TAKING STOCK of GMMB

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Congratulations to Mongolia on its 800
Anniversary from HMN
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• Reforming Health Information Systems
• The HMN Framework
• High Level Forum on Strategic Planning for
  Statistics
• Ulaanbataar 9-11 October 2006
• Dr. Lene Mikkelsen

www.healthmetricsnetwork.org
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What is health information?

• Information about
• all resources, organizations and actors that
  are involved in the regulation, financing, and
  provision of actions whose primary intent is to
  protect, promote or improve health
• WHO 2000

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Indicators
Areas of interest for a HIS
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Integrating Health Statistics into Overall
Statistical System
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A complex field

• Users general public, patients, communities,
  service providers, managers, policy-makers,
  donors and global agencies.
• Information covering mortality, morbidity,
  disease outbreaks, determinants of health, access
  to, coverage and quality of services, cost and
  expenditure.
• Sources vital registration, census, household,
  facility and district surveys, routine clinic
  based data, disease surveillance, national health
  accounts and modeling.

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HIS consists of several subsystems
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Data, Data, Everywhere .
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Why do we need to reform HIS?

• Widespread dissatisfaction among both users and
  producers of HI
• Complex and unwieldy fragmented by
  disease-focused programs and donors
• epidemic of indicators burdensome demands on
  health personnel
• Poor quality of data lack of common standards
  data inconsistencies and inefficiencies
  difficult to analyze and synthesize
• Oversupply of data coexisting with large unmet
  needs
• Poorly integrated into national statistical
  system and into broader statistical and
  development processes

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What is Health Metrics Network?

• Global health partnership launched in 2005 to
  assist LDCs in improving their HIS
• Partners include developing countries, global
  agencies, foundations and technical experts in
  various countries
• Funding
• USD 50 millions from Gates Foundation
• Also Danida, DFID, USAID, EC WHO
• Timeline
• First phase 2005-2012

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HMN Support to Countries

• All countries have access to HMN framework,
  assessment and monitoring tools.
• Low and lower-middle income countries are
  eligible for long-term technical and financial
  support up to 500,000 in a given year.
• All countries can participate in HMN workshops
  and training activities but only low and
  lower-middle income countries will be funded

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HMN Goal and Objectives

• Goal
• Increase availability and use of timely, reliable
  health information through shared agreement on
  goals and coordinated investments in health
  information systems
• Objectives
• Promote a harmonized framework for health
  information systems
• Strengthen country health information systems by
  assisting them applying the framework, by
  offering technical and financial support
• Improve access, quality and use of health
  information nationally and at the global level

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HMN Guiding Principles

• The process should be
• - nationally led and owned
• - link health and statistical constituencies and
  involve all stakeholders
• - respond to country needs and build upon what
  exists
• - draw on best international standards and be
  guided by the Fundamental Principles of Official
  Statistics
• - be tackled as a gradual process requiring
  long-term investment

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HMN Framework
Roadmap for implementation
Health information system components standards
Principles
HIS resources
Indicators
Process
Data sources
Data management
Tools
Information products
HMN GoalIncrease availability, accessibility,
quality and use of health information that are
critical for decision making at country and
global levels.
Dissemination and use
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Health Data Sources
Population-based
Health services based
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HMNs Assessment and Monitoring Tool

• Purpose
• - to provide a diagnosis of the national HIS
• What it is and does
• - a set of structured questions (274) and a
  scoring mechanism
• - identifies strengths, weaknesses and gaps in
  all six components of current HIS
• - establishes a baseline for the country
• What is its value-added
• - involves all major stakeholders
• - encourages consensus building
• - provides the evidence for the strategic plan
• - ensures that the same measure is used for all
  countries

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Countries Receiving Catalytic Grants From HMN -
Round 1
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Use of Initial HMN Grants

• Assessment of the current status of the health
  information system, using HMN tool, standardized
  framework for quality review
• Development of a 2015 plan for health information
  system development, linked to national health
  sector and poverty monitoring strategies and
  planning cycles
• Building capacity for data generation, analysis
  and use
• Focus on specific issues monitoring vital events
  , private sector data, data dictionaries, data
  warehousing

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Round 2 Grants

• In 2006 HMN has had workshops in L-A, Caribbean
  and the Middle East
• 2nd Call for Proposals. Deadline August 31,
  2006.
• Limited to countries not receiving support in
  Round 1
• Grant ceiling set to 50,000 covering only the
  assessment with stakeholders and developing a 10
  year strategic improvement plan
• 58 Proposals received which will be reviewed by
  HMN Secretariat, (based on criteria set forth by
  Independent Review Ctte)

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Ways that NSO statisticians can contribute to
strengthening HIS

• Provide high level support and guidance for the
  assessment and strategic improvement plan
• Active and continued participation in the
  assessment of the HIS together with other
  stakeholders to ensure a good outcome
• Send participants to HMN training workshops
• Participation in the group tasked with drafting
  the strategic 10 year plan for reforming the HIS
• If requested, organize training to health staff
  in data collection and data quality issues
• Help link to broader statistical and development
  processes as well as integrating health
  statistics into NSDS

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The Vicious Cycle
Decision-making
Weak demand
based on sectional interests, donor demand,
inertia etc.
for data for policy-making. Data not trusted or
used.
Weak health information Systems.
Donors focus on their own data needs
Limited capacity to generate or analyse data.
Little investment in health information systems.
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Creating a Virtuous Cycle
GFATM, GAVI. President's Initiative, MDGs
results-based decision-making
Health sector reform, SWAPs. PRSP, civil society,
media, use of IT
Global
initiatives
Increased
Demand
Donors
agree
to align
efforts
Increased
Multiple stakeholders health and statistics

Focus on building systems able to respond to
country and donor needs.
Coordination
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www.healthmetricsnetwork.org