Presented by Edward Kunyanga as part of a USAID brown bag lunch in March 2016.

1. .
Health Information Systems
Strengthening (HISS) in Kenya
Reflections and Lessons Based on the HISS Model
Edward Kunyanga
MEASURE Evaluation
USAID Washington
March 8, 2016

2. • Introduction
• Mapping MEASURE
Evaluation PIMA to HISS
model
• Contributions to HISS
• Priorities for the future
Outline

3. Health information system
in Kenya
• Too much data
• Data quality sub-optimal
• Inadequate data use
• System fragmentation
“How can we improve the performance
of HIS as an important ingredient to a
high-performing health system?”

4. Improving HIS performance:
Kenya lessons
• Comprehensive systems approach
• Long-term policies and HIS/M&E strategic
plans
• Leadership and coordination
• Systems development (National health
information systems (NHIS)
• Use of data

5. USAID and MEASURE Evaluation in
Kenya
USAID in Kenya priorities include:
• Strengthening health systems
• Working towards an AIDS-free generation
• Reducing the burden of malaria
• Ending preventable maternal and child deaths
• Increasing access to and use of family planning
MEASURE Evaluation PIMA
To strengthen health systems and improve the quality
and use of data in Kenya for the sustainable delivery
of quality services

6. MEval-PIMA and HISS model
Mapping
MEASURE
Evaluation PIMA
interventions by
key HISS model
components

7. Creating an enabling environment
for HIS
HIS governance and leadership
• Targeting the leaders and political elite
• Policy advocacy
• Governance and stakeholder coordination forums
• Nurturing partnerships
• Targeted support to institutions of coordination,
planning, and follow-up

8. Creating enabling environment
for HIS
HIS management
• Direct funding for HIS development
• Leveraging resources for systems support
• Building capacity of health workers (training, on-
the-job training)
• Support to continuous education
• Promotion of best practices in data/information
management

9. Information generation
Strengthening data sources
• Population-based
 Population surveys
 Vital registration
 Census
• Health institution-based
 Individual records (EMR, EHR, etc.)
 Service records (DHIS 2)
 Administrative and finance data
 Community-based data
Aim at systems integration

10. Information generation
Data management practices
 Data to information (databases, analysis,
storage and dissemination)
 Skills development and transfer through
mentorship
Development of information products
 Dashboards
 Score cards for RMNCH
 County profiles

11. HIS performance
• Assessment tools development
• Baselines, ongoing joint stakeholder reviews, evaluations
• Data quality improvement
 Data quality and systems audits/assessments
 Data quality SOPs
 Health worker training (including refresher training) and
mentorship
• Data use
 Information products, data visualization
 Capacity in access/data mining and use of information

12. External factors
• Shift in priorities (USAID and host
government)
• Global initiatives (i.e. SDGs)
• Governance and political situation
(i.e. devolution of government)
External factors bring opportunities to
improve HIS

13.  Measurement approaches (methods, tools and processes)
i.e., MECAT tool
 Diagnostics: Actual data and reports available:
http://www.cpc.unc.edu/measure/pima/baseline-
assessments/
 SOPs, guidelines, and curricula
 Strategic direction for national programs and counties
 Improved functionality of health systems (CRVS, referrals
and linkages, child protection)
 Leveraging of resources (stakeholder coordination, joint
planning)
Select MEval-PIMA contributions
to HIS

14. Priorities for the future
Photo:YvonneOtieno,MEASUREEvaluationPIMA

15. Enabling environment
HIS/M&E systems ownership and sustainability
• Host government institutional commitment
for HIS/M&E (i.e., funding HIS)
• Demand for health informatics (HI), a case
for value addition, incentives for demand
• Stakeholder engagement and coordination
to support and use HIS/M&E

16. Information generation
• Sustainable health worker (HW) capacity
building
 Cost-effective ways of building HW
capacity in HIS and M&E (re: pre-
service, virtual training, thresholds,
cascade approaches, partnerships with
local institutions)
• Use of technology in collection, analysis,
transmission, storage, and use of data
 Taking it to scale

17. HIS performance
Prioritizing performance reviews, evaluations, and
learning in HIS/M&E
• User-friendly performance measurement
approaches, indicators, and tools
• What interventions have the greatest impact
on HIS/M&E?
• Continuous learning and improvement
• Innovative ways of documenting and
disseminating what works

18. MEval-PIMA Kenya staff

19. MEASURE Evaluation PIMA is funded by the United States Agency
for International Development (USAID) through associate award
AID-623-LA-12-000001 and is implemented by the Carolina
Population Center at the University of North Carolina at Chapel Hill,
in partnership with ICF International; Management Sciences for
Health; Palladium; and Tulane University. Views expressed in this
publication are not necessarily those of USAID or the United States
government.
www.measureevaluation.org