220167 Routine health information systems underpin health systems performance improvement: Lessons from Afghanistan 2003-2009

Tuesday, November 9, 2010 : 9:30 AM - 9:50 AM

Paul L. Ickx, MD, MSc , Center for Health Services, Management Sciences for Health, Cambridge, MA
James Eckroad , Center for Leadership and Management, Management Sciences for Health, Cambridge, MA
M. Ashraf Mashkoor, MD , Head of HMIS Department, Afghanistan Ministry of Public Health, Kabul, Afghanistan
Abdulahmad Roshan, MD , TechServe/LMS, Management Sciences for Health, Kabul, Afghanistan
Health services delivery in Afghanistan is provided through contracting mechanisms, between the Ministry of Public Health (MOPH) and Non-Governmental Organizations (NGO). The MOPH has taken on a stewardship role: defining priorities, strategies, standards and protocols, as well as overseeing and monitoring effective implementation and progress towards Afghanistan's MDG4 goals. Health systems performance improvement is highly dependent on timely, accurate and relevant routine health information systems, in particular for service delivery and resource management, acutely absent in 2002. Factors that contribute to monthly reporting of routine services statistics by more than 90% of all health facilities in 2010 include: a highly participatory development process, ensuring buy-in from all stakeholders; focus on the conditions of Basic Package for Health Services and Essential Package for Hospital Services; flexible IT technology adaptable to the level of each province for data gathering, processing and reporting; a modular relational database structure; detailed documentation of the system from the start and regularly updated; standard reports can be customized by the user; data quality control through joint MOPH/NGO monitoring ensure more than 80% accuracy; and data use training for targeted conditions. A decentralized human resource database, updated quarterly, contains at present more than 30,000 health workers of all levels, both MOPH civil servants and NGO staff, and more than 2,000 community health workers have been registered. Modules tracking training of staff, donor funding and pharmaceuticals are being completed. The common platform for all modules ensures ready accessibility of routine data at all levels of the health system.

Learning Areas:
Administration, management, leadership
Communication and informatics
Provision of health care to the public
Public health administration or related administration
Public health or related organizational policy, standards, or other guidelines

Learning Objectives:
Describe the key factors for succesful implementation of routine health information systems in post-conflict low-income settings. Explain the advantages of using a modular approach in the development of routine health information systems

Keywords: Health Management Information Systems, Public Health

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I provided extensive in-country and remote technical assistance to the development of both the Basics Package of Health Services for Afghanistan and the development of all parts of the routine health information systems of the Ministry of Public Health of Afghanistan from 2003 till present and know its strenghts and weaknesses.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.