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48 Sandro Accorsi, Nejmudin KedirScale up of vital registration; and iii) Capacity building. The aim is to expandthe scope of data collection, analysis and interpretation, strengthening the evidencebase for action through a comprehensive HIS that includes all (routineand non-routine) data sources.Such a comprehensive design enables phased system development, reducesredundancies, increases efficiency, and improves interoperability.Interoperability is critical to ensuring, for example, that census data, vital statistics,and health facility data can be integrated to generate rates, ratios, andother indicator estimates as well as to ensure data validation and triangulation(comparison of results from several different sources of data).Triangulation may also help explaining the possible discrepancies betweensources of data, such as between routine administrative data and survey dataexplaining possible discrepancies between sources of data, such as between routinesources, therefore supporting the provision of the best possible estimate of theadministrative data and survey data sources, therefore supporting the provision of the bestindicators possible(Figure estimate of6).the indicators (Figure 6).INTEGRATION OF DIFFERENT DATASOURCESFigure 6: Integration of different types of data.Figure 6: Integration of different types of data.It mustIt mustalsoalsobebe recognized thatthatsimple,simple,conventionalconventionalperformanceperformanceindicators, usedindicators,isolationfrom the overall analysis framework, could provide misleading measures of efficiency in theused provision in isolation of health from care. the Differences overall in analysis availability framework, of resources, could quality provide of care andmislead-ing measuresdiseaseprofile acrossoftheefficiencysites shouldinbethe takenprovisioninto accountofinhealth evaluatingcare.performanceDifferencesacrossinregions.availabilityoutput of resources, (services) and quality outcomes of must care beand developed, disease and profile data analysis across must the be sites performed shouldTherefore, a comprehensive analysis framework of the health system relating input (resources),accordingly (Figure 7).be taken into account in evaluating performance across regions. Therefore, acomprehensive analysis framework of the health system relating input (resources),output (services) and outcomes must be developed, and data analysismust be performed accordingly (Figure 7).
4. Building the national health management information system (HMIS) in Ethiopia 49DEVELOPING ANALYSIS FRAMEWORKHealthdeterm inantsHealthsystem inputsHealthsystemoutputsHealthoutcom eseconom iceducationalenvironm entalgeneticbehaviouralpolicylegalorganizationfinancialhum an resourceshealthinform ationcoveragequalityusesatisfactionm ortalitym orbiditydiseaseoutbreakshealth statusFigure 7: The analysis framework.Figure 7: The analysis framework.4) 4) Monitoring the performance of the of health the health sector: from sector: data to from indicators data to indicatorsHSDP III Strategic Plan states that “the key elements for a successful programme managementHSDPandIIIimplementation are thestates designingthatof a“theprogrammekey elementsbuilt on aforhierarchya successfulof objectives,programmetargets,management activities and and measurable implementation indicators: the are agreed the indicators designing areof thea most programme important management built on atools for monitoring, review and evaluation purposes”. Therefore, the selection of a core set ofhierarchysector-wideof objectives,indicators istargets, crucial foractivitiesperformanceandmonitoringmeasurableand benchmarking,indicators:whichthe agreedis theindicators identification are the of most “best-in-class” important performance management and analysis tools for of monitoring, the process by review which that andperformance is achieved.evaluationIt is for thispurposes”.reason thatTherefore, the process of indicatorthe selectionselectionofhasa beencoreundertaken,set of sector-widewith the followingindicatorscriteria is being crucial applied for forperformance the core set of sector-wide monitoring indicators: and benchmarking, which is∞ selected against the MDGs;the identification ∞ consistent with of the“best-in-class” HSDP III and PASDEP performance indicators; and analysis of the processby which ∞ limited that in performance number; is achieved.∞ derived mainly from routinely collected data;It is for ∞ this available reason an that annual the basis process for reporting of indicator the ARM; selection has been undertaken,with the ∞ defined following their criteria procedures being forapplied data collection for the ascore well set as for of reporting sector-wide through indicators: standardformat, with specification of definition, formula, data sources and interpretation of the• selected selected against indicator; the MDGs;• consistent ∞ able to measure with the key HSDP factors of III sector and performance PASDEP under indicators;the control of MOH;∞ providing scope for monitoring input, output and outcome.• limited Setting baselines in number; and targets is at the heart of the monitoring exercise as the standards contain• derived observable, mainly explicitfrom statements routinely of service collected performance, data; described in terms of achievement of atarget against which the performance can be measured. Therefore, baselines and targets enable• available the translation on of an policies annual into basis actions. for Setting reporting baselines to and the targets ARM; influences the selection of• defined performance in indicators; their procedures in fact: for data collection as well as for reporting1. only indicators for which a baseline estimate exists should be selected;through standard format, with specification of definition, formula, datasources and interpretation of the selected indicator;• able to measure key factors of sector performance under the control ofMOH;• providing scope for monitoring input, output and outcome.
Page 1 and 2: Introduction: dermatology and human
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