Data Management and HMIS Facilitator: Dr. Lucie Blok Delhi, 31 st Jan 2006.

Data Management Data Management and HMISand HMIS

Facilitator: Dr. Lucie BlokDelhi, 31st Jan 2006

The Issue is not that we need more data….

.. but better use of data

HMIS: DefinitionHMIS: Definition

A HMIS is a system of record-keeping, reporting, processing, analysis, interpretation, use, and feedback of information.

HMIS: Functions HMIS: Functions

- Provides different levels of beneficiaries

(clients, community, service

providers, managers, planners

and policy makers)

with timely and relevant information

- Used to formulate policy, to plan, implement, monitor, supervise and evaluate health-related activities (adapted from Campbell, 1997)

HMIS provides information on:HMIS provides information on:

– Health status (through surveillance, surveys)

– Health-related interventions and services (activities, progress, quality)

(through surveillance, program monitoring and evaluation)

Purposes of HMIS: Evidence-Based Decision Making

- Monitoring and evaluation of control programs

- Plan actions, programs, and resources- To prioritize the allocation of health

resources- To provide the basis for epidemiological

research - Accountability

Management cycleManagement cycleWhere are we now?

Situation Analysis

Where do we want to go?

Objectives

Where did we reach?

Evaluation

Which route shall we take?

Strategy

Is everything going according to plan?

MonitoringIdentifying constraints

Taking action

How shall we travel there?

Plan of Activities

HMIS

M&E Framework in TBCPM&E Framework in TBCP

Context: • Political commitment • Access and utilisation of services • Socioeconomic conditions• Epidemiological context (HIV, nutrition)

Input Process Output Outcome Impact

Source: WHO: (2004); Compendium of indicators for monitoring and evaluating national tuberculosis programs,

Problems in HMIS 1: DesignProblems in HMIS 1: Design

1. Top-down control, leaving out lower level

2. Unclear objectives and targets

3. Too much working time spent on HMIS

4. No guidelines

5. Not enough skills

6. Not enough staff

7. Fragmentation in services

Problems in HMIS 2: CollectionProblems in HMIS 2: Collection

Too many recordsToo late Poor qualityPoor lay-out, confusing terminologyIncomplete Potential exclusion of private and hospitalized patientsInflexible data collection Resistance to change

Problems in HMIS 3: (Self-) AssessmentProblems in HMIS 3: (Self-) Assessment

Data not analysed to produce information, but just forwarded upward

No indicators to assess progress

Presentation not clear, out of date

Management culture does not value information (decision-making on intuitive or political basis only)

Political use (coverage = 1 microscope per dist)

Problems in HMIS 4: UseProblems in HMIS 4: Use

Inadequate training for managers

Data not available for the

right persons at the right time

No feedback to lower levels,

no pressure to use data

Data not used for supervision

Rigid criteria (success rate in the era of HIV)

A good HMIS system:A good HMIS system:

Provides all information required

Is easy to implement

Requires minimal staff time

Is consistent with other management and recording systems in place

Is useful for all stakeholders and is used

Group work HMIS - challengesGroup work HMIS - challenges

Question 1a: What are the main challenges in your country regarding design of the HMIS?

Question 1b: What solutions do you suggest?

Group work HMIS - challengesGroup work HMIS - challenges

Question 2a: What are the main challenges in your country regarding the collection and quality of data that you receive?

Question 2b: What solutions do you suggest?

Group work HMIS - challengesGroup work HMIS - challenges

Question 3a: What are the main challenges in your country regarding the use of data collected on TB management?

Question 1b: What solutions do you suggest?

Indicators chosen

Source data/ information

Process of obtaining information

How to assure quality of information/data