STRATEGIES FOR PERMANENT ACCESS TO SCIENTIFIC INFORMATION IN

STRATEGIES FOR PERMANENT ACCESS TO SCIENTIFIC INFORMATION IN SOUTHERN AFRICA: FOCUS ON HEALTH AND ENVIRONMENTAL INFORMATION FOR SUSTAINABLE DEVELOPMENT AN INTERNATIONAL WORKSHOP 5 -7 SEPTEMBER 2005 CSIR CONVENTIONCENTRE, PRETORIA, SOUTH AFRICA

UTILIZATION OF HEALTH INFORMATION IN NAMIBIA FOCUS ON CHALLENGES AND OPPORTUNITIES FACED BY HEALTH CARE DELIVERY SYSTEM DR. L. HAOSES-GORASES Ph. D, M Cur, Hon Cur, BA Cur, Adv. Univ. Dipl. in CHN & Education

INTRODUCTION • • 2001 Population Census – 1. 830, 330 Population 1. 830, 330 -2001 Housing Census Annual growth rate 2. 6% Surface area 824, 116 km 2 Average 2 persons per km 2 People spread unevenly across the country Urban 33% Rural 67% (SSS 2004)

NAMIBIA BY REGION

BACKGROUND HIS under Epidemiology Division n Collect routine data – all health facilities (clinics, health centres & hospitals) Aim: n Analyze n Documentation n Disseminate – planning n Direct changes in policies n Improve monitoring performance n Identify support needs n

KEY PLAYERS n n n n Mo. HSS & Central Bureau of Statistics (CBS) Major surveys & census Data duplications occurring With new developments new programmes on board Prevention of Mother to Child Transmission (PMTCT) Anti Retroviral Treatment (ART) Voluntary Counseling & Testing (VCT)

CONTINUE n n n Health Information System developed in 1990 after independence Many challenges –improvement in the past years In 2004 and 2005 situation analysis and comprehensive assessment of the system

OBJECTIVES To improve individual and institutional performance n To measure quality and efficiency of the strategies in place n To compare performance over time in relation to national targets n To provide support to regions, districts & health facilities To monitor trends in: n n n Coverage Quality Effectiveness of the services Guide policy-makers for resource allocation

RECORDING PROCEDURES n n n Tally sheets Daily ward census Monthly summary forms E-mail Floppy diskettes from regional to national level

CONTINUE n n n n Information covers indicators on: Human resources Population Health facilities Financing Directive in terms of MDG’s Information only from: Public and mission health facilities

QUALITY OF THE DATA n n Training of staff Computerized system E-mail functioning (80%) Floppy diskettes also introduced

SOURCES OF DATA n n n Located in different directorates Directorate Planning & Human Resources (MIS) Central Bureau of statistics in National Planning Commission (Census, vital events) Ministry of Home Affairs (registration birth, deaths, immigrants etc. ) Discussions for 3 rd national statistic plan

STRENTHENING OF HIS n n n Revision in 1994 New forms introduced in 1995 Revised again after five years International standards ICD-10 included

DECENTRALIZATION/ COMPUTERIZATION n n n All 13 regions 33 districts (computerized) To improve channels of processing of the data: Health facilities to district, regional and national level Telephoning instant training ICD-10 for coding purposes (IP)

INTRODUCTION OF STANDARD REGISTERS n n n Outpatient Department (OPD) Inpatient Department (IPD) Antenatal Care (ANC) Expanded Programme on Immunization (EPI) Legal records Reference manuals are available

INTERNATIONAL PARTNERS ROLE n n Investing in specific programmes GF, USAID, FHI, CDC, PEPFAR UN AGENCIES (Malaria, TB, HIV/AIDS) Reporting circles UN agencies support the health service e. g. Country Response Information System (CRIS)

REGULARLY & LEGAL FRAME WORK n n n Facility Act – draft Health Act –draft Consolidate information from private health facilities & other stakeholders

STRATEGIES n n n n CBS conducts surveys & household census Ministry of Home Affairs generates info on births, death and immigration Integrated disease surveillance system collects info on notifiable diseases such as: Measles Neonatal Tetanus Polio (AFP) etc NDHS scheduled for 2006 (every five years)

INFORMATION MANAGEMENT Several sets: n Health indicators used for: Planning Resources allocation Monitoring & evaluation n Compiled at district to regional and national n Data cleaned at all levels & actions taken n Several data bases coming up n Development partners choice n MOHSS is constantly updating it’s website – new version to be release this year n SPSS, EPI-INFO & Microsoft Access in used

AVAILABILITY OF SOUND HEALTH STATISTICS n n Strength (quality) of the data assessed Statistical techniques examined Major elements (domains) n n n Health profile of the population Risk factors Service coverage Factors influencing data n n n Timeliness Representativeness Periocity Consistency 65% info readily available

2004 SENTINEL SURVEY

UTILIZATION n n n Vital vehicle – M & E Reprogramming Planning Development of policies/guidelines Setting of priorities

NATIONAL HEALTH STATISTICS, 2005 Domain Indicator Score (%) Health status Overall score (mean) 65 Child mortality Maternal mortality Adult mortality Causes of death in children HIV prevalence TB incidence Underweight in children Obesity in adults 73 55 50 41 75 78 87 0

CONTINUE NATIONAL HEALTH STATISTICS, 2005 Domain Health service coverage Indicator Measles coverage Skilled birth attendant TB treatment DOT Proportion of children sleeping under bed nets Score (%) 83 70 83 50

CONTINUE NATIONAL HEALTH STATISTICS, 2005 Domain Indicator Score (%) Risk factor Smoking prevalence Condom use at higher risk sex Improved water supply 78 68 Total health expenditure (per cap) Health worker density 63 System 87 76

CHALLENGES n n n n Turn-over of staff/training Timeliness – info – national level No designated staff at district level Computer – literacy lacking Info – private sector not available Development partners agenda Coordination of the systems Involvement of top level management

OPPORTUNITIES n n n n Strengthening/coordination of system Capacity development Completion of facility & Health Act Capitalize on development partners’ support to strengthen lower levels Regional collaboration/expertise (SADC, WHO etc). Development of critical mass in the region e. g. WHO, SADC etc. Availability of expertise in the SADC region

CONCLUSION n n n Key constituencies to form coordinating mechanism Designated staff at district level Mobilization of resources by all stakeholders Involve policy-makers (vital tool) Country needs driven system Indicators to match with National Development Plan

CONTINUE n n n Train staff on computer literacy on HIS Involvement of policy makers and stakeholders for better understanding & support Computer back-up system at regional level Facility and Health Acts be finalized and implemented Sustainability of HIS address Horizontal learning (regional expertise)

NB! n n n HIS is serving as a vital instrument in our health service delivering system It is directing the Mo. HSS in identification of shortcomings (revision of the system, adjusting of the indicators, software etc. Strengthening at all levels Make information available in a user-friendly manner Proper utilization of the system

CONTINUE n n HIS is reporting on diseases targeted for eradication and elimination (e. g. Polio (80% WHO) Measles and Neonatal Tetanus HIS is in high demand by sectors – positive move Thank you!!!