Resources, indicators, data management, dissemination and use in health information systems in Sub-Saharan Africa: results of a questionnaire-based survey

OBJECTIVE:To describe the status of health information systems in 14 sub-Saharan African countries of the World Health Organization African Region.DESIGN:A questionnaire-based survey.SETTING:Fourteen sub-Saharan African countries of the African Region.PARTICIPANTS:Key informants in the ministries of health, national statistics offices, health programmes, donors and technical agencies.MAIN OUTCOME MEASURES:State of resources, indicators, data sources, data management, information products, dissemination and use of health information.RESULTS:The highest average score was in the identification and harmonisation of indicators (73%), reflecting successful efforts to identify priority indicators and reach international consensus on indicators for several diseases. This was followed by information products (63%), which indicated the availability of accurate and reliable data. The lowest score (41%) was in data management, the ability to collect, store, analyse and distribute data, followed by resources - policy and planning, human and financial resources, and infrastructure (53%). Data sources (e.g. censuses, surveys) were on average inadequate with a score of 56%. The average score for dissemination and use of health information was 57%, which indicated limited or inadequate use of data for advocacy, planning and decision-making. CONCLUSIONS:National health information systems are weak in the surveyed countries and much more needs to be done to improve the quality and relevance of data, and their management, sharing and use for policy-making and decision-making

Health information systems in Africa: descriptive analysis of data sources, information products and health statistics

Objective To identify key data sources of health information and describe their availability in countries of the World Health Organization (WHO) African Region. Methods An analytical review on the availability and quality of health information data sources in countries; from experience; observations; literature and contributions from countries. Setting Forty-six Member States of the WHO African Region. Participants No participants. Main outcome measures The state of data sources; including censuses; surveys; vital registration and health care facility-based sources. Results In almost all countries of the Region; there is a heavy reliance on household surveys for most indicators; with more than 121 household surveys having been conducted in the Region since 2000. Few countries have civil registration systems that permit adequate and regular tracking of mortality and causes of death. Demographic surveillance sites function in several countries; but the data generated are not integrated into the national health information system because of concerns about representativeness. Health management information systems generate considerable data; but the information is rarely used because of concerns about bias; quality and timeliness. To date; 43 countries in the Region have initiated Integrated Disease Surveillance and Response. Conclusions A multitude of data sources are used to track progress towards health-related goals in the Region; with heavy reliance on household surveys for most indicators. Countries need to develop comprehensive national plans for health information that address the full range of data needs and data sources and that include provision for building national capacities for data generation; analysis; dissemination and use

Strengthening the monitoring of progress on the health-related MDGs in the African Region

There is an emerging view that progress on achieving the Millennium Development Goals (MDGs) in the African Region may be better than what is currently being reflected by official statistics. This is believed to be a result of the lack of recently updated data on the MDGs in the Region. In order to strengthen the monitoring of the MDGs; it is important to look for viable options for the timely collection; processing; analysis of relevant and quality data; and the dissemination of information products based on this data. It is essential to improve the institutional capacities in countries in order to overcome the weak data sources and data management. The monitoring of progress on the MDGs could be strengthened by: improving the content; frequency; quality and efficiency of national health surveys; strengthening birth and death registration and cause of death scertainment; improving the availability of demographic data by completing the 2010 census round; improving surveillance and service statistics; enhancing the monitoring of health systems strengthening; and; strengthening country analytical and evaluation capacity; and data use for decision-making. The latter requires the establishment and strengthening of national health observatories charged with health statistics analysis; synthesis; dissemination; sharing; and use of information and evidence

Progress on the Health-related MDGs in the African Region

Progress towards the achievement of the health-related MDGs in the African Region is slow. Currently six African countries are on track to achieve the MDG target of reducing child mortality. There is no progress on the MDG target on reducing maternal mortality. Eleven countries have started to observe declines or stabilization in HIV prevalence trends among the 13 countries that have complete trend data. A third of the population with advanced HIV infection had access to antiretroviral drugs in 2007. There were increases in the proportions of children under fi ve sleeping under insecticide treated bednets between 1999 and 2006 in all 18 countries with trend data; although coverage rates were lower than 50. Few countries have shown suffi cient progress on targets related to reducing hunger; use of improved water and sanitation facilities. Countries and their partners should increase resources significantly to strengthen health systems; maternal and child health services; combat HIV/AIDS; malaria; and TB; tackle the broader determinants of health. Measures to monitor country progress towards the MDGs should also be improved by a major effort at strengthening data sources and capacity for data management

The Ouagadougou Declaration on Primary Health Care and Health Systems in Africa: Achieving better Health for Africa in the New Millennium

The Ouagadougou Declaration on Primary Health Care and Health Systems in Africa focuses on nine major priority areas: 1) leadership and governance for health; 2) health services delivery; 3) human resources for health; 4) health financing; 5) health information systems; 6) health technologies; 7) community ownership and participation; 8) partnerships for health development; and 9) research for health. This paper describes a framework constructed for implementing the necessary activities in each of these priority areas; and proposes recommendations for consideration by Member States in the development of their own country frameworks. The frameworkfor implementing activities related to health information and research for health which have been taken into account in the Algiers Framework are discussed separately elsewhere in this issue

The background to the Algiers Declaration and the Framework for its Implementation to Improve Health Systems

The Algiers Declaration on Narrowing the Knowledge Gap to Improve Africa's Health was adopted during a Conference held in Algiers; Algeria; in June 2008. The Conference; which brought Ministers from the African Region together with researchers; nongovernmental organizations; donors; and the private sector; renewed commitments to narrow the knowledge gap in order to improve health development and health equity in the Region. This paper describes the background to the Algiers Declaration and the Framework for its implementation and their signifi cance in assisting countries' eff orts to strengthen health systems in the Region