• RHINO's Newsletter

    June 24, 2014

    Summer Edition

    What is happening inside RHINO

    RHINO held its on-line forum on May 12 – 16, 2014. Thank you to all participants (more than 160 representing all the continents of the world) who participated directly by sharing their experience and their ideas. We also thank our three wonderful moderators who did a wonderful job at guiding the discussion and providing feedback to many questions. You can access the transcript of this on-line forum on RHINO’s website.


    Lessons and Recommendations from Assessment of HMIS Performance in Ethiopia

    As part of an ongoing effort to scale up health management information system (HMIS) reform in Ethiopia, the Regional Bureau of Health (RHB) of Southern Nations, Nationalities and People’s Region (SNNPR) of Ethiopia, in collaboration with the MEASURE Evaluation HMIS scale-up team, planned to enhance efforts for strengthening HMIS performance in four phases: (1) zonal HMIS performance assessment; (2) developing a HMIS strengthening action plan; (3) implement HMIS strengthening interventions, and (4) routine monitoring of the HMIS performance to measure the effect of the interventions.

    In August 2011, the first round of the zonal HMIS performance assessment was conducted in a cluster of zones (viz. Hadiya and Kambata Tembaro) and special woreda (Halaba) who were implementing the reformed HMIS since mid or late 2010. The assessment was based on the Performance of Routine Information System Management (PRISM) framework. This framework promotes strengthening of the HMIS performance, i.e. better data quality and improved information use by addressing technical, organizational and behavioral factors affecting HMIS data quality and use for health service performance improvement. Access the Document

    This document reports on the assessment findings that serve as a basis for formulating interventions to improve the HMIS performance and as a baseline for future monitoring of HMIS performance improvement in the zones.

    The recommendations from the performance assessment of the health management information system in SNNPR, Ethiopia include:

    Short term recommendations:

    •  Standardize supervision practices – develop supervisory checklists. Supervision should be conducted on a regular schedule with feedback provided to the facilities. Performance data (data quality and use indicators) should be collected, monitored and reviewed regularly.
    •  Link HMIS data with program monitoring – integrate HMIS quality controls activities into integrated supervisory visits. That is, if an EPI supervisor visits a facility they should be able to conduct the supervision for HMIS at the same time.
    • Expand remote access to the processed data set to woreda health offices to facilitate timely use of information for decision making at local level. Roll out the eHMIS to the woreda level.
    • Establish a standardized feedback mechanism between levels. eHMIS provides an opportunity for generating automated report from the HMIS software that should be forwarded to reporting sites at regular intervals.
    • Create linkages with service delivery managers – i.e. the facility in-charge should be integrated into the monitoring of HMIS performance.
    • Review the existing training materials on use of information and revise accordingly. Conduct on the job training on data analysis, interpretation and continuous use of information at all levels.
    • Conduct training/re-training for WoHOs and HCs on Family Folder procedures
    • Develop mechanisms to integrate data need by different programs – ensure HMIS data are used to generate reports for the vertical programs (HIV/AIDS, TB, malaria, nutrition).


    Long term recommendations:

    •  Establish systematic periodic assessments of HMIS performance in terms of data quality, data use and management functions on a periodic basis.
    •  Promote transparency and accountability of HMIS data. For example – institutionalize the use HMIS information to make everyone accountable for health system performance.
    •  Create procedures for dealing with non-compliance with performance targets.

     What’s New in RHINO’s bibliography

     An article written by Sachiko Ozawa and Krit Pongpirul on the Health Policy and Planning Journal discusses the best resources on mixed  methods in health systems research.

    Abstract: Mixed methods research has become increasingly popular in health systems. Qualitative approaches are often used to explain quantitative results and help to develop interventions or survey instruments. Mixed methods research is especially important in low- and middle-income country (LMIC) settings, where understanding social, economic and cultural contexts are essential to assess health systems performance. To provide researchers and programme managers with a guide to mixed methods research in health systems, we review the best resources with a focus on LMICs. We selected 10 best resources (eight peer-reviewed articles and two textbooks) based on their importance and frequency of use (number of citations), comprehensiveness of content, usefulness to readers and relevance to health systems research in resource-limited contexts. We start with an overview on mixed methods research and discuss resources that are useful for a better understanding of the design and conduct of mixed methods research. To illustrate its practical applications, we provide examples from various countries (China, Vietnam, Kenya, Tanzania, Zambia and India) across different health topics (tuberculosis, malaria, HIV testing and healthcare costs). We conclude with some toolkits which suggest what to do when mixed methods findings conflict and provide guidelines for evaluating the quality of mixed methods research. Access the full article.

    Summer Greetings from RHINO!

  • RHINO On-line Transcript

    June 19, 2014

    Here is the transcript of the on-line RHINO forum that took place from May 12 to 16, 2014. We thank all our participants (more than 160 representing all the continents of the world) who participated directly by sharing their experience and their ideas. We also thank our three wonderful moderators who did a wonderful job at guiding the discussion and providing feedback to many questions and situations. Fromdatareportingtodecisionmaking

  • RHINO on-line Forum POSTPONED for the week of May 12

    April 24, 2014

    Dear RHINOs,

    We have been transitioning to a new email and listserv format and during this transition, the listserv has been down longer than predicted. We will fix it within a few days however, we regret to announce that the on-line forum needs to be postponed.

    The new dates of the on-line forum are May 12th – 16th.

    The registration is still open and you can register until May 10th. Click HERE to register. No need to register if you already have done so.

    Thank you for your patience and understanding and we look forward to hearing from all of you during the on-line forum week.

  • RHINO's next on-line forum

    April 4, 2014

    From data-reporting to decision-making – are routine reporting systems  designed to support “business improvement” in the health sector.

     A Management Information System is a “system” that provides specific information support to the decision-making process at each level of an organization (Hurtubise 1984). Similarly, Health Information System (HIS) is designed to provide necessary information to guide decision-making and solve health problems at health facility and community level.

    Join us for a discussion on Routine Health Information System commonly known as Health Management Information System (HMIS) and Community Health Information System (CHIS). We will explore how health facility and community level information systems are being helpful to health workers, managers and policy makers to improve the business of improving quality and coverage of health services. We are eager to hear from you; on how you have used your routine data to improve the process, quality or coverage of health services. Bring your innovations and share with all the members around the world on how you and your team have used data at health facility and community level for improving the business of health service delivery. Tell us your story of what types of behavioral, technological, technical and organizational interventions were helpful to make this change.

     We would like to juggle our brains and ask ourselves the question: if given an opportunity, what is the one thing that you would like to change in the design of the information system (health facility and community) in your country that will help the managers at national, district, health facility and community or frontline health workers make better decisions on improving service delivery and increase coverage? Can we identify one behavioral, technological, technical and organizational interventions that you think will support the “business” of improving quality and coverage of health services.

     During the five days we will further explore these questions:

    •  What are some innovations that you have introduced to improve information use at health facility and community levels?
    • Are information system designed to support “business Improvement” at health facility and community levels
    • What are some of the behavioral, technological, technical and organizational interventions to improve the design and performance of HIS

    Date: April 28th to May 2nd, 2014

    Moderators: Vikas Dwivedi, Tariq Azim and Chris Wright

    To register please submit your information to this online form with you name, job title and country of work

  • Happy Holidays from RHINO

    December 24, 2013

    Happy Holidays and RHINO Greetings