Routine data systems
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Routine Data Systems. Data Use for Program Monitoring. Learning Objectives. Differentiate between routine and non-routine data Understand parameters and influences of HIS via the PRISM framework Recognize & use tools available to improve RHIS function. Session Overview.

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Routine data systems

Routine Data Systems

Data Use for Program Monitoring


Learning objectives

Learning Objectives

  • Differentiate between routine and non-routine data

  • Understand parameters and influences of HIS via the PRISM framework

  • Recognize & use tools available to improve RHIS function


Session overview

Session Overview

  • General concepts of an RHIS

  • Health information systems

  • PRISM framework for understanding factors that influence RHIS

  • PRISM Toolset for RHIS1

    • RHIS Performance Diagnostic Tool

    • RHIS Overview & Facility/Office Checklist

    • Organizational & Behavioral Questionnaire

    • RHIS Management Assessment Tool

  • Activity – Applying the PRISM Tools

1MEASURE Evaluation, Data demand and information use in the health sector: strategies and tools


Definitions

Definitions

  • Health information system

    • A system providing specific information support to decision-making process at each level of an organization1

  • Health system

    • All resources—people, institutions & other—arranged according to established policies to protect, promote and improve the health of the served population2

2 WHO, http://www.euro.who.int/observatory/Glossary/TopPage?phrase=H

1Hurtubise R (1984). Managing Information Systems. Kumarian Press, West Hartford.


Definitions routine vs non routine data

Definitions: Routine vs. Non-routine Data

  • Routine data

    • Are collected continuously at various times periods (daily, patient by patient, monthly etc.)

    • Come from the HIS and its subsystems that are collected as part of an ongoing system

  • Non-routine data

    • Are collected at certain periods of time, or over a specific period of time

    • Come from special studies or surveys carried out for specific purposes


Are we talking about this

Are we talking about this?


Or this

Or this?


Or do we mean this

Or do we mean this?


All of these but this is where we really want to get

All of these, but this is where we really want to get


Why do programs need information

Why do programs need information?


Programs need information to

Programs Need Information to

  • Understand entire context of program status

  • Enhance program performance through evidence-based decision making

    • All major functions

      • service delivery, resource mobilization, financing, stewardship

    • All levels

      • Community to national level


Health information systems his

Health Information Systems (HIS)

  • HIS is an integral part of the health system

  • Just like a health system, an HIS is not static

  • Health systems in continuous process of change due to pressure from both outside and within the system

  • HIS must amend itself to these changes


His sub systems frequency of data collection

HIS Sub-systems: Frequency of Data Collection

  • Routine or continuous data collection

    • Health facility-based (pt. info. & service stats)

    • Community based (service statistics)

    • Vital registration

    • Sentinel reporting

    • Program reporting systems

  • Non-routine or periodic data collection

    • Household or facility-based surveys

    • Population census

    • Rapid assessment procedures (RAP)

    • Research


His and hiv programs

HIS and HIV Programs

  • A subset of the comprehensive health system

  • Data sources can be routine or non-routine

  • Contribute to data collection of various HIS subsystems

  • Need harmonization and integration in data collection & utilization within context of national HIS (the Third One)


Prism framework for his performance 1

PRISM* Framework for HIS Performance1

Inputs

information system

assessment,

strategies & interventions

Behavioral determinants

Attitudes, motivation, values

  • Desired Outcomes

  • = information system performance

  • good quality information

  • appropriate use of information

  • Technical

  • Determinants

  • system design

  • data collection forms

  • Skills/knowledge of

  • personnel

Improved

Health

System

Performance

Improved

Health

Status

Systemic/Environmental Determinants:

leadership, structure, culture, roles/responsibilities, resources

*Performance of Routine Information System Management

1MEASURE Evaluation. 2006. Data demand and information use in the health sector: Strategies and Tools


Routine data systems

RHIS Performance Diagnostic Tool


His quality use influences

Standard indicators

Data collection forms

Appropriate IT

Data presentation

Trained people

Technical

Determinants

HIS Quality & Use Influences


Routine data systems

Technical

Determinants

RHIS Overview & Facility/Office Checklist


His quality use influences1

HIS Quality & Use Influences

Motivation

Attitudes & values

Confidence

Sense of responsibility

Behavioral Determinants


Routine data systems

Behavioral

Determinants

Organizational and Behavioral Questionnaire


His quality use influences2

HIS Quality & Use Influences

Resources

Health sys. structure

Roles & responsibilities

Organizational culture

System &

Environment

Determinants


Routine data systems

System &

Environmental

Determinants

RHIS Management Assessment Tool


Prism tools rationale

PRISM Tools - Rationale

  • RHIS often not produce good information for health sector decision-making

    • Data quality may low

    • No processes in place for using data

    • Managers/staff not understand importance of role in information process & have little incentive

  • Traditional Assessments of RHIS narrow in focus

    • Answer only part of why RHIS not high quality

    • Typical focus is on data collection or information technology alone


Prism tools rationale1

PRISM Tools - Rationale

  • Well designed interventions to improve RHIS should address these questions

    • Is the organization committed to information-using culture?

    • Do people responsible for data collection have necessary skills?

    • Do they understand & care about importance of their work?

    • Do managers support them with training, supervision & needed resources?


Description of prism tools

Description of PRISM Tools

  • Systematically provide answers, using an ordered process of gathering information about RHIS

  • Objectively measure performance & identify factors hindering performance

    • Assess performance of RHIS

    • Identify technical, behavioral & organizational factors affect RHIS performance

    • Aid in designing/prioritizing interventions to improve performance

    • Support ongoing efforts for M&E of data quality & use in decision-making.


Prism tools implementation

PRISM Tools - Implementation

  • Apply all four Tools for systematic assessment

  • Implement Tools in this order:

    • RHIS Performance Diagnostic Tool

    • RHIS Overview & Facility/Office Checklist

    • Organizational & Behavioral Questionnaire

    • RHIS Management Assessment Tool


Prism tools rhis performance diagnostic tool

PRISM Tools:RHIS Performance Diagnostic Tool

  • Primary component in the set

  • Determines overall RHIS performance

    • (like MESS for whole M&E system)

  • Examines data quality & information use to identify gaps

  • Identifies overall strengths and weaknesses


  • Prism tools rhis overview facility office checklist

    PRISM Tools:RHIS Overview & Facility/Office Checklist

    • Addresses technical determinants of RHIS such as

      • Structure & design of existing information systems

      • Information flows

      • Interaction between different information systems

    • Use to understand availability & status of RHIS resources & practices


    Prism tools organizational behavioral questionnaire

    PRISM Tools:Organizational & Behavioral Questionnaire

    • Addresses behavioral and organizational determinants to RHIS, examines

    • Staff capacity

      • Knowledge, skills, confidence and motivation

    • Organizational culture

      • Promote value of information quality & use?

    • Compares these factors with RHIS performance to identify related gaps


    Prism tools rhis management assessment tool

    PRISM Tools:RHIS Management Assessment Tool

    • Allows a rapid assessment of management and supportive RHIS practices

    • Results in recommendations for stronger RHIS management


    Prism tools guiding principles

    PRISM Tools – Guiding Principles

    • Holistic approach that recognizes

      • RHIS performance depends on combination of technical, organizational & behavioral factors

      • Each of these components contributes to whole system, whole is more than the sum of its parts

      • Causal influence of all determinants in 3 areas must be understood to improve performance


    Prism tools guiding principles1

    PRISM Tools Guiding Principles

    • When data collectors understand importance of their contributions, they will be more committed

    • When decision-makers believe they have high quality data, more likely to use it for evidence-based decisions

    • When people empowered to make decisions, become champions for accountability and transparency


    Prism tools

    PRISM Tools

    • Tools are administered, based on

      • Observations, document review, information technology review

    • Triangulation of multiple data sources increases validity of findings

    • Self-assessment aspect creates sense of ownership for results & atmosphere of collaboration


    Steps to use prism tools

    Steps to use PRISM Tools

    • Identify a potential opportunity

      • Determine how Tools would be used for the presenting need

    • Perform pre-assessment planning

      • Determine organization’s readiness to improve RHIS

      • Assemble core team stakeholders

      • Identify key informants to interview

      • Modify Tool to fit application

    • Assess & analyze current RHIS performance

      • Use the Tools in order (Diagnostic, overview, organizational/behavioral, management assessment)

    • Define plan for reaching desired level of RHIS performance

    • Implement plan and monitor progress


    Goal of rhis

    Goal of RHIS

    • Produce meaningful insights about performance of health system

    • Is our HIV program working?

      • Increasing people willing to be counseled & tested

      • Decreasing HIV incidence

      • Reaching more pregnant, HIV + women

    More effective information systems lead to better health status for more of the population


    Routine data systems

    MEASURE Evaluation is a MEASURE project funded by the

    U.S. Agency for International Development and implemented by

    the Carolina Population Center at the University of North Carolina

    at Chapel Hill in partnership with Futures Group International,

    ICF Macro, John Snow, Inc., Management Sciences for Health,

    and Tulane University. Views expressed in this presentation do not

    necessarily reflect the views of USAID or the U.S. Government.

    MEASURE Evaluation is the USAID Global Health Bureau's

    primary vehicle for supporting improvements in monitoring and

    evaluation in population, health and nutrition worldwide.


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