Presented by Theo Lippeveld, MD, MPH, Senior HIS Adviser for the Bhutan Health Data Collaborative meeting in June 2016.

1. Strengthening Routine Health
InformationSystems(RHIS):
StrategicDirections
Theo Lippeveld, MD, MPH, Senior HIS Adviser
MEASURE Evaluation
June 22, 2016
Bhutan Health Data Collaborative meeting

2. MEASURE Evaluation (Phase IV)
• USAID-funded project
2014 to 2019
• Focus on HIS
strengthening and more
particularly RHIS

3. Mission of MEASURE Evaluation IV
MEASURE Evaluation provides technical leadership and
advocacy to reform, strengthen and evaluate national
health information systems (HIS) and routine health
information systems (RHIS) in low- and middle-income
countries (LMIC) for the purpose of continuous and
sustainable improvement of health system performance.

4. Administrative
records systems
(NHA, etc.)
Services
records
systems
Individual
records
systems
Pop-based
surveys
Vital
registration
Census
Population-based
data sources
Health institution
facility- and community-based
information system (HIBIS)
Health Information System: Data Sources

5. The Role and Importance of Decentralized
Routine Health Information System (RHIS)
• Facility-based and ideally also community-based
• Main source of information for (daily) planning and management of
quality health services at district level and below
• Coverage and quality of health interventions
• Disease surveillance
• Commodity security
• Human resource management
• Financial information systems
• Eventually also feeding information into national and global levels
(but not its primary role)
• Ideal support to integrated management of health interventions

6. RHIS Subsystems Jargon
AKA Health Facility and Community-Based HIS
• Individual record systems (facility- and community-based)
• Paper-based records
• Electronic medical records (EMR)
• Service record systems
• Health management information systems (HMIS)
• Facility- and community-based
• Public – private – parastatal
• Laboratory and imaging information systems (LIIS)
• Disease surveillance information systems
• Resource record systems
• Financial management information systems (FMIS such as National Health
Accounts -- NHA)
• Human resource information systems (HRIS such as iHRIS)
• Logistics management information systems (LMIS)
• Infrastructure and equipment management information systems (IEMIS)
6

7. Current Context of RHIS in LMIC
• Fragmentation of health (services) systems and (R)HIS
• Limited use of validated, standard tools
• Inadequate resources for RHIS (people and $$)
• Inadequate collaboration/partnership among stakeholders for
HIS best practices
• Limited research on HIS performance and improvement

8. Global Opportunity for RHIS Strengthening in LMICs
• Call for Action by the Measurement and Accountability for Health
Summit (Washington, DC, June 2015)
“Maximize effective use of the data revolution, based on open
standards, to improve health facility and community information
systems, including disease and risk surveillance and financial and
health workforce accounts, empowering decision makers at all levels
with real-time access to information.”
• Establishment of the Health Data Collaborative in March 2016 led by
USAID, WHO, and the World Bank

9. RHIS Strengthening: Strategic Approaches
1. Participate in complex, multi-stakeholder RHIS initiatives to
promote well-structured, standardized, and integrated
RHIS at all levels of the health system
2. Organize capacity building for countries, teams, and
individuals
3. Identify and exploit leverage points in system design and
implementation
4. Establish advocacy and knowledge management networks
to promote best practices and tools around the
organization of RHIS

10. RHIS Strengthening: Illustrative Interventions
• Developed standards and harmonized tools for RHIS assessment
and strengthening in close collaboration with WHO/Geneva
• Developed a standard RHIS curriculum which was pilot tested in
India
• Assists countries to implement PRISM assessments to measure
RHIS performance
• Established AeHIN focus group on RHIS strengthening and
advocacy

11. This presentation was produced with the support of the United States Agency for
International Development (USAID) under the terms of MEASURE Evaluation
cooperative agreement AID-OAA-L-14-00004. MEASURE Evaluation is
implemented by the Carolina Population Center, University of North Carolina at
Chapel Hill in partnership with ICF International; John Snow, Inc.; Management
Sciences for Health; Palladium; and Tulane University. Views expressed are not
necessarily those of USAID or the United States government .
www.measureevaluation.org