The 131st Annual Meeting (November 15-19, 2003) of APHA

Abstract #62349

Anne K. LaFond, MS, MEASURE Evaluation Project, John Snow, Inc., 1616 North Fort Myer Drive, 11th floor, Arlington, VA 22209, 703 528 7474, anne_lafond@jsi.com, Theo Lippeveld, MD, MPH, International Group, John Snow, Inc., 44 Farnsworth Street, Boston, MA 02210, Stephanie J Posner, MPH PhD, PHRplus Project, Tulane University School of Public Health and Tropical Medicine, 4800 Montgomery Lane, Suite 600, Bethesda, MD 70112, Rebecca Fields, CHANGE project, Academy for Educational Development, 1825 Connecticut Ave., NW, Washington, DC 20009, and David R. Wilson, MPH, Deputy CIO, Management Sciences for Health, 165 Allandale Road, Boston, MA 02130.

Typically strategies to improve performance of health information systems(HIS) in developing countries emphasize technical aspects of data collection and use. This paper suggests that poor performance (defined as quality and data use) in information systems results from the interaction of three different but equally important forces: technical, behavioral, and health system. The authors introduce an analytical framework that uses these factors to 1) analyze obstacles to quality and effective use of health evidence at district level and below, and 2) identify strategies to improve collection and use of routine information in meeting health needs of populations. Technical capacity in indicator design, data analysis, and reporting forms the backbone of the HIS. However, health system factors (e.g. policies, donor priorities, and the degree of decentralization) that exist outside the structures and procedures of the information system also create or limit opportunities for sound performance. Behavioral factors, such as attitudes and motivation in both individuals and organizations, can also underlie lack of sustained change in HIS performance despite improved designs and streamlined data analysis techniques. The paper present results of the application of the framework to district HIS in South Africa and Tanzania using case studies developed during an international workshop on Enhancing the Quality and Use of Health Information at the District Level held in South Africa. These findings and subsequent field-based analysis illustrate the importance of addressing health system and behavioral factors alongside technical weaknesses in programs to improve performance of routine health information systems at district level.

Learning Objectives:

• Participants will be able to name 3-5 system, behavioral, and technical factors that influence the quality of routine health information and its use for health action at district level
• Participants will be able to apply a simple framework for analyzing health information systems and planning interventions that build and sustain a practical health information system
• Participants will be able to describe examples of where system, behavioral and technical factors have influenced the quality of district level HIS data collection and use.

Keywords: Health Information Systems, Decision-Making

Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: Health systems of South Africa and Tanzania
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.