Resolving fragmentation of the health information system

I am Dr Mursalin from Pakistan and has been National Coordinator , Health Information Systems with Ministry of Health Pakistan. I belief this is not an easy challenge to resolve. As there are multiple funding agencies and programs – specially in developing countries which are bound to establish their own information systems, in addition to National Health Infromation System. This is is continue till the continuation of different funding streams and mechanisms.

I would make following few recommendations to address this issue.

1. We should have good leadership at the central level to steer the process of health information systems development and implementation.
2. There should be a National Steering /Technical Committee- meeting regularly to discuss and find ways to address this issue.

3. Information Systems Development efforts should be made through participatory development process- while seeking partnerships from all possible stakeholders and program managers.
4. Solution to fragmentation of HISs be found through standardization of technology use/common platforms
5.. Integration of data be considered starting from the peripheral facilities and District Health Office level.

Thanks and regards

Dr. Mursalin Pakistan

Let us not ignore the role of development partners who continue to create and support fragmentation.

While development partners have played a roll in fragmentation by setting up program or disease specific information systems, there is increasing recognition of the problem internationally, and some notable development partners (e.g. Health Data Collaborative, WHO, the Global Fund, USAID, etc.) are taking pains to align with country systems.

The Health Data Collaborative (HDC) is a joint effort by countries, development
partners, civil society and academia to strengthen national health information
systems, improve the quality of health data and track progress towards the health related
Sustainable Development Goals. Arising from the call to action at the Measurement and Accountability for Health (MA4H) conference (2015), the HDC aims to (among other things),
“strengthen national and subnational systems for integrated monitoring of health programmes and performance. By helping countries collect, analyse and use timely and accurate data, the Health Data Collaborative will contribute to the goal of data-driven performance and accountability.”
(see the HDC factsheet here: https://drive.google.com/open?id=0B0kN6Fs9MipFdjN0OGZFN2Jzdkk)

From the Global Fund’s policy paper “Supporting Countries to Build Resilient and Sustainable
Systems for Health – The Role of the Global Fund” (2015), “Integrating multiple data collection systems into one single national health management information system can improve decision-making and accountability, from individual health care workers in the community to sub-national, national, regional and global policy makers.”
(http://theglobalfund.org/documents/publications/other/Publication_RSSH_FocusOn_en/)

From our work in the USAID MEASURE Evaluation Project we know that USAID is also promoting integrated national RHIS and/or interoperability to achieve de facto integration. In MEASURE Evaluation Phase III – at the request of USAID – we published a white paper on RHIS Data Management Standards which speaks to best practices for RHIS along 4 domains;

1. Users’ Data and Decision Support Needs
2. Data Collection Processing, Analysis and Dissemination of Information
3. Data Integration and Interoperability
4. Governance of RHIS Data Management
(http://www.cpc.unc.edu/measure/resources/publications/ms-15-99)

Also in MEval Phase III we published a paper on standards and best practices for integration of HIV/AIDS information systems into RHIS (as a follow-up to the chapter on Integration and Interoperability in the RHIS Data Management Standards document).(http://www.cpc.unc.edu/measure/resources/publications/ms-15-103)

So, while international development partners have certainly played a role in the fragmentation of information systems in countries, they seem to have recognized their role and are now taking steps to bring these systems back into the fold.

Enjoying reading the contributions from all participants. Keep them coming!

Dave