Uganda Health InformationStrategy
Eddie Mukooyo, MD, MSc
Assistant Commissioner Health Services
Dublin, Ireland
13th September 2010
Presentation Outline
•Health Reforms
•Monitoring & Evaluation of SectorPerformance
•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
CATEGORIES OF HEALTH INFORMATIONON
Information from
other data sources
e.g. surveys,
special studies…
Logistics
and
commodities
Data on individual
clients
Resource
Management
e.g. inventories
•Health facilities
•Equipment inventory
•Staff listing
•In-patient information
•Laboratory information
•X-ray information
•Operating theatre information
•Information on referrals
•Outpa
•Antenatal care
•Maternity services
•Child health services
•Family planning services etc.
Information on
Preventive
services
Information on curative
services
•Stocks of commodities
•Supplies like drugs and vaccines.
Issues with HMIS
•Data not timely, complete or reliable
•Inadequate funding
•Paper – based HMIS
•Recording keeping & Data capture byhealth workers
•HMIS not well appreciated
•Poor utilisation of data
Needs Assessmentsupported by Clover III Project
•Lack of national legislation and policyframework for HIS
•Lack of HMIS skills
•Inadequate funding
•Inadequate ICT Infrastructure
•Lack of records assistants
•Inadequate use of Information generated
Health System StrengtheningClover 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 StrengtheningClover Project III - Interventions
•Training 217 Health workers in electronic datamanagement, & 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-basedPlanning meetings
•Supporting the review process of the HMIS
Achievements of the Clover Project - 1
•Improved timeliness and completenessof reporting
•Informed decision on effectiveness andappropriateness of eHMIS & wHMISsystems - HMIS Review Process
•Better evidence-based plans & DistrictPerformance League Tables)
•Enhanced data capture due to integrateddatabase tools – rather than SILOs
Achievements: Improved timeliness andcompleteness of HMIS OUTPATIENT reporting(an average for the CLOVER III districts)
Achievements – Improved timeliness andcompleteness of HMIS INPATIENT reporting (anaverage for the CLOVER III districts)
Achievements of the Clover Project - 2
•Revised HMIS tools and manuals in line withHSSP III
•Increased appreciation, use & demand forinformation at district level – creation ofinformation department with a budget
•Supported a data validation exercise in 4CLOVER III districts and 2 NON CLOVERdistricts to assess the quality of data atdistrict, HSD and selected health facilities.
Proportion of district HMIS reports matchingwith reports kept at RC – Mid-West Region
Challenges - 1
•Health Information System (HIS) isfragmented
•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 iscurtailed
Challenges - 2
•Inadequate Funding both at national anddistrict level
•Paper – based HMIS for half the districts
•Challenges of New Districts – LackCapacity, Resources, logistics , etc
•A learning process for newresponsibilities
Health Sector Strategic Plan III
•HMIS has been identified in the HealthSector Master Plan as one of the priorityareas of health system strengthening foraccelerating achievements of the healthsector goals & MDGs.
National Ownership - 1
•Alignment and Efficient Utilization of Human andFinancial Resources
–Alignment of processes and integration withinmajor vertical programs
•Increase Efficiency in community and facility-basedPatient Care for Better Health Outcomes
–Strengthen patient referral and facilitating data transfer
–Capture community based Interventions (casemanagement & prevention)
–Enhance use of information for decision making for betterhealth outcomes
National Ownership - 2
•Increase Health Infrastructure Capacity
- Linkage of all districts and health units to afunctional and efficient electronic healthinformation system for better healthoutcomes (e-governance initiative &Interoperability – data warehouse)
•Private Sector Engagement
–HIS training and other allied health businessopportunities
Immediate Action
•Establishment of a “HIS Steering Committee”for coordinating a harmonized National HealthInformation System (NHIS)
•Execute national HIS Forum with key partnersincluding the private sector to facilitate donorand stakeholder engagement
•Mobilize immediate/seed/initial technical andfinancial support for core preparatoryactivities - NHIS
Key recommendations for the future
•Train health workers and end-users on dataManagement to ensure a culture of Data-driven decision-making
•Consolidate and roll out gains from the CloverIII Project districts to cover all 110 districts
•Integrate existing parallel information systems(SILOs) into one national HIS
•Prepare Resource Centre to provide leadershipand coordination
THANK YOU
