HIS Lec – HMIS Monitoring and Evaluation
Partnership (IHP+); international in scope
HMIS
- goal: to generate information
- ex: conduct research, interview concerned individuals or
stakeholders, summarize the health statistics
- this information is used to influence health care management
decisions
- these decisions may be done by the national secretary of
health, the different regional health directors or center for health
development (CHD) directors, hospital administrators, city
municipal or any other local health units or health offices
- composed of things to be done with the intention or objective of
generating information, of coming up with information to
influence the decisions being made with regards to health care
management
- collection of information with the ultimate goal of influencing
future healthcare programs
- monitoring and evaluating must be done to learn from the
mistakes of the activity
- must collect data as many as it can to incorporate them to
make future programs more successful
HMIS Monitoring & Evaluation
- HMIS M & E aims primarily at assisting in the planning and
management of national health strategy plans
- monitoring: refers to the collection, analysis, and use of
information gathered from programs for the purpose of learning
from the acquired experiences
- being done concurrently while the plan is being done
- once the plan is going on, start collecting, analyzing the data
and perform the initial summary of the data
- it is not good to only collect or analyze data after the plan or
activity is finished because memory is fickle or unsure
- very important to collect the data as the activity is going
- take those information down to not forget them
- if evaluation is only performed and not monitoring, there may
be certain information that will skip because it won’t be able to
recall them during evaluation
- evaluation: objective is to gauge the effectiveness of the
program so that adjustments can be made in areas that need
improvement
- can be performed once the plan has already finished/done
- the timeline has already elapsed
- functions:
1. Learning function: lessons learned need to be incorporated
into future proposals
- the program is good but there were some things that weren’t
able to anticipate resulted into an unsuccessful program
- the program has no problem at all but the problem lies on the
conduct of the program
2. Monitoring function: concerned partied review the
implementation of policy based on the objectives and resources
- there’s a re-visitation of the program itself; the problem is the
program not only the conduct
- time to change or overhaul the entire program to avoid
mistakes in the future
- pinpoint areas that has to be improved areas where it thinks
were deficient
- note all the problems that are able to encounter so that it will
be able to prevent them from happening again in the future
Note:
- monitoring and evaluating are both important components of
management
- management doesn’t end with doing or actualizing the plan
- it is important that while the plan is being done, it being
monitored
- after the plan has been performed, it must be evaluated
M&E Framework
- derived from the Paris Declaration and the International Health
- places health strategy and related M&E processes of each
country at the center
- before it is given, the latter should provide documents
supporting their claim of needing help or aid assistance
- 4 components:
1. Indicator domains: serve as a checklist or criteria in
determining whether there are problems when it comes to
health in a certain country; very specific checklist
2. Data collection: the health department can collect data
based on the indicators that will be checked
3. Analysis and synthesis: after data collection, it will be
analyzed and synthesized
4. Communication use: the analyzed or synthesize will be
communicated to the president, people, and countries in the
event that they need help
M&E and HMIS Indicators
Indicator: a variable which measures the value of the change in
units that can be compared to past and future
- can determine whether the plan is successful or not
- quantifiable characteristics for describing the health of a
population
- used to monitor key aspects of health systems performance
- how health professionals make use of these indicators in their
day-to-day work
- mortality: deaths/population x 100; rate of death in a
population
Categories of HMIS Key Indicators
- the United States Agency for International Development
(USAID) classifies these indicators into 5 broad categories:
1. Reproductive health: general and hard to determine what
information should one get to determine the state of RH in the
country
- family planning acceptance rate
- antenatal care coverage
- proportion of deliveries attended by skilled health personnel
- proportion of deliveries attended by health extension workers
2. Immunization:
- DPT-3 (Pentavalent-3) coverage (>1 child)
- measles immunization coverage (>1 child)
3. Disease prevention and control:
- malaria case fatality rate among patients under 5 years of age
- new malaria cases per 1,000 population
- new pneumonia cases among children under 5 per 1,000
population of <5 years
- TB case detection rate
- TB cure rate
- clients receiving voluntary counseling and testing (VCT)
services
- prevention of mother-to-child transmission (PMTCT) treatment
completion rate
- persons living with HIV/AIDS currently on antiretroviral
therapy
4. Resource utilization:
- trace drug availability (in stock)
- OPD attendance per capita
- in-patient admission rate
- average length of stay (in-patient)
- bed occupancy rate (# of patients / # of beds x 100)*
5. Data quality:
- reporting completeness rate
- reporting timeliness rate
HMIS Indicators and Health Programs
Health program: set of activities intended to promote health,
wellness, and fitness of a target sector or population (e.g.,
maternal intervention, child mortality and child survival
intervention, and stop TB program)
- HMIS: a source of routine data necessary for monitoring UN high-level meeting on TB: targets for increased funding
different aspects of various health programs implemented in a 1. Universal access to TB prevention, diagnosis, treatment
country and care:
- HMIS indicators must be carefully selected to: - target: US$ 13 billion annually by 2022; US$ 6.5 billion in 2020
1. Meet the essential information necessary for monitoring the 2. TB research:
performance of various health programs, services - target: US$ 2 billion annually 2018-2022; US$ 906 million in
- ensure that the indicators will give the information that are 2018
required or needed to determine the actual performance of the
health programs and services
2. To present an overview of available health resources
Stop TB Program (STP)
- goal: to dramatically reduce the global burden of tuberculosis
by 2015 (in line with WHOs Millennium Development Goals)
- TB: one of the most lethal diseases (top 10 killers worldwide)
- main objective of the program: achieve universal access to
high-quality care for all people with TB (including those co-
infected with HIV and those with drug-resistance)
- core: TB case detection + successful completion of the
treatment/cure of TB
- all people with TB can be detected and if they are, they must
makes sure that the treatment are completed
- the treatment for TB lasts for a few months (require taking of
antibiotics to combat TB); monitored from time to time
- thus by 2050: reduce prevalence of and deaths due to TB by
50% compared with the 1990 baseline
HMIS Indicators: Stop TB Program
1. TB patients on DOTS (number of new smear-positive
pulmonary TB cases enrolled in the cohort)
- program of DOH to allocate free medications to people who
tested positive or have TB
- all new cases of TB must be enrolled to this to be monitored
- their addresses will be noted so that they will be visited by
health workers from time to time to monitor if they taking their
medications or not
2. TB case detection (number of new smear-positive pulmonary
TB cases detected, number of new smear-negative pulmonary
TB cases detected, number of new extra-pulmonary TB cases
detected)
3. HIV-TB co-infection (proportion of newly diagnosed TB cases
tested for HIV); TB as a leading co-infection of HIV
- checking whether TB is an independent disease or due to the
HIV
4. HIV + new TB patients enrolled in DOTS (directly-observed
treatment, short-course) along with those people who only have
TB and no HIV
5. TB treatment outcome (treatment completed PTB+, cured
PTB+, defaulted PTB+, death PTB+)
Overview of progress towards global TB targets
- acquired from the 2020 TB WHO Report
- the centre of each circle shows the target, the color coding
illustrates the progress made and the text to the right of each
circle quantifies the status of progress (by the end of 2018,
except for funding)
SDGs and End TB Strategy: targets for reduction in the TB
incidence rate, TB deaths and catastrophic costs
1. TB incidence rate:
- target: 20% reduction 2015-2020; 9% reduction on 2015-2019
2. Number of TB deaths:
- target: 35% reduction 2015-2020; 14% reduction 2015-2019
3. Percentage of people with TB facing catastrophic costs:
- target: 0% by 2020; 49% of people with TB face catastrophic
costs
UN high-level meeting on TB: targets for the number of people
provided with TB treatment and TB preventive treatment
1. TB treatment:
- target: 40% million 2018-2022; 14.1 million treated in 2018-19
2. TB preventive treatment:
- target: 30 million 2018-2022; 6.3 million treated in 2018-19