7 October 2005 1

The Health Information Systems in Tanzania

ByFaraja Mukama

7 October 2005 2

Presentation outline

Health care structure and HMIS

Collected information

Working situation: Problems

Problems: Effects to the HMIS

HISP ideas

7 October 2005 3

Health care stucture & The HMIS

Flow

of plans and resources

Flow

of information Governmental

Hospitals, Health centers, Dispensaries

Health facility level

Private and NGOsHospitals, Health

centers, Dispensaries

Village (community) level(VHW, TBA, CBD)

National level (MoH)

Regional level

District level

Flow of referral information

Dispensary

Health center

District hospital

Regional hospital

Consultant hospital

7 October 2005 4

Collected information

Main source: Routine health care - Outpatients

- Inpatients

- Mother and Child Health (MCH): immunization, family planning, weighing, antenatal services

- Community outreach: Working with Village Health Workers (VHW), Traditional Birth Attendants (TBA), Community Based Distributors (CBD)

Additional: Survey data

7 October 2005 5

Data collection and reporting

Originating at the health facility level- Routine health care activities

Using HMIS designed registers and forms - Twelve registers in total - Tally sheets: children vaccination Using Vertical programmes forms: e.g. TB, Dental careReporting to the higher level in the hierarchyManually at the health facility level, computerized at District (started in novemeber 2004), Regional and National level.

7 October 2005 6

Report preparation – Health facility level

Filling a number of forms in duplicate within the Reporting

book Book 10

Individual headsfor MTUHA in

different programmes in a particular health

facility

Head of MTUHA in a particular Health facility

Individual headsfor MTUHA in

different programmes in a particular health facility

MTUHA report preparation at the health facility

Totalizing data in the OPD register

Book 5

Totalizing data in the Antenatal care register

Book 6

Summarizing data in the Health facility Data book

Book 2

Totalizing data in the Deliveries register

Book 12

Totalizing data in the Dental register

Book 11

Totalizing data in the Community register

Book 3

Totalizing data in the Ledger

Book 4

Totalizing data in the department

sheets

Totalizing data in tally sheetsF201-F204

Totalizing data in the Diarrhea cases register

Book 9

Totalizing data in Family planning register

Book 8

Transcribing the data from theHealth facility Data book to the

Reporting bookBook 10

Totalizing data in the Child register

Book 7

Note: I assume that the particularhealth facility provides all the servicesrequired in the reports. Most of the health facilities provides some of the services

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7 October 2005 7

Report prepartion at the district level – Before computerization

MTUHA report preparation at the district level

Responsible MTUHA health worker at the district

Reports from the health facilities

Recording Quarterly Reports

Sorting reports into the type of health facility

e.g. hospital or dispensary

Recording Notifiable diseases

Recording staffing and equipment and

physical structure

Recording Annual reports

District Processing File

Recording the Health facilities' details e.g. code

number and type and date of reporting.

Aggregation into an overall district report on Notifiable disease

Aggregation into an overall district report

on staffing and equipment and physical structure

Aggregation into overall district quarter report

Aggregation into overall district annual report

Group of responsible MTUHA health workers

at the district including the DMO or DNO

Note: Some of the data (reports) are being sent directly to the region, that is, without being processed or aggregated at the district, some of which are being sent monthly, for example, laboratory data which are mainly from hospitals. A detailed annual report from the health facility (individual health facility) is sent to the regional together with a summarized (overall district) annual report

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7 October 2005 8

Working Situation: Problems

Lack of resources or disproportional distribution of resources - human - material: tools for data analysis, storage tools

(folders) including transport

Lack of data collection and managerial skills- No regular training

Late receiving of data collection tool from the MoHPoor/lack of supervision and feedback

7 October 2005 9

Problems: Effects to the HMIS

gaps in data collectionpoor (minimal) analysis of datapoor data quality Late reporting resulting in incompleteness of reportsminimal use of information- Information flows reflecting the requirements of

higher levels, without addressing the local level’s information needs

7 October 2005 10

HISP ideas

Support decentralization

Build local information culture- addressing fragmantation of data

- a software for data analysis and reporting

- through training health workers

7 October 2005 11

MCH section: Children Weighing

7 October 2005 12

Dispensary Outpatient section: Patients in a queue

7 October 2005 13

Data storage

7 October 2005 14

Data storage

7 October 2005 15

Thanks