Strengthening routine facility-based health information systems in developing countries: Towards a sustainable data source for measuring the delivery of evidence-based interventions

Information generated by facility-based routine health information systems (RHIS) provides support to health managers and providers in their daily decision making and enhances efficiency in delivering quality health services. Unfortunately, as shown by various studies, RHIS in most developing countries produce low quality data and the use of information for planning and management of the health services is weak. This presentation highlights the work of the USAID funded MEASURE Evaluation Project in strengthening RHIS in developing countries. MEASURE Evaluation has developed the “Performance of Routine Information System Management (PRISM) framework” as well as a set of tools to measure RHIS performance. The framework and tools postulate that poor use of information for decision making is not only due to technical issues but also a result of organizational and behavioral barriers that hinder the effective use of information. At the end of 2012, 23 countries had applied the PRISM tools to assess the performance of their RHIS. Data quality ranged between 34% and 72%; and use of information between 30% and 53%. Some of the root causes for the low RHIS performance are lack of standardization of the data management processes as well as absence of an information culture. Interventions resulting from these assessments ranged from national RHIS reforms to capacity building in use of information. PRISM assessments after intervention in China, Cote d'Ivoire, and Mexico have shown substantial improvements in RHIS performance. Also, at the global level, MEASURE Evaluation is working on guidelines for RHIS data management standards.