Presented at the Nigeria MEASURE Evaluation End-of-Phase-III Event in June 2014.

1. Improving the National Health
Information System through
the development of a Master
Facility List
Olusesan A. Makinde & Azeez Aderemi
MEASURE Evaluation & Federal Ministry of
Health, Abuja
MEASURE Evaluation
End-of-Phase-III Meeting, June 18, 2014

2. Outline
 Introduction – System/ HIS/
NHIS
 Importance of Master Facility
List (MFL)
 Development of the MFL

3. What is a System?
 a set of things working
together as parts of a
mechanism or an
interconnecting network; a
complex whole (Google).

4. What is a Health Information System?
 ‘described as “an integrated effort to
collect, process, report and use health
information and knowledge to influence
policy-making, programme action and
research” (WHO, 2000)

5. The National Health Management
Information System
 Established in the 80s following a
yellow fever outbreak and has
subsequently undergone several
revolutions
 FMOH adopted the DHIS in 2006.
Upgraded to the Version 2, a web
enabled platform in 2012 developed on
a Java enabled platform

6. Where we were
 Fragmented (Disjointed, broken, split,
uneven, scrappy) = Dis-integrated
 Project/ Organization/ Donor focused
information systems
 Turf protection

7. Confusing System Complexities – Source HMN

8. Consequences
 Inability to achieve the potentials
attainable
 Varying statistics from different
government agencies (Depends on who is
asked)
 High cost of running information systems
with significant duplication of effort
 Overburdening of staff at health facilities

9. Where we are
Where we
were few
years ago
Ideal
situation/
Where we
want to be
Where
we are

10. Where we want to be
 Country led and owned system
 Single, Harmonized and Robust Information
System
 Health Information System that provides the data
needed for efficient decision making and guides
investment in health.
 Scalable and Interoperable health information
system

11. How do we get to where we want
to be?
 Standardization one of which is the development
of a Master Facility List (MFL) and the allocation
of National Provider Identifiers (NPIs) to each
health facility
 Embrace best practices as advised by the 66th
World Health Assembly Resolution on e-health
on standardization and interoperability

12. The HMN Framework – Source is
HMN
Data Sources Integrated Health Information System
Policies, Resources and Processes
Census
Civil
Registration
Population
Surveys
Individual
Records
Service
Records
Resource
Records
HIS Actors
Using Evidence for
Decision Making
Senior Country Official
National Public Health Official
International M&E Officer
District Health Manager
Senior Country Official
Facility Health Officer
Civil Society
Integrated
Data
Repository
Extract
and
Integrate
Data
Allocated Length-Of-Stay Utilization
0
100
200
300
400
500
600
700
Patients
Status 143 221 412 574 325 172 68 145
25% 50% 75% 100% 125% 150% 175% 200%
Allocated Length-Of-Stay Utilization
0
100
200
300
400
500
600
700
Patients
Status 143 221 412 574 325 172 68 145
25% 50% 75% 100% 125% 150% 175% 200%
Dashboard,
Reports,
Queries,
Events & Alerts
Routine and Non-Routine
Data Collection Activities

13. What is a Master Facility List?
 A Master Facility List (MFL) is a complete listing
of health facilities in a country (both public and
private) and is comprised of a set of identification
items for each facility (signature domain) and
basic information on the service capacity of each
facility (service domain). The signature domain
makes each health facility unique. (WHO, 2012)

14. The Nigerian MFL
 The MFL defines the standard for health facility
identification in the country and across
information systems.
 Developed between 2011 and 2013
 An improvement of the different lists in the
country

15. Process for the collation
of the Nigerian MFL

16. Components of the Codes in the MFL
Code Area Description Character Length
State 01-37 2 characters (AA)
LGA 01-44* 2 Characters (BB)
Health Facility
Ownership
(1)Public (2) Private 1 Character (C)
Health Facility Type (1)Primary (2) Secondary
(3) tertiary
1 Character (D)
Unique LGA level
Serial Number
0001-9999 4 Characters
(EEEE)

17. MFL Characteristics
 A unique National Provider Identifier (NPI) is
written as AABBCDEEEE (10 characters)
 Information System developers advised to create
this as a text/ string variable in order to keep the
leading “0” for some codes

18. The Published MFL

19. Importance of the MFL
 National standard for health facility
identification
 Links health facilities across different
information systems
 Sampling frame
 Service distribution by location

20. Drawbacks and Risks of the current
MFL
 Developed as a snapshot
 Electronic platform deployed before its
development
 Matching of NPIs in MFL with the DHIS has been
slow and difficult – only 3 states have been
successfully matched so far and submitted to the
FMOH
 Other information systems springing up with
another health facility identification process

21. Next Steps
 Migration of MFL codes onto an electronic
platform
 Creation of a MFL interphase application that can
interact with the Routine Health Information
System/ DHIS, Human Resources Information
System, Logistics Management Information
System and Financial Management Information
System

22. Acknowledgements
 Dr Akin Oyemakinde (FMOH)
 Mr Duke Ogbokor (USAID)
 Mrs Wura Adebayo (FMOH)
 Mr Bimbo Abioye (FMOH)
 Mr Samson Bamidele
 Dr Kola Oyediran
 Dr Bolaji Fapohunda
 All committee members, FG, states and LGA officers
who contributed to the success of the effort

23. THANK YOU
FOR
LISTENING