Grant amount: $250,000
Details: HIS assessment Task Force, pre-testing HMN Assessment Tool in Khartoum, national workshop to endorse strategic plan.
The Sudan health information system (HIS)
The Sudan health information system (HIS ) is one of the oldest systems in the region . It started as data collection from 1902 in all health units serving the military troops during the invasion of Sudan . The documented annual reports started in 1921, but the central unit in the Federal Ministry of Health was founded in 1955 which then developed to be the national health information centre (NHIC ). However it does not fulfill all the required criteria , but the system seems to be well shaped . It is a bottom up system which starts from the health centers at the bottom , those units send their reports to the State Ministry of Health (SMOH) where those reports are compiled in a single report and then sent to the Federal Ministry of health (FMOH). Currently the system is health facility based. Even though not all health facilities are regularly reporting to the state level especially the health centers, the dispensaries and the PHC units. This has resulted in confinement of the reported data from the tertiary level hospitals. Community level information are not collected or pooled in the health information system. However some vertical programs collect data for their own activities at the community level but stop short of disseminating their findings to other programs or organization. In addition the health information form the private health facilities are still not covered by the NHIS.
This is currently by far the largest “health data/information” operation in the Sudan. Such data is acquired through the State health directorates, primarily via periodically filled forms which are then keyed in. Increasingly, such data arrives on CDs or diskettes. Some direct downloading from the states has started but is severely limited by the lack of nation-wide networking of the health care institutions.
All data are fed into the National Health Statistics Data Base, after validation, and processed. A few applications process such data to produce periodic reports (e.g. with Health Indicators) and to serve Surveillance purpose. Sometimes, and when possible, it is used to respond to specific queries. These applications are mostly programmed on Access, the Microsoft data base management system. The resultant reports are usually shared back with the States also on CDs and diskettes.
The system reports are monthly and annually received from the states , which also receive their reports monthly from state health facilities. All these information are essential for health planning, decision making and identification of priorities. High quality information is crucial for prioritization of health problems and appropriate utilization of the limited scarce resources. About 65% of the localities in the Northern states have information centers. This is indicative of the inadequate coverage of the system at the locality level. The system is challenged by the expansion to attain 100% coverage of the localities in the coming future. In addition, the expansion has to be accompanied by capacity building of the information centers at the locality level.
The system is suffering from many problems regarding the quality of data , data collection , systematic storage, timeliness , utilization and dissemination.
The main requirement for monitoring and evaluation of health development is national capacity to produce adequate information support.
The efficient collection , processing, utilization and dissemination of the most relevant information at different levels of the health system are essential. Nevertheless, the utilization of the health information for policy formulation and decision–making remains as the most challenging at both the federal and state levels.
The main problems and constraints of the system can be summarized as follows:
- Weakness of monitoring and supervision.
- Low availability of registration books and formats
- The current system is based upon health facilities with minimal use of the information at the community level.
- Problems of timely sending of reports due to lack of communication and transportation.
- Limited dissemination of the annual statistical reports at the state and locality levels.
- Poor utilization of data at different levels of the health system.
- Lack of feedback systems
- The system is paralleled by a number of vertical health information systems without clear coordination and integration.
- Poor capacity of the health information system at the state and locality levels.
- Non-inclusion of the health information from the private health facilities.
- Inadequate training facilities and training resources.
- The basic and continuing training programs for statistical clerks are inadequate.
- Other problems of HIS: like coverage, desegregation and consistency.