Uganda Health Information Strategy

1. Uganda Health Information Strategy Eddie Mukooyo, MD, MSc Assistant Commissioner Health Services Dublin, Ireland 13th September 2010

2. Presentation Outline • Health Reforms • Monitoring & Evaluation of Sector Performance • Categories of Health Information • Challenges • Needs Assessment • Health system strengthening • Key recommendations

3. 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

4. Monitoring & Evaluation TWG • Sector Performance Monitoring Indicators • HMIS as main source of data/information

5. CATEGORIES OF HEALTH INFORMATIONON • Information on referrals • Outpa • In-patient information • Laboratory information • X-ray information • Operating theatre information Information on curative services Information from other data sources e.g. surveys, special studies… Resource Management e.g. inventories • Health facilities • Equipment inventory • Staff listing Logistics and commodities Data on individual clients Information on Preventive services • Stocks of commodities • Supplies like drugs and vaccines. • Antenatal care • Maternity services • Child health services • Family planning services etc.

6. 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

7. 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

8. 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

9. 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

10. 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

11. Achievements: Improved timeliness and completeness of HMIS OUTPATIENT reporting (an average for the CLOVER III districts)

12. Achievements – Improved timeliness and completeness of HMIS INPATIENT reporting (an average for the CLOVER III districts)

13. 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.

14. Proportion of district HMIS reports matching with reports kept at RC – Mid-West Region

15. 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

16. 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

17. 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.

18. 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

19. 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

20. 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

21. Key recommendations for the future • Train health workers and end-users on data Management to ensure a culture of Data-driven 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

22. THANK YOU