Uganda Health Information
Strategy
Eddie Mukooyo, MD, MSc
Assistant Commissioner Health Services
Dublin, Ireland
13th September 2010
Presentation Outline
• Health Reforms
• Monitoring & Evaluation of Sector
Performance
• Categories of Health Information
• Challenges
• Needs Assessment
• Health system strengthening
• Key recommendations
Health Reforms
To improve efficiency, effectiveness &
address equity and inequality:• Decentralisation
• Health Policy I, II
• Health Sector Strategic Plan I, II, III
• Sector Wide Approach in implementation
• National Minimum Health Care Package
Monitoring & Evaluation TWG
• Sector Performance Monitoring Indicators
• HMIS as main source of data/information
•Information on referrals
•Outpa
CATEGORIES OF HEALTH INFORMATIONON
Information on curative
services
•In-patient information
•Laboratory information
•X-ray information
•Operating theatre information
Information from
other data sources
e.g. surveys,
special studies…
Resource
Management
e.g. inventories
•Health facilities
•Equipment inventory
•Staff listing
Logistics
and
commodities
•Stocks of commodities
•Supplies like drugs and vaccines.
Data on individual
clients
Information on
Preventive
services
•Antenatal care
•Maternity services
•Child health services
•Family planning services etc.
Issues with HMIS
•
•
•
•
Data not timely, complete or reliable
Inadequate funding
Paper – based HMIS
Recording keeping & Data capture by
health workers
• HMIS not well appreciated
• Poor utilisation of data
Needs Assessment
supported by Clover III Project
• Lack of national legislation and policy
framework for HIS
• Lack of HMIS skills
• Inadequate funding
• Inadequate ICT Infrastructure
• Lack of records assistants
• Inadequate use of Information generated
Health System Strengthening
Clover Project III
Based on assessment results, new interventions
were jointly designed by all stakeholders:
• Capacity Building
• Improvement in ICT Infrastructure
• Provision of Health facility databases
• Technical support supervision
Health System Strengthening
Clover Project III - Interventions
• Training 217 Health workers in electronic data
management, & utilisation
• Provision of ICT Infrastructure & connectivity
– Procured 39 desktop computers (4 for MoH/RC,
11 for District Health Offices + 24 for the HSDs)
• Follow-up hands on support supervision &
maintenance plus trouble shooting
• Supported Regional & District evidence-based
Planning meetings
• Supporting the review process of the HMIS
Achievements of the Clover Project - 1
• Improved timeliness and completeness
of reporting
• Informed decision on effectiveness and
appropriateness of eHMIS & wHMIS
systems - HMIS Review Process
• Better evidence-based plans & District
Performance League Tables)
• Enhanced data capture due to integrated
database tools – rather than SILOs
Achievements: Improved timeliness and
completeness of HMIS OUTPATIENT reporting
(an average for the CLOVER III districts)
100%
90%
80%
70%
60%
50%
Timeliness
Completeness
40%
30%
20%
10%
0%
2007/08
2008/09
2009/10
Achievements – Improved timeliness and
completeness of HMIS INPATIENT reporting (an
average for the CLOVER III districts)
100%
90%
80%
70%
60%
Timeliness
50%
Completeness
40%
30%
20%
10%
0%
2007/08
2008/09
2009/10
Achievements of the Clover Project - 2
• Revised HMIS tools and manuals in line with
HSSP III
• Increased appreciation, use & demand for
information at district level – creation of
information department with a budget
• Supported a data validation exercise in 4
CLOVER III districts and 2 NON CLOVER
districts to assess the quality of data at
district, HSD and selected health facilities.
Proportion of district HMIS reports matching
with reports kept at RC – Mid-West Region
100%
100%
100%
100%
90%
80%
80%
70%
67%
67%
%
60%
2
2
50%
40%
30%
20%
10%
0%
Kiboga
Kibaale
District
Mubende
Challenges - 1
• Health Information System (HIS) is
fragmented
• Information definitions are not harmonized
• Methods of collection vary greatly, and
• Rules for data sharing do not exist
• Significant duplication of effort at all levels,
• As a result use of health information is
curtailed
Challenges - 2
• Inadequate Funding both at national and
district level
• Paper – based HMIS for half the districts
• Challenges of New Districts – Lack
Capacity, Resources, logistics , etc
• A learning process for new
responsibilities
Health Sector Strategic Plan III
• HMIS has been identified in the Health
Sector Master Plan as one of the priority
areas of health system strengthening for
accelerating achievements of the health
sector goals & MDGs.
National Ownership - 1
• Alignment and Efficient Utilization of Human and
Financial Resources
– Alignment of processes and integration within
major vertical programs
• Increase Efficiency in community and facility-based
Patient Care for Better Health Outcomes
– Strengthen patient referral and facilitating data transfer
– Capture community based Interventions (case
management & prevention)
– Enhance use of information for decision making for better
health outcomes
National Ownership - 2
• Increase Health Infrastructure Capacity
- Linkage of all districts and health units to a
functional and efficient electronic health
information system for better health
outcomes (e-governance initiative &
Interoperability – data warehouse)
• Private Sector Engagement
– HIS training and other allied health business
opportunities
Immediate Action
• Establishment of a “HIS Steering Committee”
for coordinating a harmonized National Health
Information System (NHIS)
• Execute national HIS Forum with key partners
including the private sector to facilitate donor
and stakeholder engagement
• Mobilize immediate/seed/initial technical and
financial support for core preparatory
activities - NHIS
Key recommendations for the future
• Train health workers and end-users on data
Management to ensure a culture of Datadriven decision-making
• Consolidate and roll out gains from the Clover
III Project districts to cover all 110 districts
• Integrate existing parallel information systems
(SILOs) into one national HIS
• Prepare Resource Centre to provide leadership
and coordination
THANK YOU