital administrators use information to monitor patient safety and quality of care.

Policymakers track the incidence and prevalence of health conditions, and quantity of service consumption, to decide on the best use of financial resources.

UNDP’s Offer

UNDP works with national entities to improve the quality and timeliness of data through:

  • Support the assessment of where ICT can deliver better, more coordinated data.
  • Improve the infrastructure to implement ICT.
  • Review and develop standards for indicators.
  • Support the implementation of District Health Information Systems to manage data.
  • Implement electronic Patient Management Systems (ePMS).
  • Strengthen skills in analysing data and its use in decision making.
  • Support to integration of data systems to consolidate indicators and their use in decision making.

Types of Data

Health information systems use data from different levels of the health-care system.

About the patient’s profile, health-care needs and treatment
From facility level records and from administrative sources, such as health products stocks, consumption and supply, to determine resource needs, support health products procurement and supply chain management, and develop community outreach.
For public health decision-making to generate information not only about those who use the services but also, crucially, about those who do not use them; eg: from household surveys.
Information from facilities and communities with a main focus on defining problems and providing a timely basis for action.

Indicators

Data collected needs to be based on clear relevant indicators. Health indicators should be valid, reliable, specific, sensitive and feasible/affordable to measure. They must also be relevant and useful for decision-making.
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The main challenge is to identify a small set of indicators. Individual programme areas often each have a defined minimum list of indicators, often at the instigation of external partners and donors. When combined, these indicators can create a huge burden in terms of data collection. A rational selection of a set of core health indicators is therefore essential.

Innovation: Electronic health records help deliver better quality of care

The Health Data Collaborative is a joint effort by WHO and other global health partners to work alongside countries to improve the availability, quality and use of data for local decision-making and tracking progress toward the Sustainable Development Goals.

Achieving these goals will require accurate and timely data in order to understand how much work needs to be done, to stay on track, and to keep leaders accountable.

The HDC objective is to strengthen country capacity for health data by getting global partners to work together to support country needs, and agree a common agenda for measurement and accountability.

The Collaborative’s first product is a list of 100 core health indicators to support data collection, which attempts to reduce the more than 600 indicators that some countries have previously reported on under their various relationships with donors.

Types of Data

Health information systems use data from different levels of the health-care system.

National health surveys to identify strategic priorities (e.g., Demographic and Health Survey, Multi-Indicator Cluster Survey). Quality censuses should be carried out on a regular 10-year cycles.
Registration of births, deaths and other vital events occurrence and production of fertility and mortality statistics to understand burden of disease on the population.
Statistics from public and private health facilities and community health systems.
Core surveillance using standardized case definitions, with active participation of communities and health workers.
Databases on health facilities and services national health accounts, supply chain and logistics and health workforce registry to track health workforce statistics.
Sources of data from statistics offices and ministries overseeing water and sanitation, education, agriculture etc.

Challenges to the use of health information

Most countries have health facility registries and service-use reporting forms; they maintain medical record rooms and may have health information units overflowing with data. However, despite this, many are still challenged to ensure timely reporting; to produce disaggregated data and use it for policy and planning.
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Data that is collected may be incomplete or of poor quality or there may be duplication and fragmentation of data across reporting systems that have been developed by different users. This makes it difficult to connect the resources invested to the results achieved. Data needs and demands are also changing with the rise in Non-Communicable Diseases. More technical skills in key areas such as epidemiology, biostatistics, and database management are needed, as well as skills to analyse statistics across different programmes and sectors.

Suggested Indicators

  • A national set of indicators to inform annual health sector reviews and other planning cycles.
  • Completeness in defining baselines and targets of indicators.
  • Measurement methods identified.
  • Data quality assessments carried out, using internationally agreed quality criteria

The Global Fund asks implementers to select their programme indicators from a core list of indicators. These indicators aim to promote a common understanding of monitoring and evaluation and to reduce the reporting burden for countries.

Guidance & Tools