Strengthening national health information systems for better reporting of regional

core indicators and the Sustainable Development Goals (SDGs)

PRE-REGIONAL COMMITTEE TECHNICAL MEETING63rd Session of the WHO Regional Committee for the Eastern Mediterranean

3 OCTOBER 2016, Cairo

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Outline

• Health information systems framework• Progress on the regional core indicators program• Outcomes and recommendations of the rapid

assessment of country capacity on reporting on core indicators

• The way forward

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Intelligence, including research

Role of CRVS in health and health care improvement and policy debates

Health systems

HIS CRVS

SDGs

Communicable diseases

NCDs and mental health

Emergencies

RMCH, Health promotion

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Health Data Collaborative Initiative

“It was necessary to determine how data

were generated, analysed, reported

and disseminated for each core indicator. “ EM/RC/61 (2014)

Dr. Ala Alwan, WHORegional Director

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SDG3 with13 targets

26 indicators (May 2016)

Other SDGs health related indicators

Further need for working CRVS systems

Increasing reliance on “estimation” processes Need for

collaboration with non-health sectors – within countries and across UN agencies

Problems with certain proposed indicators:UHC indicators, others

More comprehensive coverage of important health issues (compared with MDGs)

Focus on national, regional and global targets

Opportunities and threats of the SDG ‘agenda’ for health information system strengthening

Only ~20% of death in the region are

medically certified

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Effective health information systems

• Needed for sound policy development– Rational use of resources– Monitoring and evaluation of implementation and

outcomes. • There is increasing demand in light of SDGs and

due to equity concerns

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The regional core indicators program

• Strong political mandate through the Regional Committee

• A limited number of “core” indicators– 68 indicators – Other global or regional frameworks require a far

larger number of indicators• It has been followed with a coherent plan of

action between the WHO and Member States

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Endorsed in the 61th Session of the Regional Committee

68 indicators

In 3 categories

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Availability of reported core indicators- 2014-2016

0 5 10 15 20 25 30 35 40 45 50 55 60 65 70

group3

group2

group1

SudanPakistan

AfghanistanYemenDjiboutiSomalia

IranEgypt

MoroccoIraq

TunisiaLebanonPalestine

SyriaJordan

Libya

OmanQatar

United Arab EmiratesSaudi Arabia

KuwaitBahrain

2014 2016

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Available core indicators by countryCountries Total numbers of indicators available

2014 2015 2016Afghanistan 46 55 54Bahrain 39 46 46Djibouti 37 45 44Egypt 54 57 58Iran 54 56 57Iraq 52 53 54Jordan 45 50 51Kuwait 43 53 54Lebanon 49 49 51Libya 41 41 43Morocco 53 56 51Oman 54 55 55Pakistan 50 56 56Palestine 48 49 53Qatar 50 49 51Saudi Arabia 44 51 52Somalia 34 39 38Sudan 52 54 56Syria 46 50 47Tunisia 51 55 55United Arab Emirates 44 47 47Yemen 42 50 50

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Main observations• Improvements observed throughout the region

2014-2016– In all but one country

• Countries with better HIS infrastructures have more reporting capacity regardless of income-level

• Countries are concerned, in occasions, about– Quality of data– Estimated indicators– Reporting mechanisms, within countries and to WHO

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National health information system

Data management and standards

Effective National Health

Information System

Quality assurance

Governance framework

Infrastructure and support

Dissemination and data use

For: Routine sources of data (patient and management records), population surveys and

other (non-health sector) sources of data

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Rapid assessment of countries capacity in reporting on the 68 Core Indicators

For each core indicator, the following key questions were asked

1. Is it currently collected? 2. Responsible agency for reporting3. Data sources 4. Frequency of reporting 5. Level of reporting (national, subnational) 6. Use standardized WHO indicator definition7. Indicator measurement methods8. Electronic or paper reporting/data collection9. If not reported, feasibility of reporting in future10. Main barriers to reporting

19 countries participated in the assessment – August 2016

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Selected assessment outcomes

• None of the countries are able to produce all 68 core

indicators in a timely basis

• Most HIS systems lack adequate connectivity with

relevant stakeholders

• Population surveys do not follow a long term plan

– Most group 2 and 3 countries rely on donor support for surveys

• Data quality assessments are inadequate

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Selected assessment outcomes

• 8 countries know about the global estimation processes

and methodologies

• 15 countries publish annual statistical reports

• 12 countries use ICD 10 coding system for cause specific

mortality

• Half of core indicators are reported for all countries

– Many based on estimates

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Actions that are following the assessment

• Developing a recommended list of population surveys for different groups of countries

• Conducting comprehensive health information system assessments for interested countries– The first country in October 2016

• Expanding capacity building activities

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The way forward

• 19 countries completed the assessments– Follow up with the remaining three countries to complete

by the end of October 2016

• As gaps in the plans and indicators are identified:• We will discuss further with countries about how we

can help in – improving health information systems, and

– capacity to develop and use the key indicators

Thank you