Evaluation of Health Information System at National and State level – Khartoum - Sudan 2014

Abstract

Abstract

Introduction

The health information system is recognized as the central nervous system of the health sector

and the major informant to support evidence based decision and action and to preserve

population health. Therefore the information system has to be regularly evaluated to grantee the

development of the effective integrated system.

The last comprehensive assessment was conducted in 2007 using the metrics network tools,

identified the gaps and deficiencies and targeted them in strategic plans, so it was high time to

check progress by this assessment

Objectives

The main objective of the study was to investigate health information system components at

national and state levels by evaluation of inputs, determination of processes ,assessment of

outputs and the identification of challenges facing HIS at all levels.

Methods:

A cross sectional institutional based study was conducted at health information research and

evidence (HIRE) that replaced the national health information Centre (NHIC); 19 federal

information units and 18 health information units in the 18 states of the Sudan

Quantitative data were collected by using close and open structure questionnaire for statisticians;

Computerized HMN questionnaire for assessing indicators and data management and standard

checklist for equipment and infrastructure.

Qualitative data were also collected by in-depth interviews by informants from federal and state

directors and managers of health information and planning.

Results:

The findings of the study revealed that HIS plans and strategic were developed, and partially

implemented. The reviewed HIS policy was formulated but not indorsed. There was no

representative national coordination committee. The majority of state HIS units had adequate

number of trained information technicians and statisticians while only about half of the federal

units had them.

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Health Statistical Technicians Training Centre (HISTTC) stopped functioning in 2013 while still

needed. Continuous, refreshing and ICD-10 training programs were not adequate, supervision

visits and feedback mechanism were not regularly conducted.

Generally indicators witnessed considerable improvement. Usage of computers for data analysis

was good, but using information and indicators by decision maker was limited. Data

management witnessed a little progress. A repository, a warehouse and DHIS-2 servers were

installed and prepared to function. Reporting from PHC and private sector facilities was limited

and the coverage of births and deaths was deficient and data quality assurance was not regularly

conducted at all levels.

Generally NHIS suffered from fragmentation and lack of integration especially with vertical

programs but DHIS-2 that started implementation in 2013, gave a great push towards integration

by installing servers, distributing computers to most of localities and training of trainers to train

information workers at locality, state and national.

Conclusion:

The study concluded that there was no representative national coordination committee, no legal

regulations to assure perfect functioning of the system and the reviewed policy was not indorsed.

Lack of data capacity on information sciences, data analysis and use, lack of training health

statistical technicians and training programs for data provides and users was deficient. Data

quality assurance was not regular conducted and needs improving by using proper mechanism.

Recommendation:

- Finalization and indorsing of the representative national coordination committee,

enactment of legal regulations covering fundamental principles of information and

statistics and the endorsement of the reviewed policy.

- Strengthening capacity building focusing on information sciences, data analysis and use,

functioning and upgrading Health Statistical Technicians Training Centre and developing

needed training programs targeting all data providers and users in coordination with

health training institutions.

- Advocacy among decision-makers and other stakeholders to use the information and

indicators that are disseminated through Sudan health observatory.

- Supporting the implementation and functioning of DHIS-2to provide platform for

integration HIS data management aspects and data production and dissemination and use.