Transcript UTILIZATION OF HEALTH INFORMATION IN NAMIBIA

STRATEGIES FOR PERMANENT ACCESS TO
SCIENTIFIC INFORMATION IN SOUTHERN
AFRICA: FOCUS ON HEALTH AND
ENVIRONMENTAL INFORMATION FOR
SUSTAINABLE DEVELOPMENT
AN INTERNATIONAL WORKSHOP
5-7 SEPTEMBER 2005
CSIR CONVENTIONCENTRE, PRETORIA, SOUTH
AFRICA
UTILIZATION OF HEALTH
INFORMATION IN NAMIBIA
FOCUS ON CHALLENGES AND
OPPORTUNITIES FACED BY
HEALTH CARE DELIVERY SYSTEM
DR. L. HAOSES-GORASES
PhD, M Cur, Hon Cur, BA Cur, Adv.
Univ. Dipl. in CHN & Education
INTRODUCTION
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2001 Population Census – 1.830,330
Population 1.830,330-2001 Housing Census
Annual growth rate 2.6%
Surface area 824,116 km2
Average 2 persons per km2
People spread unevenly across the country
Urban 33%
Rural 67% (SSS 2004)
NAMIBIA BY REGION
BACKGROUND
HIS under Epidemiology Division
 Collect routine data – all health facilities
(clinics, health centres & hospitals)
Aim:
 Analyze
 Documentation
 Disseminate – planning
 Direct changes in policies
 Improve monitoring performance
 Identify support needs
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KEY PLAYERS
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MoHSS & Central Bureau of Statistics (CBS)
Major surveys & census
Data duplications occurring
With new developments new programmes on
board
Prevention of Mother to Child Transmission
(PMTCT)
Anti Retroviral Treatment (ART)
Voluntary Counseling & Testing (VCT)
CONTINUE
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Health Information System developed in
1990 after independence
Many challenges –improvement in the
past years
In 2004 and 2005 situation analysis and
comprehensive assessment of the
system
OBJECTIVES
To improve individual and institutional
performance
 To measure quality and efficiency of the
strategies in place
 To compare performance over time in relation
to national targets
 To provide support to regions, districts &
health facilities
To monitor trends in:
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Coverage
Quality
Effectiveness of the services
Guide policy-makers for resource allocation
RECORDING PROCEDURES
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Tally sheets
Daily ward census
Monthly summary forms
E-mail
Floppy diskettes from regional to
national level
CONTINUE
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Information covers indicators on:
Human resources
Population
Health facilities
Financing
Directive in terms of MDG’s
Information only from:
Public and mission health facilities
QUALITY OF THE DATA
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Training of staff
Computerized system
E-mail functioning (80%)
Floppy diskettes also introduced
SOURCES OF DATA
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Located in different directorates
Directorate Planning & Human Resources
(MIS)
Central Bureau of statistics in National
Planning Commission (Census, vital events)
Ministry of Home Affairs (registration birth,
deaths, immigrants etc.)
Discussions for 3rd national statistic plan
STRENTHENING OF HIS
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Revision in 1994
New forms introduced in 1995
Revised again after five years
International standards
ICD-10 included
DECENTRALIZATION/
COMPUTERIZATION
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All 13 regions
33 districts (computerized)
To improve channels of processing of
the data:
Health facilities to district, regional and
national level
Telephoning instant training
ICD-10 for coding purposes (IP)
INTRODUCTION OF
STANDARD REGISTERS
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Outpatient Department (OPD)
Inpatient Department (IPD)
Antenatal Care (ANC)
Expanded Programme on Immunization
(EPI)
Legal records
Reference manuals are available
INTERNATIONAL
PARTNERS ROLE
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Investing in specific programmes
GF, USAID, FHI, CDC, PEPFAR UN
AGENCIES (Malaria, TB, HIV/AIDS)
Reporting circles
UN agencies support the health service
e.g. Country Response Information
System (CRIS)
REGULARLY & LEGAL
FRAME WORK
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Facility Act – draft
Health Act –draft
Consolidate information from private
health facilities & other stakeholders
STRATEGIES
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CBS conducts surveys & household census
Ministry of Home Affairs generates info on
births, death and immigration
Integrated disease surveillance system
collects info on notifiable diseases such as:
Measles
Neonatal Tetanus
Polio (AFP) etc
NDHS scheduled for 2006 (every five years)
INFORMATION
MANAGEMENT
Several sets:
 Health indicators used for:
Planning
Resources allocation
Monitoring & evaluation
 Compiled at district to regional and national
 Data cleaned at all levels & actions taken
 Several data bases coming up
 Development partners choice
 MOHSS is constantly updating it’s website – new
version to be release this year
 SPSS, EPI-INFO & Microsoft Access in used
AVAILABILITY OF SOUND
HEALTH STATISTICS
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Strength (quality) of the data assessed
Statistical techniques examined
Major elements (domains)
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Health profile of the population
Risk factors
Service coverage
Factors influencing data
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Timeliness
Representativeness
Periocity
Consistency
65% info readily available
2004 SENTINEL SURVEY
UTILIZATION
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Vital vehicle – M & E
Reprogramming
Planning
Development of policies/guidelines
Setting of priorities
NATIONAL HEALTH STATISTICS, 2005
Domain
Indicator
Score (%)
Health status
Overall score (mean)
65
Child mortality
Maternal mortality
Adult mortality
Causes of death in children
HIV prevalence
TB incidence
Underweight in children
Obesity in adults
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55
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75
78
87
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CONTINUE NATIONAL HEALTH
STATISTICS, 2005
Domain
Health service
coverage
Indicator
Measles coverage
Skilled birth
attendant
TB treatment DOT
Proportion of
children sleeping
under bed nets
Score (%)
83
70
83
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CONTINUE NATIONAL HEALTH
STATISTICS, 2005
Domain
Indicator
Score (%)
Risk factor
Smoking prevalence
Condom use at
higher risk sex
Improved water
supply
78
68
Total health
expenditure (per
cap)
Health worker
density
63
System
87
76
CHALLENGES
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Turn-over of staff/training
Timeliness – info – national level
No designated staff at district level
Computer – literacy lacking
Info – private sector not available
Development partners agenda
Coordination of the systems
Involvement of top level management
OPPORTUNITIES
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Strengthening/coordination of system
Capacity development
Completion of facility & facility & Health Act
Capitalize on development partners’ support
to strengthen lower levels
Regional collaboration/expertise (SADC, WHO
etc).
Development of critical mass in the region
e.g. WHO, SADC etc.
Availability of expertise in the SADC region
CONCLUSION
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Key constituencies to form coordinating
mechanism
Designated staff at district level
Mobilization of resources by all stakeholders
Involve policy-makers (vital tool)
Country needs driven system
Indicators to match with National
Development Plan
CONTINUE
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Train staff on computer literacy on HIS
Involvement of policy makers and
stakeholders for better understanding &
support
Computer back-up system at regional level
Facility and Health Acts be finalized and
implemented
Sustainability of HIS address
Horizontal learning (regional expertise)
NB!
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HIS is serving as a vital instrument in our
health service delivering system
It is directing the MoHSS in identification of
shortcomings (revision of the system,
adjusting of the indicators, software etc.
Strengthening at all levels
Make information available in a user-friendly
manner
Proper utilization of the system
CONTINUE
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HIS is reporting on diseases targeted
for eradication and elimination (e.g.
Polio (80% WHO) Measles and
Neonatal Tetanus
HIS is in high demand by sectors –
positive move
Thank you!!!