RHINO or

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RHINO or Routine Health Information Network
Mini-University Washington DC May 10, 2004
An introduction for non-Rhinos Theo Lippeveld,
MD, MPH
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What is routine health information?

• Routine health information is produced at regular
  intervals of a year or less through mechanisms
  designed to meet predictable information needs.

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Routine health information includes

• Health service statistics for routine service and
  special program reporting
• Administrative data (revenue and costs, drugs,
  personnel, training, research and documentation)
• Epidemiological and surveillance data
• Data on community-based health actions
• Vital events data (birth, deaths, and migrations)

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What is the role of Routine Health Information
Systems?

• Evidence-based decision making mostly at district
  level and below
• Provide the information support for more
  effective and efficient planning and management
• Building integrated health systems
• Ultimately contribute to improving health status

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Routine Health Information Systems and the health
system
Community Level
HEALTH CARE LEVEL
CATCHMENT AREA POPULATION
Patient/Client contact
First level care unit
PRIMARY
DISTRICT LEVEL
Referred patients
District Hospital
SECONDARY
Regional Health Management Team
NON-ROUTINE DATA COLLECTION METHODS
Referred patients
REGIONAL LEVEL
Regional Hospital
TERTIARY
National Hospital University Hospital
Ministry of Health Universities Other Health
Institutions
NATIONAL LEVEL
Referred patients
INDIVIDUAL CARE MANANAGEMENT
OTHER SECTORS -Environment -Civil
Administration -Transport -Education
HEALTH UNIT MANAGEMEET
SYSTEM MANAGEMENT
Routine Health Information System
HEALTH CARE SERVICES
HEALTH SERVICES SYSTEM
HEALTH SYSTEM
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Unfortunately...

• Routine health information systems in most
  (developing) countries are woefully inadequate to
  provide the needed information support

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What is wrong with existing routine health
information systems?

• Irrelevance and poor quality of the data
  collected
• Fragmentation into program- oriented
  information systems duplication and waste
• Individual care services are not linked to a
  reference population
• Centralization of information management without
  feedback to lower levels
• Poor and inadequately used health information
  system infrastructure

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(No Transcript)
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Complex data collection systems
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Restructuring RHIS Concrete Steps

• Individual country experiences Pakistan,
  Philippines, Niger, Eritrea, etc
• First broader international consultation Potomac
  Workshop (March 2001)
• see Potomac Statement (August 2001)
• Creation of RHINO
  Routine Health Information NetwOrk

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Purpose of RHINO

• Promote high quality and practical approaches
  to the collection and use of routine health
  information in developing countries.

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Core functions of RHINO

• Analysis of experience
• Dissemination of best practices
• Networks and linkages among professionals
• Mechanisms for coordinating investment

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Progress of RHINO

• 600 network participants from 60 different
  countries
• Health and information professionals from
  developing country governments, non-profit and
  private sector organizations, multi-lateral and
  bi-lateral donors universities
• Activities
• Potomac and South Africa workshops
• Listserv - moderated on line forums
• Bibliography, consultant register, publications

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Main strategies

• Promotion of district managed RHIS
  see South Africa workshop
• Focus of HIS design and management efforts
  primarily on use of information

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rhino

• Second RHINO Workshop on District Health
  Information Systems
• Mpekweni Beach, South Africa, October 1-4, 2003

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SA Workshop Some of the lessons learned

• Potential impact of RHIS probably greatest at
  district level and below
• Need for master plan to guide incremental HIS
  restructuring.
• District level is the ideal level for integration
  of health information from various sources
• Use of  Prism  framework to guide design and
  management efforts

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PRISM Framework for understanding health
information system performance
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
• ICT
• Skills/knowledge of personnel

Improved Health System Performance
Improved Health Status
Systemic/Environmental Determinants leadership,
structure, culture, roles/responsibilities,
resources
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Example of district level integrated database
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More on RHINO

• Visit the website
• www.cpc.unc.edu/measure/rhino
• To become member
• e-mail the_rhino_at_jsi.com

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Information is like water Too little and you
die of thirst Too much and you drown in it
AND DO NOT FORGET!