REPUBLIC OF KENYA - World Health Organization

Transcription

REPUBLIC OF KENYA
HEALTH SECTOR
STRATEGIC PLAN
FOR
HEALTH INFORMATION SYSTEM
2009-2014
MINISTRY OF MEDICAL SERVICES
AFYA HOUSE
P.O. BOX 30016- NAIROBI
MINISTRY OF PUBLIC HEALTH
AND SANITATION
AFYA HOUSE
P.O. BOX 30016- NAIROBI
HIS Strategic Plan 2009-2014
TABLE OF CONTENTS
ACRONYMS......................................................................................................................................................................... iii
GLOSSARY ............................................................................................................................................................................iv
FOREWORD .........................................................................................................................................................................vi
ACKNOWLEDGEMENT ................................................................................................................................................... vii
EXECUTIVE SUMMARY.................................................................................................................................................. viii
CHAPTER 1: INTRODUCTION ..........................................................................................................................................1
1.1
1.2
1.3
1.4
Background .................................................................................................................1
Purpose/Rationale for HIS Strategic Plan.....................................................................1
Approach and Methodology for developing the Strategic Plan .....................................2
The Organization of the Strategic Plan.........................................................................2
CHAPTER 2:
2.1
2.2
2.3
2.4
2.5
2.6
Definition of HIS ........................................................................................................3
Primary objectives of HIS............................................................................................3
Current HIS Subsystems ..............................................................................................4
Health Information System (HIS) Data Sources ..........................................................4
Users of Health Information........................................................................................5
Institutional Review of HIS .........................................................................................5
CHAPTER 3:
3.1
HEALTH INFORMATION SYSTEM (HIS) .........................................................................................3
SITUATIONAL ANALYSIS REPORT ....................................................................................................8
Introduction .................................................................................................................8
CHAPTER 4: STRATEGIC MODEL AND ANALYSIS OF STRATEGIC ISSUES............................................................ 10
4.1
4.2
4.3
Vision, Mission and Mandate Statements...................................................................10
Key Strategic Issues, Strategic Objectives and Strategies ...........................................10
Strategic Objectives ...................................................................................................11
CHAPTER 5: STRATEGIC IMPLEMENTATION ............................................................................................................ 15
5.1
5.2.
5.3
5.4.
Staffing Level and Requirements ...............................................................................15
Organizational Structure ............................................................................................15
Roles and Responsibilities .........................................................................................18
Budgetary Requirements............................................................................................20
CHAPTER 6: MONITORING AND EVALUATION FRAMEWORK ...............................................................................22
CHAPTER 7: STRATEGIC IMPLEMENTATION MATRIX ............................................................................................24
ANNEX 1: Literature Reviewed ............................................................................................................................................43
ANNEX II: List Of Technical Working Group .....................................................................................................................44
ANNEX III: His Policy And Strategic Plan Stakeholders Workshop At Bontana Hotel, Nakuru ........................................45
ANNEX IV: - Budget Summary For Plan Implementation...................................................................................................47
ii
ACRONYMS
AOP AWP AMREFAfriAfyaCHISCSO CSCHAK
DHMTDPM DHS DSSEHRS
FBOFIS
FTPGoK GIS HSPSHR HIS –
HIS TWGHMIS HMN
HRIO ICT IT JPOWJHPIEGO
KDHSKEPHKEC
KHPF KNBS KNASP KMTC LAN M&E MDG –
NHISCCNHSSPNGO PEST PEPFAR
PI RBMR-HFA
SAM SWOT SUPKEMSOP TA TWG –
UNICEFWB WHO -
Annual Operational Plan
Annual Work Plan
African Medical and Research Foundation
African Network for Health Management and Communication
Community Health Information System
Civil Society Organization
Catholic Secretarial
Christian Health Association of Kenya
District Health Management Team
Directorate of Personnel Management
Demographic Health Survey
Demographic Surveillance System
Electronic Health Records System
Faith Based Organization
Financial Information System Facility Information System
File Transfer Protocol
Government of Kenya
Geographical Information System
Health Sector Programme Support
Human Resource
Health Information System
Health Information System Technical Working Group
Health Management Information System
Health Metrics Networks
Health Records and Information Officer
Information Communication Technology
Information Technology
Joint Programme of Work
Johns Hopkins Programme for International Education in Gynaecology and Obstetrics
Kenya Demographic Health Survey
Kenya Essential Package for Health
Kenya Episcopal Conference
Kenya Health Policy Framework
Kenya National Bureau of Statistics
Kenya National HIV/AIDS Strategic Plan
Kenya Medical Training College
Local Area Network
Monitoring and Evaluation
Millennium Development Goal
National Health Information System Coordinating Committee
National Health Sector Strategic Plan
Non- Governmental Organization
Political, Environment, Economic, Socio-Cultural and Technological
President s Emergency Plan for AIDS Relief
Performance Indicator
Results Based Management
Rapid Health Facility Assessment
Service Availability Mapping
Strengths, Weaknesses, Opportunities and Threat
Supreme Council of Kenya Muslims
Standard Operating Procedure
Technical Assistance
Technical Working Group
United Nations Children Education Fund
World Bank
World Health Organization
iii
GLOSSARY
Baseline:-
A reference point used to indicate the initial condition against which future
measurements are compared
Baseline data:- A set of data collected at the beginning of the study or before intervention has
occurred.
Core Values
Core Organizational Values are a set of beliefs that specify universal expectations and
preferred modes of behavior in an institution. Core values guide the actions of
everyone in the organization.
Evaluation: -
Periodic assessment of the relevance, performance, efficiency effectiveness and impact
of the projects activities
End – term
Evaluation:
Goals:-
End-term evaluation is conducted towards the end of the project to provide decision
makers and planners with the information with which to review the achievements of
the programme and generate lessons to guide the formulation and/or implementation
of a new programme/project.
Are general targets to be accomplished that are translated into actionable objectives.
Guiding
Principles:-
Broad philosophy that guides an organization throughout its life in all circumstances,
irrespective of change in its goals, strategies or the top management
HIS: -
The health information system is a comprehensive and integrated structure that
collects, collates, analyses, evaluates, stores, disseminates, health and health-related
data and information for use by all.
HMIS: -
It is defined as an Efficient collection, Collation, Analysis, Evaluation Strategy,
Dissemination and use of Information about individual patients, population,
resources used and health outcomes of intervention and the state and nature of
systems through which the intervention are applied
Health
Metrics
Network:-
Health Metrics Network (HMN) is a global partnership that works to increase the
availability and use of timely and trustworthy health information in developing
countries and globally.
Inputs:
These are goods, funds, services, personnel, technology and other resources provided
for use in the activities so as to produce outputs and achieve the objectives of the
project.
Impact:-
It is defined as the ultimate effect/change (both expected and unexpected) on all
stakeholders as a result of intervention within the project in the short, medium and
long term.
Mission
Statement:-
Describes why an organization exists and what it does (its mandate or basis of
existence)
Main (Core)
Activities:-
These are activities whose achievement will determine the success of an organization
in the long run.
Monitoring:-
A systematic process covering routine collection analysis and use of
information about how well a project/programme is going on. It involves
continuous review of the performance of all the components in the project
to ensure that input deliveries, work schedules, targeted outputs and other
required actions are proceeding as per work-plans.
Mid-term Evaluation:-
It is conducted to take an assessment of how the project is performing half
way through the project
Needs Assessment:-
It is a process to identify the gaps in services and arrange them in priority
order for resolution
Operational Planning:-
The process of setting short-range objectives and determining in advance
how they will be accomplished
Objectives:-
State what is to be accomplished in singular, specific and measurable terms
with a target date
Outputs/Results:-
Outputs comprise of specific products or services, which an activity is
expected to produce from its inputs.
Strategy:-
A plan for pursuing the Mission and achieving objectives
Strategic Planning:-
It is defined as the process by which the guiding members of an
organization envision its future and develop the necessary procedures and
operations to achieve that future
Stakeholders:-
Refers to individuals, groups of people or institutions which have vested
interest in an issue or matter
Vision Statement:-
Refers to broadest statement of what an organization hopes to achieve or
to become
Verifiable (Performance) Performance Indicators are specific and objectively verifiable measures of
Indicators:
change or result brought about by an activity.
v
FOREWORD
Since 2003 various studies have been undertaken to assess Health Information System (HIS). The
findings of the assessments outlined areas that required immediate attention to strengthen HIS in
the country. One of the priority areas identified was the need to develop a comprehensive Strategic
Plan for HIS to guide the implementation of its activities.
This Strategic Plan (2009-2014) is the first to be developed by HIS and is intended to respond to the
aspirations of National Health Sector Strategic Plan II (NHSSPII), Health Sector M&E Framework,
and Vision 2030. It was developed through an inclusive, participatory and consultative approach
intended to ensure ownership, commitment and leadership by the key stakeholders. This document
is indeed a great milestone for taking HIS ahead in the health sector to enable it provide better data
to inform evidence-based decision making, better policy framework and better health.
The Plan provides a roadmap and strategic direction on key priorities in line with the Health Sector
Strategic Plan and articulates the agreed vision, mission, mandate and core values of HIS. It also sets
strategic objectives, strategies, activities, time frame, resource requirements and assigned
responsibilities for achieving expected outputs in the next five years. It is envisaged that the
implementation of the activities outlined in the Strategic Plan will require a total of Kshs 1.9 billion
(US $ 25.3 Million).
The successful implementation of this Strategic Plan is expected to provide a basis for quality
information that can be used at all levels of the health system for planning, managing, monitoring
and evaluation of desired outputs. The Ministries of Health in partnership with key stakeholders will
provide leadership and finance the implementation of this Plan to build one universal Health
Information System for the health sector.
In conclusion, we appeal to our development partners and all stakeholders to support the
implementation of the Strategic Plan through collaboration and partnership to enable us achieve the
strategic goal of this Plan: “Establish a functional, robust, effective and efficient Health
Information System”.
Prof. James L. Ole Kiyiapi, CBS,
Mr. Mark K. Bor, EBS
PERMANENT SECRETARY,
MINISTRY OF MEDICAL SERVICES
PERMANENT SECRETARY,
MINISTRY OF PUBLIC
HEALTH AND SANITATION
vi
ACKNOWLEDGEMENT
This Health Information System (HIS) strategic plan was developed through a comprehensive
consultation process, intensive health sector Health Information System assessments and detailed
information gathering. The process was driven by the HIS Technical Working Group (HIS TWG)
in liaison with Professional Training Consultant (PTC).
We would like to acknowledge the efforts of all those institutions and individuals who participated
and contributed in the development of this document. These include government ministries and
Agencies, Development partners, UN Agencies, faith based organization, NGOs, and private sector.
We acknowledge the Director of Medical Services and Ag. Director of Public Health and Sanitation
for their leadership and stewardship, the HIS Technical Working Group (HIS TWG) members for
the coordination, technical input and commitment during the process of developing the Strategic
plan. We wish to thank all heads of departments and divisions, programme managers, Government
parastatals (KEMRI, NHIF, KEMSA), the Provincial Directors, District Directors and Health
Management Teams for their participation and invaluable inputs during the process of development.
We commend the Professional Training Consultants (PTC) for their critical review and
consolidation of this Strategic plan.
We also extend our gratitude to Ministry of Planning and Vision 2030 (KNBS), Ministry of
Immigration and registration of persons (Vital Registration), Ministry of Home affairs and National
heritage (National Archives), Implementing partners (CHAK, KEC, SUPKEM, AfriAfya, AMREF,
Aga Khan Health Services, Aga Khan Foundation, APHIAs, KNADS, FHI, NACC, JHPIEGO,
Professional bodies (Kenya Medical Practitioners and Dentist Board, Nursing Council, Kenya
Laboratory Board), training institutions (Kenyatta University, KMTC) for their participation and
practical inputs in the development process.
We are particularly grateful to the Health Metrics Network (HMN) Secretariat and Department for
International Development (DFID) through Essential Health Services (EHS), in providing technical
and financial support in the development of this strategic plan. We also appreciate the role of
development partners especially World Health Organisation (WHO), DANIDA, and USAID.
Finally we wish thank all those who contributed directly or indirectly to the development of this five
year strategic plan.
vii
EXECUTIVE SUMMARY
The overall policy guidance for the health sector is through the Government of Kenya Vision 2030
and the Kenya Health Policy Framework (KHPF, 1994-2010). One of the key challenges in the
health sector identified in First Medium Term Plan of Vision 2030 is weak health information
systems. Various weaknesses identified in the existing information systems include lack of guidelines
and policy, inadequate capacities of HIS staff, lack of integration, many parallel data collection
systems, and poor coordination, amongst others.
Rationale for HIS strategic Plan
This strategic plan is intended to respond to the aspirations of National Health Sector Strategic Plan
II (NHSSPII), Health Sector Monitoring and Evaluation Framework and the Kenya Health Policy
Framework envisioning Vision 2030 activities that will ensure a robust HIS to inform on progress of
attainment of set targets. The strategic plan provides a roadmap and direction on key priorities in
line with the health sector strategic plan. It sets the vision, mission, strategic objectives, strategies
and activities of HIS.
Methodology for Developing the Strategic Plan
The Strategic Plan was developed through an inclusive approach and a methodology intended to
ensure ownership, commitment and leadership by the key stakeholders namely Ministries of Health,
Vital Registration, Kenya National Bureau of Statistics, NGOs and development partners.
Desk and literature reviews were carried out. Consultations were done through meetings with the
officials from Ministries of Health, Technical Working Groups and Stakeholder Workshops.
Questionnaires were also posted to the sampled provinces and districts, heads of
department/divisions of ministries of health, development partners and implementing partners.
Interviews were also undertaken with selected institutions.
Health Information System
Health Information System (HIS) is defined as a comprehensive and integrated structure that
collects, collates, analyses, evaluates, stores, disseminates, health and health-related data and
information for use by all.
The HIS, like any system, consists of parts which are interrelated, interdependent and work
towards a common goal. The malfunctioning of any part affects other parts of the system. The
functionality of an HIS may differ from organization to organization. In general the system is a
combination of Health Information and Management Information. The system collects
information on health (Morbidity and mortality statistics, Service statistics) and on management
(human resources, financial, fixed assets and infrastructure, drugs and supplies logistics) and
performs comparative analysis with population- based data from various surveys. The HIS is a
powerful tool for making health care delivery more effective and efficient.
The broad objectives of HIS are:
To determine end-user information needs at the various levels of the health system.
To facilitate data collection, analysis, information generation and storage.
To facilitate information dissemination, feedback (horizontal and vertical) and use of information
for evidence- based decision making.
viii
The key components of this strategic plan are:Vision Statement
Be a centre of excellence for quality health and health-related data and information for use by all.
Mission Statement
To provide timely reliable and accessible quality health service information for evidence-based
decision making in order to maximize utilization of scarce resources in the health sector.
Mandate
To generate, analyze and disseminate health information to facilitate effective policy formulation,
management, planning, budgeting, implementation, monitoring and evaluation of health services and
programme interventions in the health sector by all.
Core Values
•
Integrity:
•
Commitment:
•
Professionalism:
•
Respect:
Strategic Thrust
Strategic thrusts are outstanding concerns that have been identified by health sector to have
considerable effect on HIS. The strategic thrust identified and in line with the First Medium Plan
2008-2012 of vision 2030 is Weak Health Information System in the health sector. Consequently
strategic thrust or priority of HIS is to:
“Establish functional, robust, effective and efficient Health Information System”
Strategic Objectives
•
To improve data management
•
To improve National Vital Registration System
•
Enhance Capacity of HIS Staff
•
Improve Financial Resources and sustainability
•
Strengthening use and Application of Information and Communication Technology in data
Management
•
Improving Monitoring Feedback, Reporting, Supervising and Data Audits
•
Enhancing Governance, Partnership, Collaboration and coordination.
The staffing level required for the implementation of the plan is 4310 HRIOs, 227 ICT officers, 221
statisticians and 16 health professionals,. The estimated cost for executing the strategic plan is Kshs
1.9 billion. A comprehensive monitoring and evaluation framework will be developed to monitor
and evaluate the implementation.
ix
CHAPTER 1: INTRODUCTION
1.1
Background
The overall policy guidance for the health sector is through the Government of Kenya Vision
2030 and the Kenya Health Policy Framework (KHPF, 1994-2010). One of the key challenges in
the health sector identified in First Medium Term Plan of Vision 2030 is weak health information
systems. Various weaknesses identified in the existing information systems include lack of
guidelines and policy, inadequate capacities of HIS staff, lack of integration, many parallel data
collection systems, and poor coordination, amongst others. Overall the current HIS provides
limited information for monitoring health goals and empowering communities and individuals
with timely and understandable information on health and health related interventions.
In view of the above weaknesses, the ministries of health, i.e. the Ministry of Medical Services
and the Ministry of Public Health and Sanitation together with her partners decided that this 5
year coasted Strategic Plan for Health Information Systems be developed and institutionalized to
guide the implementation of HIS activities at all levels.
The Ministries are keen to play their part in improving the efficiency and effectiveness in delivery
of health services by strengthening governance, decentralizing health services and management,
improving resource allocation and enhancement of collaboration with stakeholders under sector
wide approach.
1.2
Purpose/Rationale for HIS Strategic Plan
The strategic plan is intended to respond to the aspirations of NHSSP II, Health sector M&E
Framework and the Kenya Health Policy Framework envisioning the Vision 2030 activities that
will ensure a robust HIS to inform on progress on attainment of set targets.
The primary purpose of an HIS is to support informed strategic decision-making by providing
quality data which help managers and health workers at all levels of the health system in planning
and managing the health services; monitoring disease trends and control epidemics; and
providing periodic evaluation towards agreed targets. The specific objective of this component is
to increase the quality of management of the health system hence the need to develop a strategic
plan.
A functional HIS Strategic plan provides a basis for quality information that can be used at all
levels of the health system for planning, managing, monitoring and evaluating activities and
gauging progress to desired outputs. In summary the plan provides strategic directions in the
following areas:
•
•
•
Providing a roadmap and direction on key priorities in line with the health sector strategic
plan. The plan sets the vision, mission, strategic objectives, strategies and activities of
HIS. Further, costed strategic plan forms the basis for monitoring and evaluation of
planned activities and creates a mechanism for monitoring and evaluation for the health
sector. The coasted plan constitutes a pivotal tool for resource mobilization.
Improving quality of health information by providing information that has a high degree
of consistency, accuracy, timeliness and completeness.
Supporting evidence-based decision making by providing appropriate information that
facilitates knowledge based decisions in order to effect change in individual behavior,
patient care, administration, research and education and to monitor and measure health
outcomes.
1
1.3
Approach and Methodology for developing the Strategic Plan
The Strategic Plan was developed through an inclusive approach and a methodology intended to
ensure ownership, commitment and leadership by the key stakeholders namely Ministries of
Health, Vital Registration, Kenya National Bureau of Statistics, NGOs and development
partners. It is recognized that a properly organized health information system is a prerequisite for
efficient administration of health services and hence the need for using a participatory and
consultative approach in developing the Strategic Plan.
Desk and literature reviews were carried out. Consultations were done through meetings with the
Client, Technical Working Groups and stakeholder Workshop. Questionnaires were also posted
to the sampled provinces and districts, heads of department/divisions of ministries of health,
development partners and implementing partners. Interviews were also undertaken with selected
institutions.
The key steps of the methodology included;
§
Confirmation of the vision, mission and core values
§
SWOT analysis to confirm the relevant internal and external factors that impact on the
performance of the Division/Departments of HIS
§
Identification of key challenges which HIS department will need to specifically respond
to as part of its strategy.
§
Identification of key priority areas that the ministries will focus on during the strategy
period
§
Preparation of Action Plans for each priority area
In adopting the HMN methodology for preparing a strategic plan, the steps used for the
preparation of the strategic plan included analysis of HIS assessment reports and identification of
areas which required priority attention in health systems domains. The second stage was working
with Technical Working Groups in the confirmation of strategic objectives, strategies and
activities. The final stage was through preparation of an implementation matrix and costing.
The results of the above stated reviews and analysis generated appropriate data and formed the
basis for the development of HIS Strategic Plan for the period 2009-2014.
1.4
The Organization of the Strategic Plan
This Strategic Plan document is set out in six chapters. Chapter One has an introduction covering
the background, purpose and rationale for HIS strategic Plan and approach and methodology for
developing the strategic plan. Chapter Two gives an overview of HIS covering the definition,
objectives, HIS data sources, users and producers of health information and challenges. Chapter
Three presents the HIS Vision, Mission, Mandate, guiding principles and SWOT Analysis.
Chapter Four covers strategic model and analysis of strategic issues including strategic objectives.
Chapter Five gives strategic implementation arrangements covering organizational and proposed
governance structures, projected budgetary requirements and strategic implementation matrix.
Chapter Six presents the monitoring and evaluation framework, while Chapter Seven presents
Strategic Implementation Matrix.
2
CHAPTER 2: HEALTH INFORMATION SYSTEM (HIS)
2.1
Definition of HIS
Health Information System is composed of producers of health statistics including Ministries of
Health, Kenya National Bureau of Statistics (KNBS), Vital Registration, private health
institutions, research institutions, and Faith Based Organizations (FBOs), amongst others.
The health information system is defined as a comprehensive and integrated structure that
collects, collates, analyses, evaluates, stores, disseminates, health and health-related data and
information for use by all.
The value and importance of a health information system is that it supports the management of
the health system whose ultimate goal is to improve and maintain the health of individuals,
families and communities. HIS is considered as a system that provides health and health related
information to facilitate evidence-based decision making processes at all levels of the health
pyramid (Level 1 to Level 6) which are: From the level of individual patient care to the
management of specific health programmes through to the policy levels where strategic decisions
are made. The current levels of care in the health sector are:
Level 1 = Community
Level 2 = Dispensary and Clinics
Level 3 = Health Centre including maternity and nursing homes
Level 4 = Sub-district and District Hospitals (Primary hospitals)
Level 5 = Provincial and general hospitals (secondary hospitals)
Level 6 = National referral hospitals (tertiary)
2.2
Primary objectives of HIS
The primary goal of an HIS is to provide the right information to the right user at the right time.
It is therefore considered that properly organized HIS is a prerequisite for the effective and
efficient management of health services. No HIS can afford to discourage the successful use of
its information resources by producing information products that are not aligned with the needs
of the user in the forefront. HIS should be developed with a careful assessment of the levels of
the information generation, feedback mechanisms and use by all.
The broad objectives of HIS are:
To determine end-user information needs at the various levels of the health system.
To facilitate data collection, analysis, information generation and storage.
To facilitate information dissemination, feedback (horizontal and vertical) and use of information
for evidence- based decision making.
The benefits that accrue from such an HIS include:
Helping decision makers to detect and control emerging and endemic health problems, monitor
progress towards health goals, and promote equity;
Empowering individuals and communities with timely and understandable health-related
information, and drive improvements in quality of services;
Strengthening the evidence-based decision for effective health policies, permitting evaluation of
scale-up efforts, and enabling innovation through research.
Improving governance, mobilizing new resources, and ensuring accountability in the way they are
used.
3
Since a properly organized HIS is needed to produce information for taking action, the
development of HIS strategic plan will provide clear road map for implementation of planned
activities.
2.3
Current HIS Subsystems
There are various subsystems in HIS. These subsystems are summarized in three categories
namely population based data, management information and health services based data as shown
in Fig 2.1. The sub-systems exist with their own databases with no links to the centralized HIS
thus creating disjointed information systems in the health sector.
Fig. 2.1 Current HIS Sub-Systems
Source:-Kenya Health Sector M&E Framework
2.4
Health Information System (HIS) Data Sources
A Health Information System consists of several data sources, namely:
Data collection based on patient and service records and reporting from community health
workers and health facilities
Data generated through household surveys
Registration of vital events (births, deaths and causes of death)
Disease surveillance and outbreak notification
Programme specific monitoring and evaluation
Administration and resource management (including finance/budget, personnel and supplies)
4
Population based data include census, vital registration and surveys while management
information covers administrative records, and health services and disease records as shown in
Fig 2.2
Fig 2.2: HIS DATA SOURCES
HIS DATA SOURCES
Population
MIS
Health Services
Census
Surveillance
Vital Registration
Administrative
Records
Service Records
Health and Disease
Records
Surveys
Population- based
Health and Disease Records
Source: - HIS documents (various)
2.5
Users of Health Information
At each level of the health care system, users of health information have differing needs and use
information in different ways. At the most basic level of client health worker interactions,
patient records are a vital source of information at the individual level, for reviews of care and
norms, confidential enquiries and facility based audit reviews of provider practices
At the facility level, managers need information on patient profiles, patterns of admissions and
discharges, length of hospital stay, use of medicines and equipment, deployment of different
categories of health care workers and ancillary staff, costs and income. At district, provincial and
national level, policy makers, planners, managers and other stakeholders use this information and
data on locally relevant population profiles and risk factors in decision-making regarding
allocation of resources to different facilities. Within the public health sector, such information is
transmitted upwards through district and provincial levels to the national level where basic
resource allocation decisions are made.
2.6
Institutional Review of HIS
Health Information System (HIS) in Kenya has been reviewed severally with a view of putting in
place sound systems that:Provides quantitative and qualitative data which is essential for identifying major health problems
5
Generates information which can be used to evaluate health policies for planning health
programmes and the efficient provision and management of health services
Opens up continuous dialogue and coordination between those who collect data and the users of
information with the aim of improving health services.
Disseminates timely information to users, including those who work in research and health
administration
Provides regular feedback to all personnel in the information system which helps to emphasize
the important role each of them plays.
Creates and maintain a health information data base at district and community levels
Provides health information required for health planning, monitoring and evaluation of health
programmes.
2.6.1 Existing Producers of Health Information
Health Information exists at the Ministries of Health where routine health data collection is
conducted through a network of community units, 6190 health facilities (Government, Faith
Based, Non-governmental Organization and Private) that are distributed throughout the country.
Other key health information producers are Civil Registration Department of the Ministry of
Immigration, the Kenya National Bureau of Statistics, Research Institutions, and African
Network for Health Management and Communication (AfriAfya) which is a consortium of seven
Kenya based health development agencies. In all these institutions major support to HIS comes
from development partners namely DANIDA, Global Fund, UNICEF, WHO, World Bank,
DFID through STATCAP project and EHS, USAID, CDC, European Union, PEPFAR and
Clinton Foundation.
2.6.2 On-going and Planned HIS Strengthening Activities
Assessment reports on Health Information System identified priority actions required to
strengthen HIS. These included instituting mandatory reporting from private providers and
NGO facilities, building capacity for data collection at all levels, developing integrated
harmonized data collection tools and conducting census of health providers. The achievements
have been in the areas of harmonization and rationalization of the health sector data
requirements and indicators, capacity building of Health Records and Information Officers,
supply of equipment (including computers, digital mass printers, internet and communication).
The current on-going strategies to improve HIS from various producers of health information
are as follows:
Ministries of Health:Developing HIS Software system
Developing Human Resource Database
Reviewing the Financial Information System
Developing the Logistic Management Information System
Printing data collection and reporting tools
Developing HIS policy documents and strategic plan
Development of standards for Electronic Health Records (EHR)
6
Civil Registration
Registration of births and deaths at the Department of Civil Registration is still manual.
However, data entry of records of births and deaths is being computerized on pilot basis. This is
expected to be rolled out to cover more districts once the Pilot is over. Secondly, the
Government is collaborating with Plan Kenya (International) in awareness creation on birth
registration in selected districts. The Statistical Capacity Project (STATCAP) being implemented
by KNBS is planning to undertake social mobilization and training in Mandera and Isiolo
Districts. This is expected to scale up registration of births and deaths in marginalized rural
areas.
Kenya National Bureau of Statistics (KNBS)
Analysis of the Kenya Demographic Health Survey 2008. The support for this activity was
through the collaboration of Government of Kenya, World Bank, DFID, with technical
support from Macro international – Measures evaluation among others.
Mapping of the districts and the enumeration areas through the support from GOK, World
Bank, and DFID.
Preparation for the National Census 2009 to take place in August 2009.
On-going activities National Coordinating Agency for Population and Development
(NCAPD)
Preparation of the Service Provision Assessment (SPA). This has been proposed to take place
between September and December 2009.
Note: Measuring health is conceptually and technically complex, requiring statistical, public
health and biomedical knowledge and expertise unique to each disease or programme area.
Accurate measurement depends upon the availability of disease- specific biometric tests,
clinical diagnoses and the feasibility of measuring population behaviours and the coverage of
health services.
As a result, health statistics may vary greatly in terms of scientific
soundness, usability and timeliness.
7
CHAPTER 3: SITUATIONAL ANALYSIS REPORT
3.1
Introduction
This section gives a summary of internal strengths and weaknesses as well as opportunities and
threats to HIS which were identified The results were achieved through extensive consultations
with key stakeholders by undertaking a Strength, Weaknesses, Opportunity and Threats (SWOT)
analysis. The summary of the results are given in Table 3.1.
Table 3.1 SWOT Analysis of HIS
Internal Strengths
Existence of vital registration system
Regular periodic population based surveys
such as KDHS (every 5 years), census
(every 10 years)
HIS structure and reporting system in place
Technical personnel available
Existing Training curriculum for health
records and information staff.
Provinces and Districts are proactive on
HIS activities
Availability of manuals and guidelines for
data collection
Availability of computers at national,
provincial and district levels
Availability of basic communication
infrastructure
Minimum set of indicators established
Partnership arrangements in place
Draft Policy document in place
Availability of harmonized Data Collection
Tools at all levels
8
Internal Weaknesses
Lack of clear policy guidelines and legal framework
for HIS
Low reporting rate below 80%
Inadequate personnel
Inadequate finances
Unclear funding mechanism
Lack of/inadequate M&E skills at all levels
Inadequate provision of data collection tools at
facility levels
Lack of centralized data base at all levels
Lack of mechanisms for enforcing use of
standardized tools (data collection)
Inadequate working and storage space
Inadequate supply of equipments such computers,
printers, calculators at all level.
Inadequate Facilitative supervision
Weak feedback mechanism and poor dissemination at
all levels
Poor coordination of HIS Activities
Weak linkages and data sharing
Inadequate skills development for HIS Staff.
Lack of incorporation of HIS component in the
various training curricula
Lack of clear linkage between Health Records and
information professionals and HIS which is a system.
Low staff morale.
Competing priorities at implementation, policy and
strategy levels
External Threats
High staff turnover
Poor scheme of services leading to non-retention of
qualified staff
Donor driven programmes and projects establishing
parallel data management systems.
Inconsistency in political good will
Keeping pace with ICT development
Global economic melt down
Corruption
Freeze on Employment
Natural and manmade calamities
Over dependence on development Partners/Donor
support
External Opportunities
Good working collaboration with the
divisions/departments
Collaboration and networking with other
stakeholders
Capacities built on various vertical
programmes would help to roll out a better
HIS
Recognition and support of HIS by key
stakeholders in the Health Sector
Development of a national ICT policy
Development of E- health policy and strategy
Implementation of the HIS policy
Training of HIS staff in various institutions
e.g. Degree at KU
Other existing strategic plans within the
ministries of health
Implementation of the community health
information system
Technological advancement
9
CHAPTER 4: STRATEGIC MODEL AND ANALYSIS OF STRATEGIC ISSUES
This chapter summarizes the agreed Vision, Mission, Mandate and Core Values of HIS
The chapter also discusses the strategic issues, objectives, and strategies based on the challenges
outlined in the SWOT analysis.
4.1
Vision, Mission and Mandate Statements
Vision
Be a centre of excellence for quality health and health-related data and information for use by
all.
Mission Statement
To provide timely reliable and accessible quality health service information for evidence-based
decision making in order to maximize utilization of scarce resources in the health sector.
Mandate
To generate, analyze and disseminate health information to facilitate effective policy formulation,
management, planning, budgeting, implementation, monitoring and evaluation of health services
and programme interventions in the health sector by all.
Core Values
The core values are the behavior and attitudes that will be practiced and embraced by HIS in
order to create the desired culture to drive towards the vision. HIS recognizes that having the
right values will result in more efficient production of quality timely and focused health data. The
attributes are:Integrity: To be accountable, transparent and devoid of corrupt practices in service delivery
Commitment: To devote all official time to our duties and undertake to deal with those seeking
our services without unnecessary delays
Professionalism: To create and maintain public trust in health statistics by acting professionally
and promoting professionalism and transparency in data production and dissemination.
Respect: At all times, treat people with utmost respect and courtesy and especially those that
seek our services or advice. Recognize and respect the separate roles played by data producers
and users at all levels.
4.2
Key Strategic Issues, Strategic Objectives and Strategies
4.2.1
Strategic Issues
The key strategic issues which were identified and are of relevance to the implementation of this
Strategic Plan that require to be addressed are:
•
Lack of HIS policy and legal Framework
•
Inadequate data and data bases
•
Inadequate personnel in absolute numbers and in skills
•
Lack of focused training for the majority of HIS staff.
•
Lack of integration of data at all levels
•
Weak linkages and feedback
•
Inadequate hardware infrastructure
•
Inadequate supportive supervision
•
Inadequate working and storage space
10
•
•
•
Low staff morale
Inadequate Finances to support HIS activities
Presence of many data collection systems with poor coordination
4.2.2
Strategic Thrust (Priority)
Strategic thrusts are outstanding concerns that have been identified by health sector to have
considerable effect on HIS. The strategic thrust identified and in line with the First Medium
Term Plan 2008-2012 of Vision 2030 is Weak Health Information System in the health sector.
Consequently strategic thrust or priority of HIS is to:
“Establish functional, robust, effective and efficient Health Information System”
4.2.3
The key strategic issues identified in the HIS assessment of 2006 revolved around improving data
representativeness, quality of data and information. In order to address the strategic issues the
following strategic objectives have been developed.
4.3
4.3.1
Strategic Objective 1: To improve Data management
Data management is considered as the weakest area under HIS. This was as a result of the
existence of too many tools, supporting parallel initiatives/programmes, inadequate capacity of
staff collecting, collating, analyzing and managing data, training not geared towards data
management or in monitoring and evaluation, and lack of policy guidelines, amongst others.
Strategies
i)
Developing HIS Policy and Strategic Plan
ii)
Reviewing data management processes, procedures and linkages
iii)
Review minimum data sets
iv)
Determining the need for key sub-systems and the linkages in the health sector
v)
Establishing a manual integrated Community Health Information System (CHIS)
vi)
Establishing a robust integrated electronic community Health Information System
vii)
Reviewing and developing, Facility Information System (FIS)
4.3.2
Strategic objective 2: To improve National Vital Registration System
Although the department of Civil Registration is charged with the responsibility of implementing
the compulsory registration of all births and death, the registration coverage is low. In 2008 birth
registration stood at 46% while that of death was 50%. Factors contributing to low registration
include lack of essential skills, lack of ICT equipment, inadequate transport and lack of
information especially in the rural areas on the importance of civil registration.
Strategies
i)
Civil Registration awareness campaigns and social mobilization
ii)
Capacity building
iii)
Enhance transport for Monitoring
iv)
Improve on registration supplies and materials
v)
Reviewing and developing, a Vital Registration Information Systems (VRIS)
vi)
Conduct consensus stakeholders meeting
vii)
Train district registrars on use of the software database system
viii)
Roll out the software system in all districts
ix)
Monitor implementation of the system
11
4.3.3
Strategic Objective 3: Enhance Capacity of HIS staff
Capacity development for the implementation of HIS Strategic Plan is critical at all levels
amongst:• HIS staff who produce analyzed information
• Managers who use the information
• Facility staff that produce raw data and primarily use the information.
The reviews undertaken on HIS indicate that while the basic data capture and reporting skills are
present, there is little attention to data quality and the staff is not skilled to competently
undertake analysis and interpretation of data. There is therefore urgent need for a comprehensive
training program for staff in-post and those studying to become health workers. There is also
need to have pre-services training for M&E officers, District Health Managers and curricula on
HIS principles should be introduced into the courses for nurses, clinical officers, doctors and
other health professionals
Strategies
i)
Developing focused pre and in-service training program for health professionals in
HIS
ii)
Strengthening human resource capacity at all levels by undertaking focused practical
training program on HIS
iii)
Organizing best practice tours in areas with the best performance within and
outside Kenya
iv)
Enhancing HIS staff career development
v)
Employ, deploy and retain appropriate health records and information personnel at
all levels
vi)
Employing and deploying HIS staff appropriately
vii)
Enhancing transport for HIS operations
viii)
Improving general office supplies and equipment
4.3.4
Strategic Objective 4: Improve Financial Resources and sustainability
There is inadequate allocation of financial resources for HIS. This is mainly because the amount
allocated is not based on information needs. For purposes of sustainability HIS requires adequate
long-term funding for recruitment of adequate staff, ICT equipment, stationery and systems
development.
Strategies
•
Increasing allocation of GOK funds for implementing HIS interventions
•
Consolidating funds geared towards HIS activities
•
Strengthening Financial Information System (FIS)
•
Increasing financial flow and funding at all levels
4.3.5
Strategic Objective 5: Strengthening use and Application of Information and
Communication Technology, in data Management.
Though computers exist at provincial and district levels, there is urgent need to improve the use
and application of modern ICT to capture, store and exchange health information at all levels
through provision of equipment and developing capacity of staff.
Secondly given the manual nature of the existing information systems, the information is not
easily accessible mainly due to type of storage system used. There is need to have adequate
storage place and data collected and information generated must be handled with confidentiality
and security they deserve.
12
Strategies
i)
Procuring hardware and software to support data management
ii)
Developing user friendly integrated web-enabled database system.
iii)
Rolling out the integrated system at all levels
iv)
Supporting data flow, information use and sharing through the FTP
v)
Developing capacity for Health Records and Information Officers, ICT personnel and
managers on use of the software for data management
vi)
System maintenance and sustainability
vii)
Data security and backup
viii)
Developing capacity of ICT personnel and managers to develop, administrate,
implement and manage software for data management
4.3.6
Strategic Objective 6: Improving Monitoring, Feedback, Reporting, Supervision and
Data Audits
Although a lot of health data exist there is minimal interaction with the data by health staff.
Consequently very little data is used for decision making, performance assessment and resource
allocation. There is therefore need to review selected indicators and therefore reduce the number
of data reported along indicators.
There are a number of vertical systems collecting and reporting data in systems that are parallel to
HIS and have no links to it. There is need to harmonize these systems with a view of developing
one standardized system which will interface the parallel systems that exists and the HIS system.
The integration of existing data sources into one data warehouse that uses modern technology to
enable easy access to information from a variety of platforms at a single point will ensure
maximum use of available information.
Improved information use requires that coordination be strengthened vertically (between levels
of health services) and horizontally (with other stakeholders, health related ministries, NGOs and
CSOs). Secondly coordination of surveys such as DHS, facility survey, vital registration and
other surveys should be improved and placed under M&E steering committee. Further, one of
the frequent problems is lack of feedback at all levels (horizontal and vertical feedback).
Feedback of information should therefore be improved by ensuring that reports and publications
are distributed to Community units, facility staff, district levels both paper-based and
electronically and subsequently the other levels of evidence-based decision making. Repackaging
this information to different users will be critical during this period.
Strategies
•
Strengthening Effective marketing of HIS products and empowering the managers and
public
•
Organizing forums for producers, researchers and users of health statistics
•
Promoting research
•
Improving coordination of data sources
•
Establishing standardized method of data collection, collation, analysis and presentation
•
Increasing use of existing data at all levels
•
Producing regular reports or bulletins from district level upwards
•
Conducting Rapid Health Facility Assessments (R-HFAs)
•
Conducting Service Availability Mapping (SAM)
•
Strengthening Performance monitoring of the Health sector
•
Strengthening HIS and other statistical constituencies including legislation
•
Improving data Quality
13
4.3.7
Strategic Objective 7:
Enhancing Governance, partnership, collaboration and
coordination
Communication, partnership and coordination of HIS activities undertaken by various
stakeholders are weak. The existing HIS are designed with limited involvement and participation
with those who operate the systems and those who use the information from the systems. There
is therefore need to share information with partners and close coordination with other statistical
constituencies
Strategy
•
Establishment of intra and inter sectoral linkages
•
Establishment of governance structures at all levels
•
Evaluation of the HIS strategic plan
•
Evaluate the implementation of the HIS strategic plan
14
CHAPTER 5: STRATEGIC IMPLEMENTATION
5.1
Staffing Level and Requirements
Currently HIS at the Ministries of Health is grossly understaffed as indicated in Table 4.1 below.
The statistics from Table 4.1 shows that at the current staffing level there is a gap of 4774 staff.
This means that only 11% of the total human resource requirements are in post. The major gaps
are in the cadre of Health Records & Information Officers (88.3%), ICT officers (96.6%) and
statisticians (100%). In order to effectively implement activities of the strategic plan, it is
imperative that staff is recruited and trained. There will also be need to undertake service
workload analysis for the staffing.
Table 4.1 Staffing Levels
CADRE
Health Records
and Information
personnel
ICT Officers
Statisticians
Epidemiologists
Public Health
Specialists
Health
Economists
Total
5.2.
Existing
staff
currently to
support HIS
Total Human
Resource
requirements as per
staffing norms and
standards
4882
Gap
Staff to be
recruited as per
the strategic plan
( 2009-2014)
572
4310
(88.3%)
1550
235
221
12
8
0
2
227 (96.6%)
221 (100%)
10
20
4
3
4
0
4
1
2
5356
0
582
2
4774
1
1579
Organizational Structure
The current organizational structure of HIS at the Ministries of Health shown in Fig. 4.1. is
applicable at the National, Province and District levels. The major components of the structure
are:
§
Health facility statistics
§
Population based health statistics (including vital statistics) and research
§
Management statistics
§
ICT to support the functioning of HIS
15
Fig 4.1
Organogram of Health Information System
HIS
Facility based
Health statistics
Morbidity,
mortality and
service statistics
Population-based
health statistics
and Research
Workload/Hospit
al administrative
statistics
Management
statistics
Human Resource
Finance
ICT
Infrastructure and
fixed assets e.g.
Health facilities
Support
management e.g.
transport,
Commodities and
suppliers e.g.
drugs
Source: - HIS Division
16
5.2.1
Governance Structure.
In order to implement this Strategic Plan the following governance structure is to be
implemented during the plan period:i)
Establishment of a National Health Information System Coordinating
Committee (NHISCC).
This is the oversight committee with representative from key partners at senior level in
the ministries of Health, private sector, NGOs and development partners to strengthen
HIS function. The committee will ensure periodic review of the data collection tools,
ensure that we have minimum data sets, and give guidelines on data quality audit and
supervision. Similar coordinating committees will also be at provincial, district and
community levels.
ii)
Establishment of an HIS Management Structure
At each level of data collection there will be management teams. At the central level in
ministries of Health, Technical Working Group will form the management team. The
management teams will also be formed at the provincial, district and community levels.
Fig 4.2 Governance Structure
HIS MANAGEMENT
STRUCTURE
COORDINATING STRUCTURE
NATIONAL HIS
NATIONAL COORDINATING
COMMITTEE
TECHNICAL
WORKING GROUP
PROVINCIAL HIS
PROVINCIAL COORDINATING
COMMITTEE
DISTRICT HIS
DISTRICT COORDINATING
COMMITTEE
COMMUNITY
COMMUNITY COORDINATING
COMMITTEE
17
5.3
Roles and Responsibilities
This section defines roles and responsibilities of the various actors at all levels of the health
sector.
5.3.1
National HIS Coordinating Committee (NHISCC)
A NHISCC with representation from senior level officers in the Ministries of Health, Statistical
constituencies, implementing partners and development partners shall be formed to strengthen
NHIS function. The Permanent Secretary shall appoint a chairperson to steer HIS Coordinating
Committee. The Ministries of Health together with other participating stakeholders shall
provide the Committee with the financial and human resources needed to undertake its day-today activities. The Committee will establish its own internal procedures and work agenda.
The NHISCC shall provide technical advisory role for health and social welfare data
management in close collaboration with other strategic partners including KNBS, Vital
Registration and private sector. The committee shall ensure unified and timely data collection,
collation, processing and dissemination. To maximize efficiency, the NHISCC shall develop
strategic options for human resource development in data and information management and
participate in operational research.
5.3.2
The General Public
The public shall ensure that any vital events or other significant health occurrences in the
community are reported to the responsible authorities.
On the other hand the public shall be entitled to information on the Ministries of Health
performance through relevant publications by the Ministries or on specific special requests.
5.3.3
The Private Sector
Currently there is no legal obligation for the private sector to provide their activity data to
Ministries of Health. However through the HIS policy private health providers will be enforced
to submit their data regularly as stipulated in order to give a comprehensive picture of the
sector.
When the Public Health Act is reviewed, it is proposed that statutory provision be made to
require the private sector to notify at least all diseases under surveillance and report service
statistics to HIS.
5.3.4
Faith Based Organization (FBOs)
The Ministries of Health, CHAK, NGO KEC-CS shall endeavour to work together to build a
unified health and social welfare data collection, collation, analysis and publication system.
In spirit of partnership, FBOs will ensure all health facilities under their respective umbrellas to
adhere to NHIS.
In collaboration with Ministries of Health and other partners, FBOs shall mobilize resources
for, NHIS and ensure efficient data and information management in all their satellite facilities.
18
5.3.5
Ministries of Health (Roles by level)
i)
Community level
•
Every Community Unit (CU) shall maintain and update its CHIS that shall be
shared regularly with household members in a forum as stated in the health sector
community strategy.
•
The community health workers shall maintain registers recording daily activities
and reporting regularly to supervising health facility.
ii)
Health facility level
• The health facility shall maintain and update its HIS which shall include records,
filing system(s) and registry for primary data collection tools (such as Registers,
cards, file folders), summary forms (such as reporting forms, CDs, electronic
backups) safeguarded from any risks e.g. fire, floods, access by unauthorized person,
etc.
• Every health facility shall summarize health and health related data from the
community and health facility, analyse, disseminate and use the information for
decision-making, provide feedback, then, transmit summaries to the next level.
iii)
District level
• The District shall have oversight responsibility to manage all health and health
related data from all service providers within their area of jurisdiction.
• The district shall give technical, material and financial support to all service
providers in HIS.
• The District shall create and maintain a data repository.
• The district shall collaborate and work in partnership with other statistical
constituencies at the district level to built one HIS.
• The district shall collate, analyse, disseminate, use health and health related data
from all health facilities/providers and give feedback to all health care providers.
iv)
Provincial/Regional level
• The Province shall have oversight responsibility to manage all health and health
related data from all service providers within their area of jurisdiction.
• The province shall give technical, material and financial support to all districts and
service providers in HIS.
• The Province shall create and maintain a data repository.
• The province shall collaborate and work in partnership with other statistical
constituencies at the provincial level to built one HIS.
• The province shall collate, analyse, disseminate and use health and health related
data from all districts and give feedback to all health care providers.
v)
National level
• The National level shall have oversight responsibility to manage all health and health
related data from all service providers
• The national level shall give technical, material and financial support to all districts,
provinces and service providers in HIS.
• The national level shall develop guidelines and formulate policies.
• The national level shall coordinate development of minimum data sets and data
requirements of the health sector.
19
•
•
•
The national level shall collate, analyse, disseminate and use health and health
related data from all districts, provinces and service providers and give feedback to
all.
The National level shall create and maintenance a data repository.
The national level shall collaborate and work in partnership with other statistical
constituencies at the national to built one HIS.
5.3.6. Other statistical constituencies
i.
KNBS
ii.
Vital Registration
iii.
Research and training institutions
There shall be close working relationship and partnerships with HIS to provide data on
population- based statistics, vital events (births and deaths) and health related research data for
comparative analysis and warehousing.
5.3.7
Other Ministries
There shall be close collaboration and partnership with other ministries in strengthening HIS
such other ministries include, Ministry of education, Ministry of home affairs and national
heritage- Kenya national archives.
5.3.8
Training institutions
•
Will be engaged in harmonization of the human resource requirements of HIS to the
training curricular offered by training institutions.
5.3.9
Mass media
•
Shall be involved in advocacy on health and health related information
5.3.10 Implementing partners
•
Support to strengthen HIS in their areas of operation.
•
Work within the existing HIS framework and meet the reporting requirements as defined
by minimum datasets.
5.3.11 NGOs
• Close partnership in HIS strengthening especially in population based studies such as
Demographic Surveillance Systems (DSS).
5.3.12 Development partners (DPs)
• In the spirit of Kenya Health Sector wide Approach (SWAp), development partners are
encouraged to continue to give technical, material and financial support to strengthen
NHIS. The DPs should promote one national integrated health information system.
5.4.
Budgetary Requirements
Effective and successful implementation of the Strategic Plan will need funds both for recurrent
and investment expenditure. It is expected that through the budgeting process the government
funding will be enhanced to match the planned activities. Other funds will come from
development partners based on the agreements which will be developed between NHIS and the
partners. The projected budget by strategic objectives is given in Table 4.2. A total of about
Kshs 1.9 billion or US$ 25.3 Million will be required for the implementation of the Strategic
Plan during the 5 year period. Annex IV presents summary of budget by main activities.
20
Table 4.2 Budget Summaries by Strategic Objectives
Projected Resource Requirements for Plan Implementation
To improve data
management
To improve National
Vital Registration System
To enhance capacity of
HIS
Improve financial
resources
To strengthen use and
application of
information and
Communication
Technology in data
management
To improve monitoring,
feedback, reporting,
supervision and data
audits
To Enhance Governance,
partnerships,
collaboration and
coordination
GRAND TOTALS
Budget per Financial year in US $ (Dollars)
2009/10 2010/11 2011/12 2012/13 2013/14
Total Cost
in Kshs
Amount US $
(Kshs. 75)
1,184,960
2,826,895
2,709,528
2,244,260
2,681,786
888,761,950
11,850,426
442,950
543,352
534,366
407,725
301,058
167,208,800
2,229,461
245,320
1,497,890
706,090
378,150
358,550
236,950,000
3,159,333
40,619
40,619
40,619
40,619
40,619
15,232,000
203,093
402,549
531,584
509,523
393,536
315,134
161,423,000
2,152,307
893,866
1,074,021
1,226,048
1,204,755
988,350
404,028,000
5,387,040
35,227
35,227
73,793
73,793
35,227
18,995,000
253,267
3,245,491
6,549,568
5,799,966
4,945,837
4,720,721
1,892,618,750 25,234,917
21
CHAPTER 6: MONITORING AND EVALUATION FRAMEWORK
The overall purpose of Monitoring and Evaluation (M&E) is to track inputs, activities
(processes) outputs and ultimate outcome (impact) of strategic Plan implementation. It is a
process of ensuring that resources are spent as planned within the framework of strategic plan
projections and Annual Work Plans (AWPs) budgets; and that activities take place as planned
within the planned time frames to realize the stated strategic objectives. Specifically, Monitoring
of strategic plan implementation will assist in:
•
Checking whether the implementation is on schedule as planned (work-plans are
followed as closely as possible)
•
Assisting in making adjustments and corrective action when and where necessary.
•
Keeping management and stakeholders informed on time
•
Assisting in making timely solutions where bottlenecks are identified
•
Checking that allocated resources are used efficiently and effectively
•
Ensuring that inputs are ready on time.
Evaluation is defined as periodic assessment of the relevance, performance, efficiency,
effectiveness and impact of the activities. The relevance will respond to the question to what
extent are the operations responding to the needs and priorities of the system? . Efficiency
focuses on whether available resources (financial and non-financial) have been optimally used
while effectiveness responds to the question, to what extent the beneficiaries are benefiting
from the system? The purpose of evaluation will therefore be to improve planning and
management; to strengthen organization; promote institutional learning and to inform policy.
The HIS recognizes that there will be need for, adequate resources (both human and nonhuman) to successfully implement the strategic plan within the five year period and beyond. In
light of this, appropriate strategies and mechanisms will be put in place internally and with
support from partners to mobilize financial/funding and material resources to support
implementation of the plan in terms of recurrent and development expenditures.
In order to justify and enhance funding and resources mobilization to support plan
implementation and longer term sustainability, appropriate strategies, will include but not
limited to:
•
Assessing results and effects of system activities
•
Assessing impact to justify the resources
•
Drawing lessons learnt and best practices
•
Justifying replication, scaling up, expansion etc
The system will monitor and evaluate the implementation processes (inputs and activities),
outputs and outcomes to ensure efficiency and effectiveness in achieving the strategic
objectives.
The strategic plan logical framework already provides key inputs into a Monitoring and
Evaluation System. Specifically, Performance Indicators and Means of Verification will be
crucial in monitoring and evaluation of the strategic plan implementation. It is expected that a
comprehensive M&E framework will be developed consisting of:•
•
Detailed AWPs as basis for both plan implementation as well as M&E
Preparation of shorter term Operational Plans (OPs) possibly at thematic, resource
centers and clusters levels as appropriate
22
•
•
•
•
Appropriate data collection tools/instruments at all levels from community to
Secretariat for purposes of monitoring and evaluation
Preparation of Monitoring and Evaluation indicators
Monitoring and evaluation process at all stages of inputs, processes, outputs and
outcomes, frequencies (monthly, quarterly, half yearly and annual etc)
Feedback reporting mechanism including reporting formats, reports writing,
documentation and dissemination processes
The financial and other resources monitoring and evaluation will constitute part of the M&E
system to ensure that all the resources are utilized according to approved work plans and
budgets, and in accordance with the approved financial management guidelines and regulations
to ensure accountability.
The following activities will generate the information required as process, output and impact
indicators to monitor and evaluate the work of the programme.
•
Expected outputs, strategic objectives, strategies and respective major activities
•
Capacity needs assessments conducted and subsequent capacity building
•
Standard M&E instruments and guidelines including report formats, standard checklists
and other tools developed
•
Supervision and monitoring visits
•
Periodic review meetings
•
Quarterly and annual reports on performance of the system
•
Data bases developed and used to inform policies, planning, decision making and plan
implementation.
Interim, Mid-term and End of Period evaluation by external agencies will be undertaken as
appropriate.
23
CHAPTER 7: STRATEGIC IMPLEMENTATION MATRIX
The HIS Strategic Plan, 2009 2014 implementation Matrix is presented below. For ease of
presentation, an implementation framework for each objective is provided but should be
viewed as integrated components. The matrix consists of:•
Stated Strategic Objectives
•
Expected Output based on the Strategic Objective
•
Strategies
•
Main activities for the respective strategies
•
Responsibility
•
Strategic Partners
•
Implementation Time Frame within the five year period
•
Performance Indicators
•
Budget Projections
The Implementation Matrix is a critical management tool for mobilization, allocation and
utilization of resources for plan implementation; management and coordination of Strategic
Plan implementation; and monitoring progress as well as evaluating results/outputs and impact
of the Health Information System.
It is important to note that detailed Annual Work Plans (AWPs) as well as shorter term Annual
Operational Plans (AOPs) are to be developed for each year of the plan as initial and
subsequent operationalization of the Strategic Plan processes.
In addition to the Implementation Matrix as well as Annual Operational Plans (AOPs), there
will be a comprehensive Monitoring and Evaluation System to be developed to facilitate
efficient and effective monitoring and evaluation of Strategic Plan implementation including
feedback reporting mechanism, documentation and information dissemination.
24
HEALTH SECTOR
Strategic Objective 1: To improve data management
Expected
Output/
Results
Strategies
Improved
policy,
procedures and
institutional
Capacity
i)Developing HIS
Policy and
Strategic Plan
Main Activities
HEALTH INFORMATION SYSTEM (HIS)
STRATEGIC PLAN 2009-2014
IMPLEMENTATION MATRIX
Responsibility
Verifiable
Indicators
Time Frame (Implementation Period)
2009/2010
ii)Reviewing data
management
processes,
procedures and
linkages
iii) Review
minimum data sets
Print and
distribute M&E
tools for data
collection and
reporting
Operationalization and
Enforcement of HIS
Policy
NHIS Coordinating
committee
Develop HIS Strategic
Plan 2015-2020
HIS, TWG
Review data
management
processes, and
procedures
Ministries of Health
(HIS)
Establish linkages for
the existing subsystems
HIS, TWG
Review and define
health sector core
indicators
Revise data collection,
collation and analysis
tools and set up
quality assurance
procedures
HIS TWG
Standardized minimal
datasets defined
HIS
Revised data
collection, collation
and analysis tools in
place and quality
assurance procedures
Conduct orientation
training for health care
workers on use of
revised integrated HIS
M&E tools
Supply of data capture
and reporting tools
HIS
2010/2011
2011/2012
Total Budget
2012/2013
2013/2014
HIS Policy in place
and operational
Kshs
Source
of
Funds
US$
2,939,000
39,187
2,955,000
39,400
2,588,800
34,517
96,000
1,280
X
HIS
Strategic Plan
development
completed and
launched
Framework for Data
Management process
and procedures
reviewed and in place
X
X
Linkages between
sub-systems in place
and functional
X
X
X
X
7,131,600
95,088
X
X
3,139,000
41,853
List of health care
workers trained on
HIS M&E tools and
training report
Printed M&E tools
X
X
X
Sub- total
25
X
X
29,300,000
390,667
X
X
202,200,000
2,696,000
250,349,400
3,337,992
Expected
Output/
Results
Strategies
Report of
key subsystems and
linkages
Determine the
need for key subsystems and the
linkages in the
health sector
Functional
CHIS
Main Activities
Responsibility
Verifiable Indicators
2009/2010
Establish a manual
integrated
community Health
Information
System (CHIS)
Assess plan and link
the sub systems:Master health facility,
Finances, Drugs, and
logistic management,
Human Resources,
Assets, Vital
registration.
Print other health
systems data
collection forms
Ministries of
Health (HIS)
2010/2011
2011/2012
Total Budget
2012/2013
2013/2014
Kshs
Source of
Funds
US$
Needs Assessment
Report (s) &
Centralized database
linked to sub-systems
in place
Ministries of
Health (HIS)
Health Systems data
collection tools printed
and utilized
Develop the
integrated CHIS
(Community Health
Information Systems)
tools
Pre-test the CHIS
tools in 6 selected
sites in the provinces
Hold consensus
workshops
HIS,DCH, All
Stakeholders
Number of CHIS
tools developed
HIS,DCH, All
Stakeholders
X
X
X
X
X
X
3,058,050
40,774
21,500,000
286,667
X
X
80,000
1,067
Reports on pre-tested
CHIS tools
X
X
3,810,000
50,800
HIS
Number of consensus
workshops held
X
X
750,000
10,000
Print CHIS tools
HIS
CHIS tools in place
X
X
X
X
X
122,000,000
1,626,667
Procure and
synchronize PDAs
for CHIS
All stakeholders
Number of PDAs for
CHIS procured
List of participants
attending the
workshops
X
X
X
X
X
95,740,000
1,276,533
26
Expected
Output/
Results
Developed
functional
electronic
CHIS
Strategies
Main Activities
Responsibility
2009/2010
Establish a robust
integrated
electronic
community
Health
Information
System
Design and develop a
CHIS system for data
management
Hold consensus
workshop for CHIS
Technical support to
the system
Establish and equip
CHEWs and resource
centers in each
administrative
division for
information sharing
HIS/DCH
Integrated electronic
CHIS in place
2010/2011
2011/2012
X
X
2012/2013
Total Budget
2013/2014
US$
1,737,500
Number of consensus
meeting held
HIS,DCH, CDF
Committee
Kshs
650,000
Technical support
provided
Community Resource
Centers established
Source of
Funds
23,167
8,667
18,667
1,400,000
X
X
X
X
Sub- total
27
297,000,000
547,725,550
3,960,000
7,303,008
Expected
Output/
Results
Strategies
Developed
integrated
electronic data
management
and
Information
health facility
system
Review and
develop Facility
data
Management
and Information
Systems
Main Activities
Responsibility
2009/2010
robust facility
management
information system
HIS
2010/2011
2011/2012
2012/2013
Total Budget
2013/2014
Kshs
US$
2,224,000
Robust facility MIS in
place and functional
X
X
X
X
X
X
Rollout the facility
system in the 400
hospitals
System rolled out in
the 400 hospitals
Maintenance of
facility system
Maintenance report
Develop an
Electronic Health
Records System
(EHRS)
EHRS rolled out in all
the 400 hospitals
EHRS in place and
operational
X
EHRS rolled out in
the 400 hospitals
Maintenance reports
M&E Reports in
operations of HER
system
Maintenance report
156,800
20,000,000
266,667
X
13,843,000
184,573
X
X
34,580,000
461,067
X
X
8,300,000
110,667
Sub-Total
Total
28
29,653
11,760,000
X
X
Source of
Funds
90,707,000
1,209,427
888,781,950
11,850,427
Strategic Objective: 2 To Improve National Vital Registration System
Expected
Output/
Results
Raised
registration
coverage of
births from
46% to 80%
and Deaths
from 50% to
90% by 2014
Strategies
i) Civil
Registration
awareness
campaigns and
social
mobilization
ii) Capacity
building
Main Activities
Conduct social
mobilization
campaigns at
national, provincial
and district levels.
VR, DCR, HIS
Sensitize the
community through
media
VR
Capacity Building of
registrars and
registration agents on
vital registration
Train 21,600 Chiefs
and sub-chiefs on
causes of deaths
Train VR staff on
short course
VR
Train 800 clinicians
and nurses on vital
registration, causes of
deaths ,basic coding
of diseases and use of
vital information
Improved
transport for
Vital
Registration
Enhance transport
for Monitoring
Responsibility
Provision of
transport (vehicles
and motorcycles)
VR, DCR, HIS
VR
HIS, VR
VR
Total Budget
2009/2010
2010/2011
2011/2012
2012/2013
2013/2014
X
X
X
X
X
35,223,000
469,640
X
X
X
X
X
3,850,000
51,333
X
X
4,495,000
59,933
X
X
13,865,000
184,867
X
X
X
X
X
X
X
X
1,280,000
17,067
X
X
X
X
X
37,500,000
500,000
Registration
Coverage of births
increase from 40% to
80% and coverage of
deaths increased from
50% to 90% by 2014
Number of Aired
programmes and
proportion of
communities reached
No of staff trained an
Vital Registration and
use of information
No of chiefs trained
Number of staff
trained
X
X
Kshs
US$
Source
of Funds
5,662,000
75,493
Number of clinician
and nurses sensitized
Number of vehicles
and motorcycles
purchased
29
Expected
Output/Result
s
Strategies
Developed
integrated
electronic Vital
Registration
data
management
and
information
system
Review and
develop, a Vital
Registration
Information
Systems (VRIS)
Main Activities
Data Conversion
Responsibility
VR
robust vital
registration
information system
VR
Train district
registrars on use of
the software database
system
Roll out the software
system in all district
VR
Monitor
implementation of
the system
VR
VR
Total Budget
2009/2010
2010/2011
2011/2012
2012/2013
2013/2014
X
X
X
X
X
Number of Records
entered/converted
Integrated electronic
vital data management
and information
system developed and
in place
X
Number of Districts
installed the system
X
Total
30
US$
50,000,000
666,667
1,499,000
19,987
X
5,759,800
76,797
X
825,000
11,000
7,250,000
96,667
167,208,800
2,229,451
X
Number of registrars
trained
Kshs
X
X
X
Source
of Funds
Strategic Objective 3: To Enhance Capacity of HIS
Expected
Output/
Results
Improved
institutional
capacity
Strategies
i) Develop focused
pre and in-service
training program
for health
professionals
ii) Strengthen
human resource
capacity at all
levels by
undertaking
focused practical
training program
on HIS
Study tour
report
Organize best
practice tours in
areas within Kenya
and outside with
the best
performance
Main Activities
Mainstreaming HIS
in the regular preservice training of
health workers and
Review curricula for
health records
professionals
Orientate 100
lecturers/ Trainers
on curricula
Responsibility
HIS & Training
institutions
Training institutions
Develop a training
manual in
information
management for
health workers
Train managers on
information
management and use
Train Health care
workers on data
management and use
On Job Training on
data management for
health workers
Conduct five
exchange
programmes in
country by
provinces/ districts
HIS
Conduct exchange
programme in 3 best
countries in the
region (AFRO)
HIS
Verifiable
Indicators
HIS
mainstreamed in
the medical
Training
curricular
Number of
lecturers oriented
2011/2012
2012/2013
Total Budget
2009/2010
2010/2011
2013/2014
Kshs
US$
X
X
1,665,000
22,200
X
X
2,966,000
39,547
1,935,000
25,800
Training manual
in place
X
X
HIS
Number of
managers trained
X
X
X
X
5,410,000
72,133
HIS/province/Dist
rict
Number of
health care
workers trained
Number of
health care with
proficiency
Number of
exchange
programmes
conducted
Exchange
programmes
reports
Exchange
programme
reports
X
X
X
X
33,530,000
447,067
X
X
X
X
6,500,000
86,667
X
X
1,350,000
18,000
3,295,000
43,933
56,651,000
755,347
District/Province
HIS
X
Sub-Total
31
X
Source of
Funds
Expected
Output/
Results
Strategies
60% 0f staff
developed
Enhance HIS staff
career
development
Number of
staff employed
and deployed
i) Employ, deploy
and retain
appropriate health
records and
information
personnel at all
levels
Main Activities
Develop curricula
for pre-service
training program
for HIS staff
Sponsor HIS staff
for short term
courses in-post
(statistical software,
Planning, M&E,
GIS, )
Train Health
records and
information
officers and
clinicians on ICD
10 use
Support long term
trainings for HIS
(Medical
demography,
Epidemiology,
Medical statistics,
Informatics, Health
Records and
Information
Management)
Review, Develop
and implement
norms and standard
for staffing at
various levels of
HIS
Develop and pilot
retention scheme of
service for Health
Records and
Information
Officers
Responsibility
Training institution
HIS
HIS
HIS/ development
partners
HRD,HIS
HRD,HIS
Verifiable
Indicators
2009/2010
Curricula for preservice training
developed
2010/2011
2011/2012
X
X
2012/2013
Total Budget
2013/2014
Kshs
US$
300,000
Number of staff
sponsored
Source of
Funds
4,000
392,000
X
X
X
X
X
X
X
X
Number of health
records and
information
officers and
clinicians trained
on ICD 10 use
Number of
officers supported
for training.
X
X
Norms and
standards
developed and
implemented
X
X
Scheme of service
developed and
piloted
X
32
X
X
29,400,000
14,410,000
192,133
20,000,000
266,667
2,670,000
35,600
64,000
853
Expected
Output/Results
Strategies
ii)Employ and
deploy HIS staff
appropriately
Enhanced
transport for HIS
activities
Enhance
transport for
HIS operations
Improved
infrastructure,
office supplies
and general
equipment
Improve general
office supplies
and equipment
Main Activities
Responsibility
Advertise the positions
PS
Employ and deploy
750 health records and
information
technicians
Employ and deploy
750 health records and
information Officers
PS
Employ and deploy
200 Health records
and information
degree/masters
holders
Employ and deploy 20
ICT officers in all
provinces to give
technical support
Employ and deploy 10
statistical officers for
national and provincial
levels
Provision of transport
(vehicles and
motorcycles) at all
levels
PS
PS
PS
PS
Development
partners and HIS
Renovate the office
buildings in selected
sites.
HIS
Equip one resource
centre at the national
level
Procure office
supplies at all levels
HIS/
Administration
Verifiable
Indicators
Number of
Positions
advertised
Number of
HRITs of staff
employed and
deployed
Number of
HRIOs of staff
employed and
deployed
Number of
Degree/Masters
holders employed
and deployed
2010/2011
2011/2012
2012/2013
2013/2014
X
X
X
X
X
1,500,000
20,000
X
X
X
X
X
15,000,000
200,000
X
X
X
X
X
26,250,000
350,000
X
X
X
9,000,000
120,000
Number of ICT
officers employed
and deployed
Number of
statistical officers
employed and
deployed
Number of
vehicles and
motorcycles
provided to all
levels
Number of offices
renovated
X
National resource
center equipped
Register of office
supplies procured
at all level
Total Budget
2009/2010
X
US$
X
X
900,000
12,000
X
X
180,000
2,400
X
X
42,000,000
560,000
X
X
2,000,000
26,667
X
X
10,500,000
140,000
X
X
6,125,000
81,667
180,299,000
2,403,987
236,950,000
3,159,333
Sub- Total
Total
33
Kshs
X
X
X
X
Source of
Funds
Strategic Objective 4: Improve Financial Resources
Expected
Output/Results
Strategies
At least 10% of
total budgets
allocated for
M&E/HIS
activities at all
levels
Increase
allocation of
GOK funds for
implementing
HIS
interventions
Improved
Financial
Resources
Consolidated
funds geared
towards
HIS/M&E
activities
Strengthening
Financial
Information
System (FIS)
Increase
financial flow
and funding at
all levels
Main Activities
Responsibility
Lobby for more GOK
funds
PS/HIS
Lobby for at least
10% funds from
donor/ partners
funding for every
project in the health
sector towards M&E
and HIS
Support one M&E
framework
DP/PS/HIS
DP/PS/HIS
Support and generate
Financial information
on allocations and
expenditures
HIS/HCF/DPs
Train managers and
system operators on
financial information
system
Support districts,
provinces and national
level by allocation of
funding at all levels.
HCF/HIS
PS
Total Budget
2009/2010
2010/2011
2011/2012
2012/2013
2013/2014
X
X
X
X
X
X
X
X
X
X
320,000
4,267
X
X
X
X
X
2,655,000
35,400
X
X
X
X
X
2,150,000
28,667
X
X
X
X
X
9,517,000
126,893
X
X
X
X
X
590,000
7,867
10% of the funding
are allocated to HIS
and M&E
Kshs
US$
Source of
Funds
10% of the fun ding
are allocated to HIS
and M&E.
one M&E framework
Strengthened financial
information system in
place
Number of managers
and system operators
trained on financial
management
Number of provinces
and districts
supported/allocated
with funds
Total
34
15,232,000
203,094
Strategic Objective 5: To Strengthen use and application of Information and Communication Technology in Data Management
Expected
Output/Results
Developed
Functional
Integrated data
warehouse
Strategies
Develop user
friendly integrated
web-enabled
database system.
Roll out the
integrated system
at all levels
Support data flow
(FTP) and
information use
or sharing
Improved use of
ICT and computers
Procure hardware
and software to
support data
management
Main Activities
Responsibility
Develop a user friendly
integrated, web-based
database that can link
multiple data sources
and ensure controlled
access by users.
Pre-test the integrated
system
Hold stakeholders
consensus workshop
HIS/ICT
Verifiable
Indicators
Web based data
warehouse
established and
integrated
HIS/ICT
Pre testing report
HIS
Consensus report
Develop system
manuals
HIS/ICT
System/operational
manual in place
Roll out the system in 8
provinces
HIS/ICT
System roll out in all
8 provinces
Support and develop
capacity on use of File
Transfer Protocol
(FTP) as a mechanism
of data transfer
Procure computer
hardwares and its
accessories and printers
for data management
HIS
FTP mechanism for
data transfer is
maintained and
operational
Procure PDAs and
Laptops for data
management
Train managers at
district, province and
national level on use of
PDAs
HIS/ICT
HIS/ICT
Number of
equipment
(computers,
accessories and
printers) acquired
Number of
PDAs/Laptops
procured
Number of managers
trained on use of
PDA and training
reports
35
2010/2011
X
X
3,635,000
48,467
X
X
825,000
11,000
X
535,000
7,133
X
400,000
5,333
6,740,000
89,867
X
2011/2012
2012/2013
Total Budget
2009/2010
2013/2014
Kshs
US$
X
X
X
X
X
X
X
X
20,880,000
278,400
X
X
X
X
X
64,000,000
853,333
X
X
X
X
X
31,500,000
420,000
X
X
X
X
X
3,700,000
49,333
Source
of
Funds
Expected
Output/Results
Strategies
Number of HRIOs
and other
healthcare
managers capacity
in ICT developed
Develop capacity
for Health
Records and
Information
Officers, ICT
personnel and
managers on use
of the software
for data
management
System
maintenance and
sustainability
Maintained and up
to date system
Established data
security guidelines,
remote sites and
backups (storage)
Data security and
backup
Main Activities
Train Users on use of
the hospital software
model
Train Users on use of
the integrated district
HIS database
Orientate managers on
use of integrated HIS
software
Responsibility
HIS
HIS
HIS
Verifiable
Indicators
2009/2010
Number of HRIOs
train and training
report
Number of DHRIOs
trained and training
report
Number of managers
orientated train and
training report
Support maintenance
of hard and software,
including in-house
capacity
Establish remote sites
for data backup and
procure backup devices
HIS/ICT
Number of district
supported
HIS/ICT/eGovernment
Number of backup
and remote site
established
Develop data security
guidelines and SOPs on
data recovery
HIS/ICT
Data security
guidelines and SOPs
disseminated and in
use
X
X
X
2010/2011
2011/2012
2012/2013
X
X
X
X
X
X
X
X
X
X
X
X
X
X
Total
36
Total Budget
2013/2014
X
X
Kshs
US$
11,790,000
157,200
5,386,000
71,813
4,170,000
55,600
730,000
9,733
5,900,000
78,667
1,232,000
16,427
161,423,000
2,152,306
Source
of
Funds
Strategic Objective 6: To Improve Monitoring, Feedback, Reporting, Supervision, use of Data and Data Audits
Expected
Output/Results
Strategies
Increased
awareness, access
and use of
information
Strengthen Effective
marketing of HIS
products and
empowering the
managers and public
Organize forums for
producers,
researchers and users
of health statistics
Main Activities
Produce IEC
materials on HIS
Responsibility
HIS
Types and quantities of
IEC materials
developed and
distributed
Conduct local
radio and TV
programmes
HIS and
Community
Number of radio and
TV programmes
developed and
communicated
Support,
maintain and
market the
MOH website
ICT
Up to date Health
information and
Operational MOH
website
Conduct Health
statistics
symposiums/
conference
HIS and all
stakeholders
Conference reports
Support the
membership in
East Africa
Community and
international
health
information
networks
HIS
Total Budget
2009/2010
2010/2011
2011/2012
2012/2013
2013/2014
x
x
x
x
x
2,000,000
26,667
x
x
x
x
x
5,000,000
66,667
x
x
x
x
x
3,200,000
42,667
4,300,000
57,333
100,000
1,333
14,600,000
194,667
x
x
Kshs
US$
Source of
Funds
Membership of the
health information
Network (s)
x
x
x
x
Sub-Total
37
x
Expected
Output/Results
Strategies
Responsibility
2009/2010
Increased use of
available
information
Promote research
Improved
governance,
coordination and
enhanced
linkages
Improve
coordination of
data sources
Established
standards and
SOPs for data
collection,
collation, analysis
and
dissemination
Main Activities
Establish
standardized
method of data
collection, collation,
analysis and
presentation
Increase use of
existing data at all
levels
Strengthen research
and survey capacity
at all levels
HIS, KNBS,
KEMRI
Support TWGs
Administration and
Coordination of
quarterly review.
HIS TWG
Participate in
quarterly Review
Meetings Provincial
and National levels
HIS, Province
and stakeholders
Joint Monitoring
and Evaluation
HIS TWG
Harmonize and
integrate data
collection and
reporting tools
HIS TWG
Develop medical
data dictionary
HIS TWG
Establish and
maintain data
coding and Master
Health facility
HIS and Districts
Develop
dashboards at
different levels of
service delivery and
use of data
HIS TWG
2010/2011
Reports on
strengthened research
and survey capacity,
coordination of HIS
activities; and integration
of data collection and
reporting tools
2011/2012
2012/2013
x
x
Total Budget
2013/2014
Kshs
US$
20,195,000
269,267
Number of TWG
meetings held and shared
Regular reports
x
x
x
x
x
1,350,000
18,000
Number of quarterly
meetings held and shared
Regular reports
x
x
x
x
x
3,360,000
44,800
6,200,000
82,667
1,290,000
17,200
4,110,000
54,800
Regular reports
Minimum data sets and
indicators
x
Standard medical data
dictionary
Updated Master health
facility list and
Established criteria for
coding
Updated Dashboards at
all levels and regular
reports
38
x
x
x
x
x
x
x
x
13,398,000
178,640
x
x
x
x
x
192,000
2,560
Source
of
Funds
Expected
Output/Results
Enhanced and
published HIS
reports
Strategies
Increase capacity to
Produce regular
reports
Main Activities
Responsibility
Train Health
records and
information officers
on data analysis,
presentations and
use
HIS
Number of health
records and information
officers trained
Train district
registrars on data
analysis,
presentation and
use
Develop annual
health statistical
reports
HIS/ VR
HIS TWG
Number of annual
reports produced and
disseminated
Develop quarterly
bulletins
HIS TWG
Develop annual
Health data sheet
HIS and Districts
Develop MDG
progress report and
other relevant
record reviews and
surveys
HIS TWG
Number of quarterly
reports produced and
disseminated
Number of health fact
sheets produced and
Disseminated
Number of reports
disseminated
Number of district
registrars trained
2010/2011
2011/2012
2012/2013
2013/2014
x
x
x
x
x
13,045,000
173,933
x
x
x
x
x
3,945,000
52,600
x
x
x
x
x
18,615,000
248,200
x
x
x
x
x
4,735,000
63,133
x
x
x
x
x
8,260,000
110,133
3,114,000
41,520
101,809,000
1,357,453
Sub-Total
39
Total Budget
2009/2010
Kshs
US$
Source
of
Funds
Expected
Output/Results
R-HFA and SAM
reports
Performance
monitoring of health
sector, HIS strategic
plan, Legislation and
other statistical
constituencies
Strategies
Main Activities
Responsibility
Verifiable
Indicators
Conduct Rapid
Health Facility
Assessments (RHFAs)
Conduct RHFAs in
specific areas of
service delivery
HIS/ KNBS
Reports on RHFAs
conducted
Conducting
Service
Availability
Mapping (SAM)
Conduct SAM
HIS/ KNBS/
planning and
policy
Reports on
SAM conducted
Train SAM
focal persons on
GIS and use of
information
HIS/ RCMRD
Reports on
SAM and GIS
focal persons
trained
Strengthen
monitoring of
the health sector
AOPs
Strengthen
performance
monitoring of
performance
contracts
Monitor
implementation
of the HIS
strategic plan
HIS
Number of
AOP reports
produced and
disseminated
Number of
Performance
contracts signed
and monitored
Ensure vertical
programs and
service
managers using
HIS format for
feedback and
reports to
respond to and
report on health
events/
management
support
DMS/ PS
Strengthening
Performance
monitoring of
the Health
sector
HIS/ MMU
HIS TWG
Regular
management
support reports
on progress HIS
indicators
2009/2010
2010/2011
2011/2012
Total Budget
2012/2013
2013/2014
x
x
Kshs
US$
6,016,000
80,213
8,280,000
110,400
x
x
x
x
x
x
x
11,500,000
153,333
x
x
x
x
x
59,443,000
792,573
x
x
x
x
x
240,000
3,200
x
x
x
x
x
174,550,000
2,327,333
x
x
240,000
3,200
Source
of
Funds
One M& E
framework for
the health sector
40
Expected
Output/Results
Strategies
Strengthen HIS
and other
statistical
constituencies
including
legislation
Data quality
audits
Improve data
Quality
Main
Activities
Conduct a joint
Support
supervision of
health
information
activities
Develop the
health
information
legislation
Conduct Data
quality audits
Responsibility
HIS TWG
Verifiable
Indicators
Number of
support
Supervisions
conducted
HIS TWG
HIS
legislation in
place
HIS TWG
Improved
data quality
and DQA
reports
Total Budget
2009/2010
2010/2011
2011/2012
2012/2013
2013/2014
x
x
x
x
x
x
41
US$
7,600,000
101,333
2,200,000
29,333
17,550,000
234,000
Sub-Total
287,619,000
3,834,920
Total
404,028,000
5,387,040
x
x
Total
Kshs
x
Source
of Funds
Strategic Objective7: To Enhance Governance, Partnership Collaboration and Coordination
Expected
Output/Results
Enhanced
mechanisms for
effective
communication,
collaboration and
coordination
Strategies
Establishment of
intra and inter
sectoral linkages
Enhancement of
governance
structures at all
levels
HIS Evaluation
Report
Evaluate the
implementation of
the HIS strategic
plan
Main Activities
Responsibility
Verifiable
Indicators
Data Base of all
stakeholders at all
levels available
Quarterly HIS
Coordinating
Committee reports
and Quarterly TWG
meeting reports
Develop
strategies for
effective
communication
between data
providers and
data users at
different levels,
including the
provision of
regular feedback
mechanisms
Strengthen intra
and inter sectoral
linkages and
partnership
HIS TWG and
HIS coordinating
committee
HIS TWG and
HIS coordinating
committee
Good collaboration,
harmonization and
alignment
Coordinate and
link with other
statistical
constituencies
HIS TWG and
HIS coordinating
committee
Number of Meetings
and linkages among
the statistical
constituencies
Conduct
Quarterly HIS
coordinating
committee
meetings at all
levels
Conduct
quarterly TWG
regular meetings
HIS coordinating
committee
Number of quarterly
meetings
Conduct Mid
and End Term
evaluation of
HIS strategic
plan
Number of quarterly
TWG meetings held
Total Budget
Kshs
US$
2009/2010
2010/2011
2011/2012
2012/2013
2013/2014
x
x
x
x
x
1,250,000
16667
x
x
x
x
x
6,550,000
87,333
x
x
x
x
x
2,660,000
35,467
x
x
x
x
x
2,750,000
36,667
x
x
x
x
x
x
x
5,785,000
77,133
18,995,000
253,267
Source
of
Funds
HIS TWG
Reports on external
evaluation of Strategic
Plan implementation
(mid-term and end of
period)
Total
42
ANNEX 1: LITERATURE REVIEWED
1)
Republic of Kenya: - Health Sector Health Information System
2)
Republic of Kenya- Ministry of Health
3)
Republic of Kenya
Assessment Report June 2008
Annual Health Sector Status Report 2005-2007
Ministry of Public Heal and Sanitation Draft Ministry of Public Heal and
Sanitation Strategic Plan 2008 -2012
4)
Republic of Kenya
2008
5)
Ministry of Medical Services:- Draft Ministry of Medical Services Strategic Plan
2012
Republic of Kenya
Health Sector: Indicator and Standard Operating Procedures Manual for
Health Workers 2008
6)
Health Metrics Network Manual
7)
Ministry of Health: Strengthening District Level M&E and HIS in Phase I Districts
8)
Republic of Kenya Health Sector: From Data Production to Data use
9)
Strengthening of the Zambian Health Management Information System Plan of Action
10)
Cordaid
11)
DFID Health Resource Centre
12)
The HIS in Zambia: A Trace on the implementation steps
13)
Pepela Wanjala
14)
National Bureau of statistics, Dares-Salaam: Strategic Plan 2008/09
15)
Republic of Uganda, Ministry of Health
16)
Kenya Vision 2030
17)
Needs Assessment Report for HIS 2004
18)
George W. Odhiambo-Otieno: Evaluation of existing District Health Management Information
2008
IICD Health Programme Uganda
Health, Management Information Systems
2003
The Role of HIS in SWAP and M&E
2010/11
Assessment of the Health Information System in Uganda
Systems in Kenya
19)
Ghana- Health Information Management Strategic Plan 2007-2011
20)
George W. Odhiambo-Otieno: Evaluation Criteria for District Health Management Information
Systems
21)
HMN
Guidance for the Health Information Systems (HIS) Strategic Planning Process
Feb. 2009
22)
MOH
Strategy for the Delivery of Level one Services
23)
MOH
Reversing the trends: The Second National Health Sector Strategic Plan (NHSSP 11- 2005-
2010)
24)
Ministry of Industrialization: Strategic Plan 2008
25)
Government of Malawi: Health Information System: National Policy and Strategy - 2003
43
2012
ANNEX II
LIST OF TECHNICAL WORKING GROUP FOR THE PREPARATION OF THE STRATEGIC
PLAN
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23.
Dr. Kibet Sergon
Sophia Karanja
Nancy Amayo
J.M. Kavale
Rose Ayugi
Dr Martha Muthami
Hannah Gitungo
Julius Mutiso
Olum Gondi
Duncan Ochoro
Dr. Odhiambo-Otieno
Francis Gikunda
Faith Ikiara
Dorcas N. Nguyo
Jedida Obure
Boniface Isindu
Dr Koki Kinagwi
A N Mutua
Pepela Wanjala
Samuel Cheburet
Dr. Maina W. I.
Benadette Ajwang
John Mwihia
Head, HIS
HIS
HIS
Vital Registration
T/Planning
HIS
HIS
NASCOP
PTC
PTC
PTC
HIS
ICT
HIS
DCH
DMC
AFRIAFYA
Vital Registration
HIS
HIS
Tech/Planning
Opthalmic Services
NPHLS
0722659568
0722436048
0721991652
0722618623
0722710176
0722246717
0722849123
0728968515
0720677189
0720716770
0722299309
0722990749
0720265846
0722831629
0722493307
0722875171
0721298811
0722375633
0721624338
0722710176
0726773870
0722918272
44
[email protected]
[email protected]
[email protected]
[email protected]
[email protected]
[email protected]
[email protected]
[email protected]
[email protected]
[email protected]
[email protected]
[email protected]
[email protected]
[email protected]
[email protected]
[email protected].
[email protected]
[email protected]
[email protected]
[email protected]
[email protected]
[email protected]
[email protected]
ANNEX III
HIS POLICY AND STRATEGIC PLAN STAKEHOLDERS WORKSHOP AT BONTANA HOTEL,
NAKURU ON 30TH MARCH TO 3RD APRIL 2009
ATTENDANCE LIST
S/No
.
1.
2
3.
4.
Name
Stella Alusiola
Christine Ayuyo
Patrick Kisabei
Geoffrey Kimani
5
6.
7.
8.
9.
10.
11.
12.
13.
14.
15.
16.
17.
18.
19.
20.
21.
22.
Lisha Lala
Dr. Akanga Zebedee
Christopher Ziro
Naomi Choge
David Wambua
Robert Kinoti
Dr. James Gitonga
Mathews Odongo
Raphael Kimeu
Rankesh Mutisya
Joseph Onwong a
Tecla J. Kogo
Dr. Ruth Kitetu
Dorcas Mugure
Mkaya Gifton
J.M. Kavale
Douglas Ngaira
Titus K. Waita
23.
24.
25.
26.
27.
28.
29.
30.
31.
32.
33.
34.
35.
36.
37.
38.
Francis G. Mwangi
Felix A. Agoi
Mercy K. Ndemo
Benadette A. Ajwang
Jedidah Obure
Peter Wainaina
Naftal Chweya O.
Viterlis W. Sitati
Dr. S. M. Irungu
Beatrice Adieri
Dr. Kibet Sergon
Gideon Emukule
Faith K. Ikiara
Diana Kamar
Rose Ayugi
Dr. Amyn Lakhani
Organization/
Affiliation
MOPHAS Western
Johpiego
NPHLS
Planning & Policy
(MOMS) Ext. 45145
Aga Khan Foundation
DMOH Kaloleni
PHRIO Coast
NHIF
Nursing Council
DHRIO Imenti North
DMOH Imenti North
MOPHAS Nyanza
KEMSA
CNO s Office
DEH-MOPHS
PMO - Nairobi
MOPHS
Afya House- DOCs
MOMS Afya House
Vital Registration
MOMS (Tech P/C)
MPHS Human
Resources
KNADS
AKHSK CHD
AKHSK CHD
DDS
DCAH/MOPHS
MOMS RVP
National Archives
KULTTB
MOMS/Surgical/ Dental
MOMS/Human Resources
Head, HIS
FHI
MOMS
DRH
Technical Planning
Aga Khan
45
Tel/Cell Phone
E-mail Address/phone
0729-080966
0726-429663
0722-249282
0721-854492
[email protected]
cayuyo@jhpiego
[email protected]
[email protected]
+255-784-221887
0722-936230
0722-653387
0722-703084
0733-622593
020-2114942
0722-916765
0721-551318
0722-700465
0724-172158
0722-468500
0721-284216
0729-344256
0720-475522
0722-617608
0722-618623
0721-828395
0735-544863
[email protected].
dmohkaloleni @yahoo.com
[email protected]
[email protected]
[email protected]
[email protected]
[email protected]
[email protected]
[email protected]
[email protected]
[email protected]
[email protected]
[email protected]
[email protected]
[email protected]
[email protected]
[email protected]
[email protected]
0722-785604
0721-250628
0736-193999
0726-773870
0722-831629
0722-336582
0722-835584
0723-867898
0722-637655
0722-578219
0722-659568
0721-323749
0722-990749
0722-674998
0728023414
0736-397840
[email protected]
[email protected]
[email protected]
[email protected]
[email protected]
[email protected]
[email protected]
[email protected]
[email protected]
[email protected]
[email protected]
[email protected]
[email protected]
[email protected]
[email protected]
[email protected]
S/No
.
39.
40.
41
42.
43.
44.
45.
46.
47.
48.
49.
50.
51.
52.
53.
54.
55.
56.
57.
58.
59
60.
61.
62.
63.
64.
65.
66.
67.
68.
69.
70.
71.
72.
73.
74.
75.
76.
77.
78.
79
80.
81.
Name
Dr. J. Gitonga
Dr. Paul Dielemans
Dorcas Wandera
Linda N. Muyumbu
Gideon Emukule
Onesmus M. Kamau
Washington Omwomo
Job Ollongo
Ambrose Rotich
Organization/
Affiliation
MOPHS
EHS/DRH
MOMS
APHIA II R.V.
APHIA II R.V.
DNCD-Afya-House
USAID/K
PHRIO Nyanza Province
DMOH Kericho
Tel/Cell
Phone
0722-916765
0723-777963
0722-233265
0720-200536
0721-323749
0721-670730
0721-739435
0734645684
0722-884603
Franklin Songok
George Onguru
John Odira
Paul Malusi
Edward Odhiambo
Peter Opondo
Duncan Ocholo
Olum Gondi
Odhiambo Otieno
Dorcas Nguyo
Nancy Amayo
Sophia Karanja
Samuel Cheburet
Pepela Wanjala
Hannah Gitungo
David Mwangi
Tumo Kimeto
Dariah Sikolia
Mrs. Margaret Kungu
Hannington O. Onyango
Anna Nduku Mutua
J.M. Kavale
Catherine Njogu
Nduta Waweru
Dr. Koki Anagwi
Charles Chiuri
Karuga Wachira
Awes Amin
Dr. Ali A. Swaleh
Racheal Wanjiru
Patrick Musyoki
Doreen Imanyara
Julius Mutisyo
Francis Gikunda
DHRIO Kericho
DDSC - Migori
DHRIO Migori
DLTLD
PTC
PTC
PTC
PTC
PTC
HIS Secretary
HIS
HIS
HIS
HIS
HIS
DDSR
DHRIO Kaloleni
KMTC
Kenyatta University
NACC South Rift
Vital Registration
Vital Registration
NASCOP
DLTLD
AfriAfya
Central PHRIO
HRIO-PDMS- Central
KNBS
SUPKEM
ICT MOMS
HRIO Eastern
PHRIO Eastern
NASCOP
HIS
0722-839011
0722-379424
0734-735206
0721-359910
0720-265846
0721-991652
0722-436048
0721-624338
0722-375633
0722-849123
0722-988395
0722-998582
0724-666180
0722-586713
0722-275478
0721298811
0722618623
0713-911994
0721-851116
0722-875171
0722-605184
0722-379391
0722-836503
0726-231636
020-2519044
0724-224037
0733-539089
0728-968515
0722-299309
E-mail Address/phone
[email protected]
[email protected]
[email protected]
[email protected]
[email protected]
[email protected]
womwomoAusaid.gor
[email protected]
[email protected]
[email protected]
[email protected]
[email protected]
[email protected]
[email protected]
[email protected]
[email protected]
[email protected]
[email protected]
[email protected]
[email protected]
[email protected]
[email protected]
[email protected]
[email protected]
[email protected]
[email protected]
[email protected]
[email protected]
[email protected]
[email protected]
[email protected]
[email protected]
[email protected]
[email protected]
[email protected]
[email protected]
[email protected]
[email protected]
[email protected]
[email protected]
[email protected]
[email protected]
[email protected]
[email protected].
Quarterly TWG reports Quarterly TWG reports
46
ANNEX IV: - BUDGET SUMMARY FOR PLAN IMPLEMENTATION
Strategic objectives
Out put
Improved policy, procedures and
institutional capacity
Report of key sub-systems and linkages
To Improve data
management
Functional CHIS
Developed functional electronic CHIS
Developed integrated electronic data
management and communication health
facility system
Budget per financial year in US $ (Dollars)
2009/10 2010/11
2011/12
2012/13
2013/14
To Improve National
Vital Registration
system
2,826,895 2,709,528 2,447,260 2,681,784 888,781,950
578,387
557,739
556,459
628,597
1,016,811 250,349,400
3,337,992
-
163,720
163,720
-
-
24,558,050
327,441
606,573
616,573
580,640
580,640
580,640
222,380,000
2,965,067
-
1,040,500
990,000
990,000
990,000
300,787,500
4,010,500
-
448,362
418,709
248,022
94,333
90,707,000
1,209,427
139,617
Study tour report
To enhance capacity
of HIS
543,352
215,800
170,000
133,333
534,366
215,800
111,667
215,885
245,320
Improved institutional capacity
Amount US$
(KSHS. 75)
1,184,960
442,950
Raised registration coverage of births from
46% to 72% and Deaths from 50% to 90%
by 2014
Improved transport for Vital Registration
Developed integrated electronic Vital
registration data management and
communication system
Total cost in
KSHS
407,725
143,558
111,667
206,899
1,497,890
301,058
143,558
106,667
157,500
706,090
157,500
378,150
358,550
167,208,800
11,850,426
2,229,451
64,375,000
858,333
37,500,000
500,000
65,333,800
871,117
236,950,000
3,159,333
22,200
184,140
184,140
151,467
151,467
52,006,000
693,413
-
18,000
43,933
-
-
4,645,000
61,933
53,333
315,378
315,378
117,378
53,333
64,110,000
854,800
36,453
704,400
-
-
-
55,564,000
740,853
133,333
80,000
133,333
80,000
133,333
42,000,000
560,000
-
195,973
29,306
29,306
20,417
20,625,025
275,000
60% 0f staff developed
Number of staff employed and deployed
Enhanced transport for HIS activities
Improved infrastructure, office supplies
and general equipment
47
Out put
Improve financial
resources
At least 10% of total budgets allocated for
M&E/HIS activities at all levels
Improved Financial Resources
To Strengthen use and
application of
Information and
Communication
Technology in data
management
Developed Functional Integrated data
warehouse
Improved use of ICT (PDAs and
computers)
Number of HRIOs and other healthcare
managers capacity in ICT developed
Maintained and up to date system
Established data security guidelines, remote
sites and backups (storage)
To Improve
monitoring, feedback,
reporting, supervision
and data audits
Increased awareness, access and use of
information
Increased use of available information
Improved governance, coordination and
enhanced linkages
Established standards and SOPs for data
collection, collation, analysis and
dissemination
Enhanced and Published HIS reports
R-HFA and SAM reports
Performance monitoring of health sector,
HIS strategic plan, legislation and other
statistical constituencies
Data quality audits
2009/10
2010/11
2011/12
2012/13
2013/14
40,619
40,619
40,619
40,619
40,619
Total cost in
KSHS
15,232,000
Amount US$
(KSHS. 75)
203,093
7,933
32,685
7,933
32,685
7,933
32,685
7,933
32,685
7,933
32,685
2,975,000
12,257,000
39,667
163,427
402,549
531,564
509,523
393,536
315,134
161,423,000
2,152,307
115,147
98,102
85,636
85,636
55,680
33,015,000
440,200
254,667
271,111
271,111
271,111
254,667
99,200,000
1,322,667
14,363
1,947
121,071
1,947
111,496
1,947
32,896
3,893
4,787
-
21,346,000
730,000
284,613
9,733
16,427
39,333
39,333
-
-
7,132,000
95,093
893,866
1,074,021
1,226,048
1,204,755
988,350
404,028,000
5,387,040
38,933
-
38,933
-
38,933
89,756
38,933
89,756
38,933
89,756
14,600,000
20,195,000
194,667
269,267
29,093
36,240
29,093
63,640
29,093
72,240
29,093
44,840
29,093
36,240
10,910,000
18,990,000
145,467
253,200
129,600
659,999
129,600
131,867
680,888
150,360
78,711
649,955
150,360
93,263
641,510
129,600
40,107
624,621
51,714,000
25,796,033
244,273,008
689,520
343,947
3,256,973
-
-
117,000
117,000
-
17,550,000
234,000
48
To Enhance
Governance,
partnerships,
collaboration and
coordination
Grand Totals
Out put
Enhanced mechanisms for effective
communication, collaboration and
coordination
2009/10
2010/11
2011/12
2012/13
2013/14
Total cost in
KSHS
Amount US$
(KSHS. 75)
35,227
35,227
73,793
73,793
35,227
18,995,000
253,267
35,227
35,227
73,793
73,793
35,227
18,995,000
253,267
3,245,491 6,549,568 5,799,966 4,945,837 4,720,721 1,892,618,750
49
25,234,917

REPUBLIC OF KENYA - World Health Organization

Transcription

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