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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-GORASESPhD, M Cur, Hon Cur, BA Cur, Adv.
Univ. Dipl. in CHN & Education
INTRODUCTION• 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
KEY PLAYERS 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 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
facilitiesTo monitor trends in: Coverage Quality Effectiveness of the services Guide policy-makers for resource allocation
RECORDING PROCEDURES Tally sheets Daily ward census Monthly summary forms E-mail Floppy diskettes from regional to
national level
CONTINUE 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 Training of staff Computerized system E-mail functioning (80%) Floppy diskettes also introduced
SOURCES OF DATA 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 Revision in 1994 New forms introduced in 1995 Revised again after five years International standards ICD-10 included
DECENTRALIZATION/COMPUTERIZATION
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
Outpatient Department (OPD) Inpatient Department (IPD) Antenatal Care (ANC) Expanded Programme on
Immunization (EPI) Legal records Reference manuals are available
INTERNATIONAL PARTNERS ROLE
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
Facility Act – draft Health Act –draft Consolidate information from
private health facilities & other stakeholders
STRATEGIES 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:PlanningResources allocationMonitoring & 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
Strength (quality) of the data assessed Statistical techniques examinedMajor elements (domains) Health profile of the population Risk factors Service coverageFactors influencing data Timeliness Representativeness Periocity Consistency 65% info readily available
2004 SENTINEL SURVEY
UTILIZATION 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)
Child mortalityMaternal mortalityAdult mortalityCauses of death in childrenHIV prevalenceTB incidenceUnderweight in childrenObesity in adults
65
73555041
7578870
CONTINUE NATIONAL HEALTH STATISTICS, 2005
Domain Indicator Score (%)
Health service coverage
Measles coverageSkilled birth attendantTB treatment DOTProportion of children sleeping under bed nets
837083
50
CONTINUE NATIONAL HEALTH STATISTICS, 2005
Domain Indicator Score (%)
Risk factor Smoking prevalenceCondom use at higher risk sexImproved water supply
7868
87
System Total health expenditure (per cap)Health worker density
63
76
CHALLENGES 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 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
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 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! 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 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!!!