Strengthening service delivery =>> Health information and monitoring systems =>>
Health system (HMIS) and immunization (EPI) specific reporting coordinated, where possible
Responsible entity: WHO
Completed by: December 2005
Total budget: $1,859,187
Target description and how it will help reach GAVI milestones
A reliable information infrastructure is critical to track performance of health programmes and systems but should be as simple as possible to be manageable and should avoid unnecessary duplications. Integration of health data flows should be a goal when it is not associated with a loss in data integrity, timeliness and validity. The Health Metrics Network aims precisely at facilitating integration and coordination of health data. The activities proposed to achieve this target will therefore also feed into strengthening this network. Improving data collection will be crucial to assess whether the Millennium Development Goals will have been achieved. The proposed tasks include a situation analysis of the main barriers towards integration of health information systems, followed by technical assistance and development of appropriate material. The support of regional level is essential to stimulate and maintain data use and collection.
ACCESS MILESTONE: Consolidated data (Health system, or HMIS, and immunization, or EPI) plus feedback from regional levels will enhance immunization managers’ understanding of the real situation, leading to improved and better targeted immunization services.
Justification for selection of activities
A better understanding of failures to integrate HMIS and EPI will be the stepping stone to improve the use of information in selected countries.
Reinforcement of regional structures is crucial to support reliable, timely and valid integrated district data management.
||Coordinating partner/ support partners
|Situation analysis of problems of integrating HMIS and EPI data in selected countries
|• There will be a better understanding of the factors affecting integration of HMIS and EPI.
• Potential data collection links between the healths related MDG indicators will be identified.
• Factors crucial to ensuring integration of EPI data in the Health Metrics Network will have been clarified
|Provision of technical support to align the monitoring processes in selected countries with perceived coordination problems
|• In coordination with activities advised in the context of Health Metrics Network, selected countries will be encouraged to take action to improve coordination between HMIS and EPI.
• Regular meetings between relevant staff at country level, development of an interface to compare data generated by different systems and use of DQAs to strengthen HMIS.
|Efficient information systems in place at regional levels and in selected countries
|• With improved data collection goes the need for strengthening of data management and data analysis. Capacity building at regional, national, and district levels is required, supported by appropriate software. The aim is that all levels can manage, analyze and interpret data relevant for their own level, and provide feedback to levels below. In addition, at regional level a database will be maintained to provide feedback to countries. This feedback will be essential to improve decision-making by EPI managers and hence improve immunization coverage (e.g. RED). Appropriate use of available technology will be ensured and new technologies will be stimulated (including web-based information sharing). It will be explored how country-level agencies and NGOs can become involved in maintaining, strengthening and coordinating monitoring systems.
Detailed information on activities
Improved synergy between existing reporting systems in developing countries and between disease- reduction initiatives is a goal of the Health Metrix Network. Related to the immunization program, discordance between EPI-related data generated by the immunization program and those generated by the HMIS is a problem in many countries. The activities proposed here aim at addressing this issue from the point of view of immunization programs. Better understanding of the factors that influence integration between EPI and HMIS is seen as a first step. A situation analysis will be conducted in five selected countries and at global level.
Cost: $ 216,127 including 15 man-months plus costs involved to country visits. Approximately $28,000 is intended for global level analysis, and the balance for country-visits and country-level analysis.
Exploration of ways to improve harmonization between HMIS and EPI will be initiated in selected countries, with focus on practical activities that can help to reach that aim. Examples could be promotion of regular meetings between staff from different departments, development of an interface to compare the data, use/adaptation of DQA to strengthen HMIS, etc.
Cost: $ 129,500, including 7 man-months and financial support to selected countries. It is expected that the manpower support to countries would be given by regional-based staff ($ 87,500). The balance ($ 42,000) is intended for implementation activities at country level.
Regional leadership to guide the process of improving data collection systems is essential. Hardware and software will be needed to maintain a regional database in every region (subregions in Africa), and a dedicated staff member will be recruited in each region (subregions in Africa) to oversee, give feedback and technical advice, and provide training on local NGOs and other agencies will need to be explored.
Cost: $ 1,513,560 including 5 staff members (1 per region for 2 years, except PAHO and EMRO), hard- and software, training, and funds to support local NGO involvement. Breakdown: $ 1,250,000 goes to support 5 staff members, based at regional level, to support countries; $ 193,500 will support training of country- level staff (organized by (sub) region) and local NGO involvement; and $ 70,000 will be allocated for hard-and software (regional level).
Targets by priority area
Strengthening service delivery
==>> Health information and monitoring systems
• Data Quality Self-Assessment (DQS) methodology and other tools finalized
• All countries with failed DQAs have received timely and adequate support
• DQS systematically used by at least 10 countries
• Health system (HMIS) and immunization (EPI) specific reporting coordinated, where possible
==>> Contributing to alleviation of system-wide barriers
==>> Enhanced efforts in large population countries
Ensuring access to vaccines and related products
==>> Procurement/Supply of existing products
==>> Development and introduction of new, near-term products
==>> Managing process for country support from Vaccine Fund
Securing long-term financing
==>> Financial sutainability
==>> Recapitalization of The Vaccine Fund
Strategic planning & monitoring
==>> Setting priorities
==>> Monitoring progress
==>> Alliance coordination