FRONTESPIZIO - Cooperazione Italiana allo Sviluppo

44 Sandro Accorsi, Nejmudin Kedirpractice throughout the health sector. This information architecture shouldalso ensure standardization for comparison across geographical units and overtime as well as integration of data elements from a variety of subsystems.HMIS reform is urgently needed. However, because of the delay in the designand implementation of the HMIS reform at the national level, uncoordinatedregional initiatives have emerged to improve data collection and reporting(and, to a minor extent, data use). While well-intentioned, these initiativesthreaten to further fragment an already fragile system. HMIS reformat the national level should take advantage of these regional experiences andbe built on the best practices existing in the country.It is imperative to capitalize on these best practices and to integrate health informationsystem reform with overall health system development.3) HMIS reform: from data collection to information useThe Federal Ministry of Health (FMOH) is committed to leading a comprehensiveHealth Management Information System (HMIS) and Monitoringand Evaluation (M&E) reform and envisions that all key stakeholders at federal,regional, woreda and facility levels are involved in the initiative. This isto ensure that they contribute to and use the revised HMIS and M&E thatprovide a reliable resource and platform for evidence-based planning, implementationand monitoring towards a more equitable, efficient and effectivehealth care system (Figure 3).CREATING A VIRTUOUS CYCLEUse ofinformationfor evidence -baseddecision -makingDecisionSupportSystemIncreasedDemandHSDP III,PASDEP, MDG,civil society,mediaFocus onbuilding a nationaland standardizedHMIS able torespond toinformation needsof the countryStakeholdersagreeto aligneffortsIncreasedCoordinationFMOH, RHB,programmes,private sector,other sectors,CSA etc .Figure 3: The virtuous cycle in building the national HMIS.Reform of HMIS has already started with simple and achievable objectives and introducingfurther changes in a staged and scaleable approach, enhancing capacity at each stage andensuring the engagement of all partners in the process. A complex set of activities should beimplemented in an integrated way, as outlined in the Health Metrics Network (HMN)framework, including: