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This document provides guidance on the integrated analysis and use, at district and facility levels, of data collected from health facilities through routine health information systems (RHIS). The guidance includes a sample set of indicators, with recommended ways of visualizing these indicators in standard dashboards, as well as guidance on interpretation and use of the indicators. Objectives: The guidanceillustrates integrated analysis of RHIS data at district and facility levels. It aims to build understanding and skills in a recommended analytic approach that: focuses on a minimum set of indicators organized into three cross-cutting groups; uses standard visualizations to facilitate data interpretation: charts and tables organized into integrated dashboards that can be automatically updated in an electronic database; supports use of dashboards for decision-making as part of district meetings, supervision visits and feedback to health facilities. Target audience: This guidance targets managers and analysts at the level of the district health system. It may also be useful to staff making operational decisions at any subnational level. The guidance may also be useful to implementing partners, donors, academics and others involved in using data to strengthen health service delivery at subnational levels.
The routine health information system (RHIS) is an integral part of the overall national health information system (HIS). RHIS collects health service data directly from the health facilities, where they are produced regularly by the healthcare workers and community health workers.
To ensure that countries can effectively benefit from digital health investments, “digital adaptation kits” (DAKs) are designed to facilitate the accurate reflection of WHO’s clinical, public health and data use guidelines in the digital systems that countries are adopting. DAKs are operational, software-neutral, standardized documentations that distil clinical, public health and data use guidance into a format that can be transparently incorporated into digital systems. For this particular DAK, the operational requirements are based on systems that provide the functionalities of digital tracking and decision support (DTDS) and include components such as personas, workflows, core data elements, decision-support algorithms, scheduling logic and reporting indicators. Web annexes provide certain components in additional detail including: data dictionary (Web Annex A), decision-support logic (Web Annex B), indicator definitions (Web Annex C), and functional and non-functional requirements (Web Annex D). Data elements within the DAK (Web Annex A) are mapped to standards-based terminology, such as the International Classification of Diseases (ICD), to facilitate interoperability. This DAK focuses on providing the content requirements for a DTDS system for HIV care used by health workers in primary health care settings. It also includes cross- cutting elements focused on the client, such as self-care interventions.
This guidance describes a catalogue of indicators for maternal, newborn, child, and adolescent health (MNCAH) that can be monitored through health management information system data. It is a module of the WHO Toolkit for Routine Health Information Systems (RHIS) Data and links to relevant indicators from other programmatic modules of the WHO toolkit. The document provides guidance on possible analysis and visualization of the indicators, including considerations for interpreting and using the data for decisionmaking. An annex on data quality considerations for MNCAH managers provides suggestions for reviewing and interpreting routine health facility data through a quality lens. Accompanying this guidance are a series of presentations and exercises, including a facilitator guide, that can be used in workshops to strengthen capacity of analysis, interpretation, and use of data by MNCAH managers. The target audience for the guidance and accompanying materials are ministry of health staff working on MNCAH programmes and monitoring and evaluation activities at national and subnational levels; health workers; and partner organizations involved in supporting MNCAH programmes and monitoring. This text will be submitted to Language Services for translation whenever a publication is requested for translation and also provided to WHO Press at the same time as the translation.
Health financing is a core pillar of health systems and encompasses the three functions of how revenues for health are collected, pooled and paid out to providers of health care services. It can be leveraged to pursue key universal health coverage goals of enhancing access, ensuring quality and financial protection against catastrophic or impoverishing out-of-pocket expenditure. But knowledge on how health financing practices can be harnessed to promote the delivery of rehabilitation services is limited. This document is the first WHO resource on health financing for rehabilitation. It considers current practices for financing rehabilitation services, frames major challenges and opportunities, and offers guidance to decision-makers engaged in strengthening rehabilitation within health systems.
This User’s Guide is intended to support the design, implementation, analysis, interpretation, and quality evaluation of registries created to increase understanding of patient outcomes. For the purposes of this guide, a patient registry is an organized system that uses observational study methods to collect uniform data (clinical and other) to evaluate specified outcomes for a population defined by a particular disease, condition, or exposure, and that serves one or more predetermined scientific, clinical, or policy purposes. A registry database is a file (or files) derived from the registry. Although registries can serve many purposes, this guide focuses on registries created for one or more of the following purposes: to describe the natural history of disease, to determine clinical effectiveness or cost-effectiveness of health care products and services, to measure or monitor safety and harm, and/or to measure quality of care. Registries are classified according to how their populations are defined. For example, product registries include patients who have been exposed to biopharmaceutical products or medical devices. Health services registries consist of patients who have had a common procedure, clinical encounter, or hospitalization. Disease or condition registries are defined by patients having the same diagnosis, such as cystic fibrosis or heart failure. The User’s Guide was created by researchers affiliated with AHRQ’s Effective Health Care Program, particularly those who participated in AHRQ’s DEcIDE (Developing Evidence to Inform Decisions About Effectiveness) program. Chapters were subject to multiple internal and external independent reviews.
This book provides a practical guide to the design and implementation of health information systems in developing countries. Noting that most existing systems fail to deliver timely, reliable, and relevant information, the book responds to the urgent need to restructure systems and make them work as both a resource for routine decisions and a powerful tool for improving health services. With this need in mind, the authors draw on their extensive personal experiences to map out strategies, pinpoint common pitfalls, and guide readers through a host of conceptual and technical options. Information needs at all levels - from patient care to management of the national health system - are considered in this comprehensive guide. Recommended lines of action are specific to conditions seen in government-managed health systems in the developing world. In view of common constraints on time and resources, the book concentrates on strategies that do not require large resources, highly trained staff, or complex equipment. Throughout the book, case studies and numerous practical examples are used to explore problems and illustrate solutions. Details range from a list of weaknesses that plague most existing systems, through advice on when to introduce computers and how to choose appropriate software and hardware, to the hotly debated question of whether patient records should be kept by the patient or filed at the health unit. The book has fourteen chapters presented in four parts. Chapters in the first part, on information for decision-making, explain the potential role of health information as a managerial tool, consider the reasons why this potential is rarely realized, and propose general approaches for reform which have proved successful in several developing countries. Presentation of a six-step procedure for restructuring information systems, closely linked to an organizational model of health services, is followed by a practical discussion of the decision-making process. Reasons for the failure of most health information to influence decisions are also critically assessed. Against this background, the second and most extensive part provides a step-by-step guide to the restructuring of information systems aimed at improving the quality and relevance of data and ensuring their better use in planning and management. Steps covered include the identification of information needs and indicators, assessment of the existing system, and the collection of both routine and non-routine data using recommended procedures and instruments. Chapters also offer advice on procedures for data transmission and processing, and discuss the requirements of systems designed to collect population-based community information. Resource needs and technical tools are addressed in part three. A comprehensive overview of the resource base - from staff and training to the purchase and maintenance of equipment - is followed by chapters offering advice on the introduction of computerized systems in developing countries, and explaining the many applications of geographic information systems. Practical advice on how to restructure a health information system is provided in the final part, which considers how different interest groups can influence the design and implementation of a new system, and proposes various design options for overcoming specific problems. Experiences from several developing countries are used to illustrate strategies and designs in terms of those almost certain to fail and those that have the greatest chances of success