Conflict zone data: Coordinating health information in Burma

Background:

Military regime policies have severely restricted the collection and distribution of health information from eastern Burma. Community-based organizations (CBOs) serving internally displaced people (IDPs) in these “conflict zones” are the main source of data about health status in the region. In 2006, a needs assessment found that data management and a comprehensive border-wide health information system (HIS) were among the highest priorities for local organizations. The Burma Medical Association coordinated with five other CBOs to create a standardized HIS curriculum and training.

Evaluation Methods:

In 2007, the CBOs recruited individuals from their communities to attend a 10-week training aimed at building local HIS capacity. In 2008, nine of these participants were given more advanced “Training of Trainers” instruction so they could continue training within their own organizations, and could also lead HIS trainings for future cohorts. Global Health Access Program (GHAP) provided technical support for the design of the HIS and TOT curricula.

The trainings were supplemented by direct observation and mentorship in individual organizations' offices working with their real data. In addition, ongoing collaboration between local CBOs was facilitated by conducting follow-up trainings on a regular basis. Leaders from local organizations coordinate with each other to standardize indicators, data collection methods, database design, and analysis methods.

Outcomes:

• A comprehensive HIS curriculum was developed to build capacity for data management; CBOs use this adaptable curriculum to teach their staff HIS principles and skills.

• The program trained 42 community members from 6 CBOs in data entry, data analysis, improvement of M&E processes, and database design.

• Data forms, collection procedures, analysis methods, and targets for improving M&E were standardized across CBOs, overcoming political, linguistic and geographic barriers in the process.

• CBOs improved the quality and consistency of their M&E indicators, thus increasing their ability to advocate for populations living in conflict areas not reached by government or international non-governmental programs.

Conclusions:

Training community workers from refugee and IDP populations in basic health information systems and data management is a potential method to address the problem of delivering, monitoring and advocating for coordinated and effective health care services for IDPs living in otherwise unreachable areas of active conflict.