HIS Strategic Plan 2009-2014, 05.08

REPUBLIC OF KENYA
HEALTH SECTOR
STRATEGIC PLAN FOR
HEALTH INFORMATION SYSTEM 2009-2014
MINISTRY OF MEDICAL SERVICES AFYA HOUSE P.O. BOX 30016- NAIROBI
MINISTRY OF PUBLIC HEALTH AND SANITATION AFYA HOUSE P.O. BOX 30016- NAIROBI
HIS Strategic Plan 2009-2014
TABLE OF CONTENTS
ACRONYMS......................................................................................................................................................................... iii GLOSSARY ............................................................................................................................................................................iv FOREWORD .........................................................................................................................................................................vi ACKNOWLEDGEMENT ................................................................................................................................................... vii EXECUTIVE SUMMARY.................................................................................................................................................. viii CHAPTER 1: INTRODUCTION ..........................................................................................................................................1
1.1 1.2 1.3 1.4 2.1 2.2 2.3 2.4 2.5 2.6 3.1 4.1 4.2 4.3 5.1 5.2. 5.3 5.4.
Background .................................................................................................................1 Purpose/Rationale for HIS Strategic Plan.....................................................................1 Approach and Methodology for developing the Strategic Plan .....................................2 The Organization of the Strategic Plan.........................................................................2
HEALTH INFORMATION SYSTEM (HIS) .........................................................................................3
CHAPTER 2:
Definition of HIS ........................................................................................................3 Primary objectives of HIS............................................................................................3 Current HIS Subsystems ..............................................................................................4 Health Information System (HIS) Data Sources ..........................................................4 Users of Health Information........................................................................................5 Institutional Review of HIS .........................................................................................5
SITUATIONAL ANALYSIS REPORT ....................................................................................................8
CHAPTER 3:
Introduction .................................................................................................................8 Vision, Mission and Mandate Statements...................................................................10 Key Strategic Issues, Strategic Objectives and Strategies ...........................................10 Strategic Objectives ...................................................................................................11 Staffing Level and Requirements ...............................................................................15 Organizational Structure ............................................................................................15 Roles and Responsibilities .........................................................................................18 Budgetary Requirements............................................................................................20
CHAPTER 4: STRATEGIC MODEL AND ANALYSIS OF STRATEGIC ISSUES............................................................ 10
CHAPTER 5: STRATEGIC IMPLEMENTATION ............................................................................................................ 15
CHAPTER 6: MONITORING AND EVALUATION FRAMEWORK ...............................................................................22 CHAPTER 7: STRATEGIC IMPLEMENTATION MATRIX ............................................................................................24 ANNEX 1: Literature Reviewed ............................................................................................................................................43 ANNEX II: List Of Technical Working Group .....................................................................................................................44 ANNEX III: His Policy And Strategic Plan Stakeholders Workshop At Bontana Hotel, Nakuru ........................................45 ANNEX IV: - Budget Summary For Plan Implementation...................................................................................................47
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ACRONYMS
AOP AWP AMREFAfriAfyaCHISCSO CSCHAK DHMTDPM DHS DSSEHRS FBOFIS FTPGoK GIS HSPSHR HIS HIS TWGHMIS HMN HRIO ICT IT JPOWJHPIEGO KDHSKEPHKEC KHPF KNBS KNASP KMTC LAN M&E MDG NHISCCNHSSPNGO PEST PEPFAR PI RBMR-HFA SAM SWOT SUPKEMSOP TA TWG UNICEFWB WHO Annual Operational Plan Annual Work Plan African Medical and Research Foundation African Network for Health Management and Communication Community Health Information System Civil Society Organization Catholic Secretarial Christian Health Association of Kenya District Health Management Team Directorate of Personnel Management Demographic Health Survey Demographic Surveillance System Electronic Health Records System Faith Based Organization Financial Information System Facility Information System File Transfer Protocol Government of Kenya Geographical Information System Health Sector Programme Support Human Resource Health Information System Health Information System Technical Working Group Health Management Information System Health Metrics Networks Health Records and Information Officer Information Communication Technology Information Technology Joint Programme of Work Johns Hopkins Programme for International Education in Gynaecology and Obstetrics Kenya Demographic Health Survey Kenya Essential Package for Health Kenya Episcopal Conference Kenya Health Policy Framework Kenya National Bureau of Statistics Kenya National HIV/AIDS Strategic Plan Kenya Medical Training College Local Area Network Monitoring and Evaluation Millennium Development Goal National Health Information System Coordinating Committee National Health Sector Strategic Plan Non- Governmental Organization Political, Environment, Economic, Socio-Cultural and Technological President s Emergency Plan for AIDS Relief Performance Indicator Results Based Management Rapid Health Facility Assessment Service Availability Mapping Strengths, Weaknesses, Opportunities and Threat Supreme Council of Kenya Muslims Standard Operating Procedure Technical Assistance Technical Working Group United Nations Children Education Fund World Bank World Health Organization
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GLOSSARY Baseline:A reference point used to indicate the initial condition against which future measurements are compared
Baseline data:- A set of data collected at the beginning of the study or before intervention has occurred. Core Values Core Organizational Values are a set of beliefs that specify universal expectations and preferred modes of behavior in an institution. Core values guide the actions of everyone in the organization. Periodic assessment of the relevance, performance, efficiency effectiveness and impact of the projects activities End-term evaluation is conducted towards the end of the project to provide decision makers and planners with the information with which to review the achievements of the programme and generate lessons to guide the formulation and/or implementation of a new programme/project. Are general targets to be accomplished that are translated into actionable objectives. Broad philosophy that guides an organization throughout its life in all circumstances, irrespective of change in its goals, strategies or the top management The health information system is a comprehensive and integrated structure that collects, collates, analyses, evaluates, stores, disseminates, health and health-related data and information for use by all. It is defined as an Efficient collection, Collation, Analysis, Evaluation Strategy, Dissemination and use of Information about individual patients, population, resources used and health outcomes of intervention and the state and nature of systems through which the intervention are applied Health Metrics Network (HMN) is a global partnership that works to increase the availability and use of timely and trustworthy health information in developing countries and globally. These are goods, funds, services, personnel, technology and other resources provided for use in the activities so as to produce outputs and achieve the objectives of the project. It is defined as the ultimate effect/change (both expected and unexpected) on all stakeholders as a result of intervention within the project in the short, medium and long term. Describes why an organization exists and what it does (its mandate or basis of existence) These are activities whose achievement will determine the success of an organization in the long run.
Evaluation: End term Evaluation: Goals:Guiding Principles:HIS: -
HMIS: -
Health Metrics Network:Inputs:
Impact:-
Mission Statement:Main (Core) Activities:-
Monitoring:-
A systematic process covering routine collection analysis and use of information about how well a project/programme is going on. It involves continuous review of the performance of all the components in the project to ensure that input deliveries, work schedules, targeted outputs and other required actions are proceeding as per work-plans. It is conducted to take an assessment of how the project is performing half way through the project It is a process to identify the gaps in services and arrange them in priority order for resolution The process of setting short-range objectives and determining in advance how they will be accomplished State what is to be accomplished in singular, specific and measurable terms with a target date Outputs comprise of specific products or services, which an activity is expected to produce from its inputs. A plan for pursuing the Mission and achieving objectives It is defined as the process by which the guiding members of an organization envision its future and develop the necessary procedures and operations to achieve that future Refers to individuals, groups of people or institutions which have vested interest in an issue or matter Refers to broadest statement of what an organization hopes to achieve or to become
Mid-term Evaluation:Needs Assessment:Operational Planning:Objectives:Outputs/Results:Strategy:Strategic Planning:-
Stakeholders:Vision Statement:-
Verifiable (Performance) Performance Indicators are specific and objectively verifiable measures of Indicators: change or result brought about by an activity.
FOREWORD Since 2003 various studies have been undertaken to assess Health Information System (HIS). The findings of the assessments outlined areas that required immediate attention to strengthen HIS in the country. One of the priority areas identified was the need to develop a comprehensive Strategic Plan for HIS to guide the implementation of its activities. This Strategic Plan (2009-2014) is the first to be developed by HIS and is intended to respond to the aspirations of National Health Sector Strategic Plan II (NHSSPII), Health Sector M&E Framework, and Vision 2030. It was developed through an inclusive, participatory and consultative approach intended to ensure ownership, commitment and leadership by the key stakeholders. This document is indeed a great milestone for taking HIS ahead in the health sector to enable it provide better data to inform evidence-based decision making, better policy framework and better health. The Plan provides a roadmap and strategic direction on key priorities in line with the Health Sector Strategic Plan and articulates the agreed vision, mission, mandate and core values of HIS. It also sets strategic objectives, strategies, activities, time frame, resource requirements and assigned responsibilities for achieving expected outputs in the next five years. It is envisaged that the implementation of the activities outlined in the Strategic Plan will require a total of Kshs 1.9 billion (US $ 25.3 Million). The successful implementation of this Strategic Plan is expected to provide a basis for quality information that can be used at all levels of the health system for planning, managing, monitoring and evaluation of desired outputs. The Ministries of Health in partnership with key stakeholders will provide leadership and finance the implementation of this Plan to build one universal Health Information System for the health sector. In conclusion, we appeal to our development partners and all stakeholders to support the implementation of the Strategic Plan through collaboration and partnership to enable us achieve the strategic goal of this Plan: Establish a functional, robust, effective and efficient Health Information System.
Prof. James L. Ole Kiyiapi, CBS,

PERMANENT SECRETARY, MINISTRY OF MEDICAL SERVICES
Mr. Mark K. Bor, EBS

PERMANENT SECRETARY, MINISTRY OF PUBLIC HEALTH AND SANITATION
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ACKNOWLEDGEMENT This Health Information System (HIS) strategic plan was developed through a comprehensive consultation process, intensive health sector Health Information System assessments and detailed information gathering. The process was driven by the HIS Technical Working Group (HIS TWG) in liaison with Professional Training Consultant (PTC). We would like to acknowledge the efforts of all those institutions and individuals who participated and contributed in the development of this document. These include government ministries and Agencies, Development partners, UN Agencies, faith based organization, NGOs, and private sector. We acknowledge the Director of Medical Services and Ag. Director of Public Health and Sanitation for their leadership and stewardship, the HIS Technical Working Group (HIS TWG) members for the coordination, technical input and commitment during the process of developing the Strategic plan. We wish to thank all heads of departments and divisions, programme managers, Government parastatals (KEMRI, NHIF, KEMSA), the Provincial Directors, District Directors and Health Management Teams for their participation and invaluable inputs during the process of development. We commend the Professional Training Consultants (PTC) for their critical review and consolidation of this Strategic plan. We also extend our gratitude to Ministry of Planning and Vision 2030 (KNBS), Ministry of Immigration and registration of persons (Vital Registration), Ministry of Home affairs and National heritage (National Archives), Implementing partners (CHAK, KEC, SUPKEM, AfriAfya, AMREF, Aga Khan Health Services, Aga Khan Foundation, APHIAs, KNADS, FHI, NACC, JHPIEGO, Professional bodies (Kenya Medical Practitioners and Dentist Board, Nursing Council, Kenya Laboratory Board), training institutions (Kenyatta University, KMTC) for their participation and practical inputs in the development process. We are particularly grateful to the Health Metrics Network (HMN) Secretariat and Department for International Development (DFID) through Essential Health Services (EHS), in providing technical and financial support in the development of this strategic plan. We also appreciate the role of development partners especially World Health Organisation (WHO), DANIDA, and USAID. Finally we wish thank all those who contributed directly or indirectly to the development of this five year strategic plan.
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EXECUTIVE SUMMARY The overall policy guidance for the health sector is through the Government of Kenya Vision 2030 and the Kenya Health Policy Framework (KHPF, 1994-2010). One of the key challenges in the health sector identified in First Medium Term Plan of Vision 2030 is weak health information systems. Various weaknesses identified in the existing information systems include lack of guidelines and policy, inadequate capacities of HIS staff, lack of integration, many parallel data collection systems, and poor coordination, amongst others. Rationale for HIS strategic Plan This strategic plan is intended to respond to the aspirations of National Health Sector Strategic Plan II (NHSSPII), Health Sector Monitoring and Evaluation Framework and the Kenya Health Policy Framework envisioning Vision 2030 activities that will ensure a robust HIS to inform on progress of attainment of set targets. The strategic plan provides a roadmap and direction on key priorities in line with the health sector strategic plan. It sets the vision, mission, strategic objectives, strategies and activities of HIS. Methodology for Developing the Strategic Plan The Strategic Plan was developed through an inclusive approach and a methodology intended to ensure ownership, commitment and leadership by the key stakeholders namely Ministries of Health, Vital Registration, Kenya National Bureau of Statistics, NGOs and development partners. Desk and literature reviews were carried out. Consultations were done through meetings with the officials from Ministries of Health, Technical Working Groups and Stakeholder Workshops. Questionnaires were also posted to the sampled provinces and districts, heads of department/divisions of ministries of health, development partners and implementing partners. Interviews were also undertaken with selected institutions. Health Information System Health Information System (HIS) is defined as a comprehensive and integrated structure that collects, collates, analyses, evaluates, stores, disseminates, health and health-related data and information for use by all. The HIS, like any system, consists of parts which are interrelated, interdependent and work towards a common goal. The malfunctioning of any part affects other parts of the system. The functionality of an HIS may differ from organization to organization. In general the system is a combination of Health Information and Management Information. The system collects information on health (Morbidity and mortality statistics, Service statistics) and on management (human resources, financial, fixed assets and infrastructure, drugs and supplies logistics) and performs comparative analysis with population- based data from various surveys. The HIS is a powerful tool for making health care delivery more effective and efficient. The broad objectives of HIS are: To determine end-user information needs at the various levels of the health system. To facilitate data collection, analysis, information generation and storage. To facilitate information dissemination, feedback (horizontal and vertical) and use of information for evidence- based decision making.
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The key components of this strategic plan are:Vision Statement Be a centre of excellence for quality health and health-related data and information for use by all. Mission Statement To provide timely reliable and accessible quality health service information for evidence-based decision making in order to maximize utilization of scarce resources in the health sector. Mandate To generate, analyze and disseminate health information to facilitate effective policy formulation, management, planning, budgeting, implementation, monitoring and evaluation of health services and programme interventions in the health sector by all. Core Values Integrity: Commitment: Professionalism: Respect: Strategic Thrust Strategic thrusts are outstanding concerns that have been identified by health sector to have considerable effect on HIS. The strategic thrust identified and in line with the First Medium Plan 2008-2012 of vision 2030 is Weak Health Information System in the health sector. Consequently strategic thrust or priority of HIS is to: Establish functional, robust, effective and efficient Health Information System Strategic Objectives To improve data management To improve National Vital Registration System Enhance Capacity of HIS Staff Improve Financial Resources and sustainability Strengthening use and Application of Information and Communication Technology in data Management Improving Monitoring Feedback, Reporting, Supervising and Data Audits Enhancing Governance, Partnership, Collaboration and coordination. The staffing level required for the implementation of the plan is 4310 HRIOs, 227 ICT officers, 221 statisticians and 16 health professionals,. The estimated cost for executing the strategic plan is Kshs 1.9 billion. A comprehensive monitoring and evaluation framework will be developed to monitor and evaluate the implementation.
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CHAPTER 1: INTRODUCTION
1.1 Background The overall policy guidance for the health sector is through the Government of Kenya Vision 2030 and the Kenya Health Policy Framework (KHPF, 1994-2010). One of the key challenges in the health sector identified in First Medium Term Plan of Vision 2030 is weak health information systems. Various weaknesses identified in the existing information systems include lack of guidelines and policy, inadequate capacities of HIS staff, lack of integration, many parallel data collection systems, and poor coordination, amongst others. Overall the current HIS provides limited information for monitoring health goals and empowering communities and individuals with timely and understandable information on health and health related interventions. In view of the above weaknesses, the ministries of health, i.e. the Ministry of Medical Services and the Ministry of Public Health and Sanitation together with her partners decided that this 5 year coasted Strategic Plan for Health Information Systems be developed and institutionalized to guide the implementation of HIS activities at all levels. The Ministries are keen to play their part in improving the efficiency and effectiveness in delivery of health services by strengthening governance, decentralizing health services and management, improving resource allocation and enhancement of collaboration with stakeholders under sector wide approach. 1.2 Purpose/Rationale for HIS Strategic Plan The strategic plan is intended to respond to the aspirations of NHSSP II, Health sector M&E Framework and the Kenya Health Policy Framework envisioning the Vision 2030 activities that will ensure a robust HIS to inform on progress on attainment of set targets. The primary purpose of an HIS is to support informed strategic decision-making by providing quality data which help managers and health workers at all levels of the health system in planning and managing the health services; monitoring disease trends and control epidemics; and providing periodic evaluation towards agreed targets. The specific objective of this component is to increase the quality of management of the health system hence the need to develop a strategic plan. A functional HIS Strategic plan provides a basis for quality information that can be used at all levels of the health system for planning, managing, monitoring and evaluating activities and gauging progress to desired outputs. In summary the plan provides strategic directions in the following areas: Providing a roadmap and direction on key priorities in line with the health sector strategic plan. The plan sets the vision, mission, strategic objectives, strategies and activities of HIS. Further, costed strategic plan forms the basis for monitoring and evaluation of planned activities and creates a mechanism for monitoring and evaluation for the health sector. The coasted plan constitutes a pivotal tool for resource mobilization. Improving quality of health information by providing information that has a high degree of consistency, accuracy, timeliness and completeness. Supporting evidence-based decision making by providing appropriate information that facilitates knowledge based decisions in order to effect change in individual behavior, patient care, administration, research and education and to monitor and measure health outcomes.
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1.3
Approach and Methodology for developing the Strategic Plan The Strategic Plan was developed through an inclusive approach and a methodology intended to ensure ownership, commitment and leadership by the key stakeholders namely Ministries of Health, Vital Registration, Kenya National Bureau of Statistics, NGOs and development partners. It is recognized that a properly organized health information system is a prerequisite for efficient administration of health services and hence the need for using a participatory and consultative approach in developing the Strategic Plan. Desk and literature reviews were carried out. Consultations were done through meetings with the Client, Technical Working Groups and stakeholder Workshop. Questionnaires were also posted to the sampled provinces and districts, heads of department/divisions of ministries of health, development partners and implementing partners. Interviews were also undertaken with selected institutions. The key steps of the methodology included; Confirmation of the vision, mission and core values SWOT analysis to confirm the relevant internal and external factors that impact on the performance of the Division/Departments of HIS Identification of key challenges which HIS department will need to specifically respond to as part of its strategy. Identification of key priority areas that the ministries will focus on during the strategy period Preparation of Action Plans for each priority area In adopting the HMN methodology for preparing a strategic plan, the steps used for the preparation of the strategic plan included analysis of HIS assessment reports and identification of areas which required priority attention in health systems domains. The second stage was working with Technical Working Groups in the confirmation of strategic objectives, strategies and activities. The final stage was through preparation of an implementation matrix and costing. The results of the above stated reviews and analysis generated appropriate data and formed the basis for the development of HIS Strategic Plan for the period 2009-2014.
1.4
The Organization of the Strategic Plan This Strategic Plan document is set out in six chapters. Chapter One has an introduction covering the background, purpose and rationale for HIS strategic Plan and approach and methodology for developing the strategic plan. Chapter Two gives an overview of HIS covering the definition, objectives, HIS data sources, users and producers of health information and challenges. Chapter Three presents the HIS Vision, Mission, Mandate, guiding principles and SWOT Analysis. Chapter Four covers strategic model and analysis of strategic issues including strategic objectives. Chapter Five gives strategic implementation arrangements covering organizational and proposed governance structures, projected budgetary requirements and strategic implementation matrix. Chapter Six presents the monitoring and evaluation framework, while Chapter Seven presents Strategic Implementation Matrix.
CHAPTER 2: HEALTH INFORMATION SYSTEM (HIS) 2.1 Definition of HIS Health Information System is composed of producers of health statistics including Ministries of Health, Kenya National Bureau of Statistics (KNBS), Vital Registration, private health institutions, research institutions, and Faith Based Organizations (FBOs), amongst others. The health information system is defined as a comprehensive and integrated structure that collects, collates, analyses, evaluates, stores, disseminates, health and health-related data and information for use by all. The value and importance of a health information system is that it supports the management of the health system whose ultimate goal is to improve and maintain the health of individuals, families and communities. HIS is considered as a system that provides health and health related information to facilitate evidence-based decision making processes at all levels of the health pyramid (Level 1 to Level 6) which are: From the level of individual patient care to the management of specific health programmes through to the policy levels where strategic decisions are made. The current levels of care in the health sector are: Level 1 = Community Level 2 = Dispensary and Clinics Level 3 = Health Centre including maternity and nursing homes Level 4 = Sub-district and District Hospitals (Primary hospitals) Level 5 = Provincial and general hospitals (secondary hospitals) Level 6 = National referral hospitals (tertiary) 2.2 Primary objectives of HIS The primary goal of an HIS is to provide the right information to the right user at the right time. It is therefore considered that properly organized HIS is a prerequisite for the effective and efficient management of health services. No HIS can afford to discourage the successful use of its information resources by producing information products that are not aligned with the needs of the user in the forefront. HIS should be developed with a careful assessment of the levels of the information generation, feedback mechanisms and use by all. The broad objectives of HIS are: To determine end-user information needs at the various levels of the health system. To facilitate data collection, analysis, information generation and storage. To facilitate information dissemination, feedback (horizontal and vertical) and use of information for evidence- based decision making. The benefits that accrue from such an HIS include: Helping decision makers to detect and control emerging and endemic health problems, monitor progress towards health goals, and promote equity; Empowering individuals and communities with timely and understandable health-related information, and drive improvements in quality of services; Strengthening the evidence-based decision for effective health policies, permitting evaluation of scale-up efforts, and enabling innovation through research. Improving governance, mobilizing new resources, and ensuring accountability in the way they are used.
Since a properly organized HIS is needed to produce information for taking action, the development of HIS strategic plan will provide clear road map for implementation of planned activities. 2.3 Current HIS Subsystems There are various subsystems in HIS. These subsystems are summarized in three categories namely population based data, management information and health services based data as shown in Fig 2.1. The sub-systems exist with their own databases with no links to the centralized HIS thus creating disjointed information systems in the health sector. Fig. 2.1 Current HIS Sub-Systems
Source:-Kenya Health Sector M&E Framework 2.4 Health Information System (HIS) Data Sources A Health Information System consists of several data sources, namely: Data collection based on patient and service records and reporting from community health workers and health facilities Data generated through household surveys Registration of vital events (births, deaths and causes of death) Disease surveillance and outbreak notification Programme specific monitoring and evaluation Administration and resource management (including finance/budget, personnel and supplies)
Population based data include census, vital registration and surveys while management information covers administrative records, and health services and disease records as shown in Fig 2.2 Fig 2.2: HIS DATA SOURCES HIS DATA SOURCES
Population Health Services MIS
Census
Surveillance
Administrative Records
Vital Registration
Service Records
Surveys
Health and Disease Records
Population- based
Health and Disease Records
Source: - HIS documents (various) 2.5 Users of Health Information At each level of the health care system, users of health information have differing needs and use information in different ways. At the most basic level of client health worker interactions, patient records are a vital source of information at the individual level, for reviews of care and norms, confidential enquiries and facility based audit reviews of provider practices At the facility level, managers need information on patient profiles, patterns of admissions and discharges, length of hospital stay, use of medicines and equipment, deployment of different categories of health care workers and ancillary staff, costs and income. At district, provincial and national level, policy makers, planners, managers and other stakeholders use this information and data on locally relevant population profiles and risk factors in decision-making regarding allocation of resources to different facilities. Within the public health sector, such information is transmitted upwards through district and provincial levels to the national level where basic resource allocation decisions are made. 2.6 Institutional Review of HIS Health Information System (HIS) in Kenya has been reviewed severally with a view of putting in place sound systems that:Provides quantitative and qualitative data which is essential for identifying major health problems
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Generates information which can be used to evaluate health policies for planning health programmes and the efficient provision and management of health services Opens up continuous dialogue and coordination between those who collect data and the users of information with the aim of improving health services. Disseminates timely information to users, including those who work in research and health administration Provides regular feedback to all personnel in the information system which helps to emphasize the important role each of them plays. Creates and maintain a health information data base at district and community levels Provides health information required for health planning, monitoring and evaluation of health programmes. 2.6.1 Existing Producers of Health Information Health Information exists at the Ministries of Health where routine health data collection is conducted through a network of community units, 6190 health facilities (Government, Faith Based, Non-governmental Organization and Private) that are distributed throughout the country. Other key health information producers are Civil Registration Department of the Ministry of Immigration, the Kenya National Bureau of Statistics, Research Institutions, and African Network for Health Management and Communication (AfriAfya) which is a consortium of seven Kenya based health development agencies. In all these institutions major support to HIS comes from development partners namely DANIDA, Global Fund, UNICEF, WHO, World Bank, DFID through STATCAP project and EHS, USAID, CDC, European Union, PEPFAR and Clinton Foundation. 2.6.2 On-going and Planned HIS Strengthening Activities Assessment reports on Health Information System identified priority actions required to strengthen HIS. These included instituting mandatory reporting from private providers and NGO facilities, building capacity for data collection at all levels, developing integrated harmonized data collection tools and conducting census of health providers. The achievements have been in the areas of harmonization and rationalization of the health sector data requirements and indicators, capacity building of Health Records and Information Officers, supply of equipment (including computers, digital mass printers, internet and communication). The current on-going strategies to improve HIS from various producers of health information are as follows: Ministries of Health:Developing HIS Software system Developing Human Resource Database Reviewing the Financial Information System Developing the Logistic Management Information System Printing data collection and reporting tools Developing HIS policy documents and strategic plan Development of standards for Electronic Health Records (EHR)
Civil Registration Registration of births and deaths at the Department of Civil Registration is still manual. However, data entry of records of births and deaths is being computerized on pilot basis. This is expected to be rolled out to cover more districts once the Pilot is over. Secondly, the Government is collaborating with Plan Kenya (International) in awareness creation on birth registration in selected districts. The Statistical Capacity Project (STATCAP) being implemented by KNBS is planning to undertake social mobilization and training in Mandera and Isiolo Districts. This is expected to scale up registration of births and deaths in marginalized rural areas. Kenya National Bureau of Statistics (KNBS) Analysis of the Kenya Demographic Health Survey 2008. The support for this activity was through the collaboration of Government of Kenya, World Bank, DFID, with technical support from Macro international Measures evaluation among others. Mapping of the districts and the enumeration areas through the support from GOK, World Bank, and DFID. Preparation for the National Census 2009 to take place in August 2009. On-going activities National Coordinating Agency for Population and Development (NCAPD) Preparation of the Service Provision Assessment (SPA). This has been proposed to take place between September and December 2009. Note: Measuring health is conceptually and technically complex, requiring statistical, public health and biomedical knowledge and expertise unique to each disease or programme area. Accurate measurement depends upon the availability of disease- specific biometric tests, clinical diagnoses and the feasibility of measuring population behaviours and the coverage of health services. As a result, health statistics may vary greatly in terms of scientific soundness, usability and timeliness.
CHAPTER 3: SITUATIONAL ANALYSIS REPORT 3.1 Introduction This section gives a summary of internal strengths and weaknesses as well as opportunities and threats to HIS which were identified The results were achieved through extensive consultations with key stakeholders by undertaking a Strength, Weaknesses, Opportunity and Threats (SWOT) analysis. The summary of the results are given in Table 3.1. Table 3.1 SWOT Analysis of HIS Internal Strengths Existence of vital registration system Regular periodic population based surveys such as KDHS (every 5 years), census (every 10 years) HIS structure and reporting system in place Technical personnel available Existing Training curriculum for health records and information staff. Provinces and Districts are proactive on HIS activities Availability of manuals and guidelines for data collection Availability of computers at national, provincial and district levels Availability of basic communication infrastructure Minimum set of indicators established Partnership arrangements in place Draft Policy document in place Availability of harmonized Data Collection Tools at all levels Internal Weaknesses Lack of clear policy guidelines and legal framework for HIS Low reporting rate below 80% Inadequate personnel Inadequate finances Unclear funding mechanism Lack of/inadequate M&E skills at all levels Inadequate provision of data collection tools at facility levels Lack of centralized data base at all levels Lack of mechanisms for enforcing use of standardized tools (data collection) Inadequate working and storage space Inadequate supply of equipments such computers, printers, calculators at all level. Inadequate Facilitative supervision Weak feedback mechanism and poor dissemination at all levels Poor coordination of HIS Activities Weak linkages and data sharing Inadequate skills development for HIS Staff. Lack of incorporation of HIS component in the various training curricula Lack of clear linkage between Health Records and information professionals and HIS which is a system. Low staff morale. Competing priorities at implementation, policy and strategy levels
External Opportunities Good working collaboration with the divisions/departments Collaboration and networking with other stakeholders Capacities built on various vertical programmes would help to roll out a better HIS Recognition and support of HIS by key stakeholders in the Health Sector Development of a national ICT policy Development of E- health policy and strategy Implementation of the HIS policy Training of HIS staff in various institutions e.g. Degree at KU Other existing strategic plans within the ministries of health Implementation of the community health information system Technological advancement
External Threats High staff turnover Poor scheme of services leading to non-retention of qualified staff Donor driven programmes and projects establishing parallel data management systems. Inconsistency in political good will Keeping pace with ICT development Global economic melt down Corruption Freeze on Employment Natural and manmade calamities Over dependence on development Partners/Donor support
CHAPTER 4: STRATEGIC MODEL AND ANALYSIS OF STRATEGIC ISSUES This chapter summarizes the agreed Vision, Mission, Mandate and Core Values of HIS The chapter also discusses the strategic issues, objectives, and strategies based on the challenges outlined in the SWOT analysis. 4.1 Vision, Mission and Mandate Statements Vision Be a centre of excellence for quality health and health-related data and information for use by all. Mission Statement To provide timely reliable and accessible quality health service information for evidence-based decision making in order to maximize utilization of scarce resources in the health sector. Mandate To generate, analyze and disseminate health information to facilitate effective policy formulation, management, planning, budgeting, implementation, monitoring and evaluation of health services and programme interventions in the health sector by all. Core Values The core values are the behavior and attitudes that will be practiced and embraced by HIS in order to create the desired culture to drive towards the vision. HIS recognizes that having the right values will result in more efficient production of quality timely and focused health data. The attributes are:Integrity: To be accountable, transparent and devoid of corrupt practices in service delivery Commitment: To devote all official time to our duties and undertake to deal with those seeking our services without unnecessary delays Professionalism: To create and maintain public trust in health statistics by acting professionally and promoting professionalism and transparency in data production and dissemination. Respect: At all times, treat people with utmost respect and courtesy and especially those that seek our services or advice. Recognize and respect the separate roles played by data producers and users at all levels. 4.2 4.2.1 Key Strategic Issues, Strategic Objectives and Strategies Strategic Issues The key strategic issues which were identified and are of relevance to the implementation of this Strategic Plan that require to be addressed are: Lack of HIS policy and legal Framework Inadequate data and data bases Inadequate personnel in absolute numbers and in skills Lack of focused training for the majority of HIS staff. Lack of integration of data at all levels Weak linkages and feedback Inadequate hardware infrastructure Inadequate supportive supervision Inadequate working and storage space
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4.2.2
Low staff morale Inadequate Finances to support HIS activities Presence of many data collection systems with poor coordination
Strategic Thrust (Priority) Strategic thrusts are outstanding concerns that have been identified by health sector to have considerable effect on HIS. The strategic thrust identified and in line with the First Medium Term Plan 2008-2012 of Vision 2030 is Weak Health Information System in the health sector. Consequently strategic thrust or priority of HIS is to: Establish functional, robust, effective and efficient Health Information System Strategic Objectives The key strategic issues identified in the HIS assessment of 2006 revolved around improving data representativeness, quality of data and information. In order to address the strategic issues the following strategic objectives have been developed. Strategic Objectives Strategic Objective 1: To improve Data management Data management is considered as the weakest area under HIS. This was as a result of the existence of too many tools, supporting parallel initiatives/programmes, inadequate capacity of staff collecting, collating, analyzing and managing data, training not geared towards data management or in monitoring and evaluation, and lack of policy guidelines, amongst others. Strategies i) Developing HIS Policy and Strategic Plan ii) Reviewing data management processes, procedures and linkages iii) Review minimum data sets iv) Determining the need for key sub-systems and the linkages in the health sector v) Establishing a manual integrated Community Health Information System (CHIS) vi) Establishing a robust integrated electronic community Health Information System vii) Reviewing and developing, Facility Information System (FIS)
4.2.3
4.3 4.3.1
4.3.2
Strategic objective 2: To improve National Vital Registration System Although the department of Civil Registration is charged with the responsibility of implementing the compulsory registration of all births and death, the registration coverage is low. In 2008 birth registration stood at 46% while that of death was 50%. Factors contributing to low registration include lack of essential skills, lack of ICT equipment, inadequate transport and lack of information especially in the rural areas on the importance of civil registration. Strategies i) Civil Registration awareness campaigns and social mobilization ii) Capacity building iii) Enhance transport for Monitoring iv) Improve on registration supplies and materials v) Reviewing and developing, a Vital Registration Information Systems (VRIS) vi) Conduct consensus stakeholders meeting vii) Train district registrars on use of the software database system viii) Roll out the software system in all districts ix) Monitor implementation of the system
11
4.3.3
Strategic Objective 3: Enhance Capacity of HIS staff Capacity development for the implementation of HIS Strategic Plan is critical at all levels amongst: HIS staff who produce analyzed information Managers who use the information Facility staff that produce raw data and primarily use the information. The reviews undertaken on HIS indicate that while the basic data capture and reporting skills are present, there is little attention to data quality and the staff is not skilled to competently undertake analysis and interpretation of data. There is therefore urgent need for a comprehensive training program for staff in-post and those studying to become health workers. There is also need to have pre-services training for M&E officers, District Health Managers and curricula on HIS principles should be introduced into the courses for nurses, clinical officers, doctors and other health professionals Strategies i) Developing focused pre and in-service training program for health professionals in HIS ii) Strengthening human resource capacity at all levels by undertaking focused practical training program on HIS iii) Organizing best practice tours in areas with the best performance within and outside Kenya iv) Enhancing HIS staff career development v) Employ, deploy and retain appropriate health records and information personnel at all levels vi) Employing and deploying HIS staff appropriately vii) Enhancing transport for HIS operations viii) Improving general office supplies and equipment
4.3.4
Strategic Objective 4: Improve Financial Resources and sustainability There is inadequate allocation of financial resources for HIS. This is mainly because the amount allocated is not based on information needs. For purposes of sustainability HIS requires adequate long-term funding for recruitment of adequate staff, ICT equipment, stationery and systems development. Strategies Increasing allocation of GOK funds for implementing HIS interventions Consolidating funds geared towards HIS activities Strengthening Financial Information System (FIS) Increasing financial flow and funding at all levels
4.3.5
Strategic Objective 5: Strengthening use and Application of Information and Communication Technology, in data Management. Though computers exist at provincial and district levels, there is urgent need to improve the use and application of modern ICT to capture, store and exchange health information at all levels through provision of equipment and developing capacity of staff. Secondly given the manual nature of the existing information systems, the information is not easily accessible mainly due to type of storage system used. There is need to have adequate storage place and data collected and information generated must be handled with confidentiality and security they deserve.
12
Strategies i) Procuring hardware and software to support data management ii) Developing user friendly integrated web-enabled database system. iii) Rolling out the integrated system at all levels iv) Supporting data flow, information use and sharing through the FTP v) Developing capacity for Health Records and Information Officers, ICT personnel and managers on use of the software for data management vi) System maintenance and sustainability vii) Data security and backup viii) Developing capacity of ICT personnel and managers to develop, administrate, implement and manage software for data management 4.3.6 Strategic Objective 6: Improving Monitoring, Feedback, Reporting, Supervision and Data Audits Although a lot of health data exist there is minimal interaction with the data by health staff. Consequently very little data is used for decision making, performance assessment and resource allocation. There is therefore need to review selected indicators and therefore reduce the number of data reported along indicators. There are a number of vertical systems collecting and reporting data in systems that are parallel to HIS and have no links to it. There is need to harmonize these systems with a view of developing one standardized system which will interface the parallel systems that exists and the HIS system. The integration of existing data sources into one data warehouse that uses modern technology to enable easy access to information from a variety of platforms at a single point will ensure maximum use of available information. Improved information use requires that coordination be strengthened vertically (between levels of health services) and horizontally (with other stakeholders, health related ministries, NGOs and CSOs). Secondly coordination of surveys such as DHS, facility survey, vital registration and other surveys should be improved and placed under M&E steering committee. Further, one of the frequent problems is lack of feedback at all levels (horizontal and vertical feedback). Feedback of information should therefore be improved by ensuring that reports and publications are distributed to Community units, facility staff, district levels both paper-based and electronically and subsequently the other levels of evidence-based decision making. Repackaging this information to different users will be critical during this period. Strategies Strengthening Effective marketing of HIS products and empowering the managers and public Organizing forums for producers, researchers and users of health statistics Promoting research Improving coordination of data sources Establishing standardized method of data collection, collation, analysis and presentation Increasing use of existing data at all levels Producing regular reports or bulletins from district level upwards Conducting Rapid Health Facility Assessments (R-HFAs) Conducting Service Availability Mapping (SAM) Strengthening Performance monitoring of the Health sector Strengthening HIS and other statistical constituencies including legislation Improving data Quality
13
4.3.7
Strategic Objective 7: Enhancing Governance, partnership, collaboration and coordination Communication, partnership and coordination of HIS activities undertaken by various stakeholders are weak. The existing HIS are designed with limited involvement and participation with those who operate the systems and those who use the information from the systems. There is therefore need to share information with partners and close coordination with other statistical constituencies Strategy Establishment of intra and inter sectoral linkages Establishment of governance structures at all levels Evaluation of the HIS strategic plan Evaluate the implementation of the HIS strategic plan
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CHAPTER 5: STRATEGIC IMPLEMENTATION 5.1 Staffing Level and Requirements Currently HIS at the Ministries of Health is grossly understaffed as indicated in Table 4.1 below. The statistics from Table 4.1 shows that at the current staffing level there is a gap of 4774 staff. This means that only 11% of the total human resource requirements are in post. The major gaps are in the cadre of Health Records & Information Officers (88.3%), ICT officers (96.6%) and statisticians (100%). In order to effectively implement activities of the strategic plan, it is imperative that staff is recruited and trained. There will also be need to undertake service workload analysis for the staffing. Table 4.1 Staffing Levels CADRE Total Human Resource requirements as per staffing norms and standards 4882 235 221 12 4 2 5356 Existing staff currently to support HIS 572 8 0 2 0 0 582 Gap Staff to be recruited as per the strategic plan ( 2009-2014) 1550 20 4 3 1 1 1579
Health Records and Information personnel ICT Officers Statisticians Epidemiologists Public Health Specialists Health Economists Total 5.2.
4310 (88.3%) 227 (96.6%) 221 (100%) 10 4 2 4774
Organizational Structure The current organizational structure of HIS at the Ministries of Health shown in Fig. 4.1. is applicable at the National, Province and District levels. The major components of the structure are: Health facility statistics Population based health statistics (including vital statistics) and research Management statistics ICT to support the functioning of HIS
15
Fig 4.1
Organogram of Health Information System
HIS
Facility based Health statistics
Population-based health statistics and Research
Management statistics
ICT
Support management e.g. transport,
Morbidity, mortality and service statistics
Workload/Hospit al administrative statistics
Human Resource
Finance
Infrastructure and fixed assets e.g. Health facilities
Commodities and suppliers e.g. drugs
Source: - HIS Division
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5.2.1
Governance Structure. In order to implement this Strategic Plan the following governance structure is to be implemented during the plan period:i) Establishment of a National Health Information System Coordinating Committee (NHISCC). This is the oversight committee with representative from key partners at senior level in the ministries of Health, private sector, NGOs and development partners to strengthen HIS function. The committee will ensure periodic review of the data collection tools, ensure that we have minimum data sets, and give guidelines on data quality audit and supervision. Similar coordinating committees will also be at provincial, district and community levels. Establishment of an HIS Management Structure At each level of data collection there will be management teams. At the central level in ministries of Health, Technical Working Group will form the management team. The management teams will also be formed at the provincial, district and community levels.
ii)
Fig 4.2 Governance Structure HIS MANAGEMENT STRUCTURE

NATIONAL HIS
COORDINATING STRUCTURE
NATIONAL COORDINATING COMMITTEE TECHNICAL WORKING GROUP
PROVINCIAL HIS
PROVINCIAL COORDINATING COMMITTEE
DISTRICT HIS
DISTRICT COORDINATING COMMITTEE
COMMUNITY
COMMUNITY COORDINATING COMMITTEE
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5.3
Roles and Responsibilities This section defines roles and responsibilities of the various actors at all levels of the health sector.
5.3.1
National HIS Coordinating Committee (NHISCC) A NHISCC with representation from senior level officers in the Ministries of Health, Statistical constituencies, implementing partners and development partners shall be formed to strengthen NHIS function. The Permanent Secretary shall appoint a chairperson to steer HIS Coordinating Committee. The Ministries of Health together with other participating stakeholders shall provide the Committee with the financial and human resources needed to undertake its day-today activities. The Committee will establish its own internal procedures and work agenda. The NHISCC shall provide technical advisory role for health and social welfare data management in close collaboration with other strategic partners including KNBS, Vital Registration and private sector. The committee shall ensure unified and timely data collection, collation, processing and dissemination. To maximize efficiency, the NHISCC shall develop strategic options for human resource development in data and information management and participate in operational research.
5.3.2
The General Public The public shall ensure that any vital events or other significant health occurrences in the community are reported to the responsible authorities. On the other hand the public shall be entitled to information on the Ministries of Health performance through relevant publications by the Ministries or on specific special requests.
5.3.3
The Private Sector Currently there is no legal obligation for the private sector to provide their activity data to Ministries of Health. However through the HIS policy private health providers will be enforced to submit their data regularly as stipulated in order to give a comprehensive picture of the sector. When the Public Health Act is reviewed, it is proposed that statutory provision be made to require the private sector to notify at least all diseases under surveillance and report service statistics to HIS.
5.3.4
Faith Based Organization (FBOs) The Ministries of Health, CHAK, NGO KEC-CS shall endeavour to work together to build a unified health and social welfare data collection, collation, analysis and publication system. In spirit of partnership, FBOs will ensure all health facilities under their respective umbrellas to adhere to NHIS. In collaboration with Ministries of Health and other partners, FBOs shall mobilize resources for, NHIS and ensure efficient data and information management in all their satellite facilities.
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5.3.5
Ministries of Health (Roles by level) i) Community level Every Community Unit (CU) shall maintain and update its CHIS that shall be shared regularly with household members in a forum as stated in the health sector community strategy. The community health workers shall maintain registers recording daily activities and reporting regularly to supervising health facility. ii) Health facility level The health facility shall maintain and update its HIS which shall include records, filing system(s) and registry for primary data collection tools (such as Registers, cards, file folders), summary forms (such as reporting forms, CDs, electronic backups) safeguarded from any risks e.g. fire, floods, access by unauthorized person, etc. Every health facility shall summarize health and health related data from the community and health facility, analyse, disseminate and use the information for decision-making, provide feedback, then, transmit summaries to the next level. District level The District shall have oversight responsibility to manage all health and health related data from all service providers within their area of jurisdiction. The district shall give technical, material and financial support to all service providers in HIS. The District shall create and maintain a data repository. The district shall collaborate and work in partnership with other statistical constituencies at the district level to built one HIS. The district shall collate, analyse, disseminate, use health and health related data from all health facilities/providers and give feedback to all health care providers. Provincial/Regional level The Province shall have oversight responsibility to manage all health and health related data from all service providers within their area of jurisdiction. The province shall give technical, material and financial support to all districts and service providers in HIS. The Province shall create and maintain a data repository. The province shall collaborate and work in partnership with other statistical constituencies at the provincial level to built one HIS. The province shall collate, analyse, disseminate and use health and health related data from all districts and give feedback to all health care providers. National level The National level shall have oversight responsibility to manage all health and health related data from all service providers The national level shall give technical, material and financial support to all districts, provinces and service providers in HIS. The national level shall develop guidelines and formulate policies. The national level shall coordinate development of minimum data sets and data requirements of the health sector.
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iii)
iv)
v)
The national level shall collate, analyse, disseminate and use health and health related data from all districts, provinces and service providers and give feedback to all. The National level shall create and maintenance a data repository. The national level shall collaborate and work in partnership with other statistical constituencies at the national to built one HIS.
5.3.6. Other statistical constituencies i. KNBS ii. Vital Registration iii. Research and training institutions There shall be close working relationship and partnerships with HIS to provide data on population- based statistics, vital events (births and deaths) and health related research data for comparative analysis and warehousing. 5.3.7 Other Ministries There shall be close collaboration and partnership with other ministries in strengthening HIS such other ministries include, Ministry of education, Ministry of home affairs and national heritage- Kenya national archives. Training institutions Will be engaged in harmonization of the human resource requirements of HIS to the training curricular offered by training institutions. Mass media Shall be involved in advocacy on health and health related information
5.3.8
5.3.9
5.3.10 Implementing partners Support to strengthen HIS in their areas of operation. Work within the existing HIS framework and meet the reporting requirements as defined by minimum datasets. 5.3.11 NGOs Close partnership in HIS strengthening especially in population based studies such as Demographic Surveillance Systems (DSS). 5.3.12 Development partners (DPs) In the spirit of Kenya Health Sector wide Approach (SWAp), development partners are encouraged to continue to give technical, material and financial support to strengthen NHIS. The DPs should promote one national integrated health information system. 5.4. Budgetary Requirements Effective and successful implementation of the Strategic Plan will need funds both for recurrent and investment expenditure. It is expected that through the budgeting process the government funding will be enhanced to match the planned activities. Other funds will come from development partners based on the agreements which will be developed between NHIS and the partners. The projected budget by strategic objectives is given in Table 4.2. A total of about Kshs 1.9 billion or US$ 25.3 Million will be required for the implementation of the Strategic Plan during the 5 year period. Annex IV presents summary of budget by main activities.
20
Table 4.2 Budget Summaries by Strategic Objectives Projected Resource Requirements for Plan Implementation Strategic Objectives
To improve data management To improve National Vital Registration System To enhance capacity of HIS Improve financial resources To strengthen use and application of information and Communication Technology in data management To improve monitoring, feedback, reporting, supervision and data audits To Enhance Governance, partnerships, collaboration and coordination GRAND TOTALS
Budget per Financial year in US $ (Dollars) 2009/10 2010/11 2011/12 2012/13 2013/14
1,184,960 442,950 245,320 40,619 2,826,895 543,352 1,497,890 40,619 2,709,528 534,366 706,090 40,619 2,244,260 407,725 378,150 40,619 2,681,786 301,058 358,550 40,619
Total Cost in Kshs

888,761,950 167,208,800 236,950,000 15,232,000
Amount US $ (Kshs. 75)

11,850,426 2,229,461 3,159,333 203,093
402,549
531,584
509,523
393,536
315,134
161,423,000
2,152,307
893,866
1,074,021
1,226,048
1,204,755
988,350
404,028,000
5,387,040
35,227 3,245,491
35,227 6,549,568
73,793 5,799,966
73,793 4,945,837
35,227 4,720,721
18,995,000
253,267
1,892,618,750 25,234,917
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CHAPTER 6: MONITORING AND EVALUATION FRAMEWORK The overall purpose of Monitoring and Evaluation (M&E) is to track inputs, activities (processes) outputs and ultimate outcome (impact) of strategic Plan implementation. It is a process of ensuring that resources are spent as planned within the framework of strategic plan projections and Annual Work Plans (AWPs) budgets; and that activities take place as planned within the planned time frames to realize the stated strategic objectives. Specifically, Monitoring of strategic plan implementation will assist in: Checking whether the implementation is on schedule as planned (work-plans are followed as closely as possible) Assisting in making adjustments and corrective action when and where necessary. Keeping management and stakeholders informed on time Assisting in making timely solutions where bottlenecks are identified Checking that allocated resources are used efficiently and effectively Ensuring that inputs are ready on time. Evaluation is defined as periodic assessment of the relevance, performance, efficiency, effectiveness and impact of the activities. The relevance will respond to the question to what extent are the operations responding to the needs and priorities of the system? . Efficiency focuses on whether available resources (financial and non-financial) have been optimally used while effectiveness responds to the question, to what extent the beneficiaries are benefiting from the system? The purpose of evaluation will therefore be to improve planning and management; to strengthen organization; promote institutional learning and to inform policy. The HIS recognizes that there will be need for, adequate resources (both human and nonhuman) to successfully implement the strategic plan within the five year period and beyond. In light of this, appropriate strategies and mechanisms will be put in place internally and with support from partners to mobilize financial/funding and material resources to support implementation of the plan in terms of recurrent and development expenditures. In order to justify and enhance funding and resources mobilization to support plan implementation and longer term sustainability, appropriate strategies, will include but not limited to: Assessing results and effects of system activities Assessing impact to justify the resources Drawing lessons learnt and best practices Justifying replication, scaling up, expansion etc The system will monitor and evaluate the implementation processes (inputs and activities), outputs and outcomes to ensure efficiency and effectiveness in achieving the strategic objectives. The strategic plan logical framework already provides key inputs into a Monitoring and Evaluation System. Specifically, Performance Indicators and Means of Verification will be crucial in monitoring and evaluation of the strategic plan implementation. It is expected that a comprehensive M&E framework will be developed consisting of: Detailed AWPs as basis for both plan implementation as well as M&E Preparation of shorter term Operational Plans (OPs) possibly at thematic, resource centers and clusters levels as appropriate
22
Appropriate data collection tools/instruments at all levels from community to Secretariat for purposes of monitoring and evaluation Preparation of Monitoring and Evaluation indicators Monitoring and evaluation process at all stages of inputs, processes, outputs and outcomes, frequencies (monthly, quarterly, half yearly and annual etc) Feedback reporting mechanism including reporting formats, reports writing, documentation and dissemination processes
The financial and other resources monitoring and evaluation will constitute part of the M&E system to ensure that all the resources are utilized according to approved work plans and budgets, and in accordance with the approved financial management guidelines and regulations to ensure accountability. The following activities will generate the information required as process, output and impact indicators to monitor and evaluate the work of the programme. Expected outputs, strategic objectives, strategies and respective major activities Capacity needs assessments conducted and subsequent capacity building Standard M&E instruments and guidelines including report formats, standard checklists and other tools developed Supervision and monitoring visits Periodic review meetings Quarterly and annual reports on performance of the system Data bases developed and used to inform policies, planning, decision making and plan implementation. Interim, Mid-term and End of Period evaluation by external agencies will be undertaken as appropriate.
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CHAPTER 7: STRATEGIC IMPLEMENTATION MATRIX The HIS Strategic Plan, 2009 2014 implementation Matrix is presented below. For ease of presentation, an implementation framework for each objective is provided but should be viewed as integrated components. The matrix consists of: Stated Strategic Objectives Expected Output based on the Strategic Objective Strategies Main activities for the respective strategies Responsibility Strategic Partners Implementation Time Frame within the five year period Performance Indicators Budget Projections The Implementation Matrix is a critical management tool for mobilization, allocation and utilization of resources for plan implementation; management and coordination of Strategic Plan implementation; and monitoring progress as well as evaluating results/outputs and impact of the Health Information System. It is important to note that detailed Annual Work Plans (AWPs) as well as shorter term Annual Operational Plans (AOPs) are to be developed for each year of the plan as initial and subsequent operationalization of the Strategic Plan processes. In addition to the Implementation Matrix as well as Annual Operational Plans (AOPs), there will be a comprehensive Monitoring and Evaluation System to be developed to facilitate efficient and effective monitoring and evaluation of Strategic Plan implementation including feedback reporting mechanism, documentation and information dissemination.
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HEALTH SECTOR HEALTH INFORMATION SYSTEM (HIS) STRATEGIC PLAN 2009-2014 IMPLEMENTATION MATRIX
Verifiable Indicators Time Frame (Implementation Period) 2009/2010 i)Developing HIS Policy and Strategic Plan Operationalization and Enforcement of HIS Policy Develop HIS Strategic Plan 2015-2020 ii)Reviewing data management processes, procedures and linkages Review data management processes, and procedures Establish linkages for the existing subsystems iii) Review minimum data sets Review and define health sector core indicators Revise data collection, collation and analysis tools and set up quality assurance procedures Conduct orientation training for health care workers on use of revised integrated HIS M&E tools Supply of data capture and reporting tools NHIS Coordinating committee HIS Policy in place and operational X HIS, TWG Strategic Plan development completed and launched Framework for Data Management process and procedures reviewed and in place Linkages between sub-systems in place and functional Standardized minimal datasets defined Revised data collection, collation and analysis tools in place and quality assurance procedures List of health care workers trained on HIS M&E tools and training report Printed M&E tools X X X 2010/2011 2011/2012 2012/2013 2013/2014 Total Budget Kshs US$ Source of Funds
Strategic Objective 1: To improve data management

Expected Output/ Results Strategies Main Activities
Responsibility
Improved policy, procedures and institutional Capacity
2,939,000
39,187
2,955,000
39,400
Ministries of Health (HIS)
2,588,800
34,517
HIS, TWG
X X X
96,000 7,131,600
1,280 95,088
HIS TWG HIS
3,139,000
41,853
HIS
29,300,000
390,667
Print and distribute M&E tools for data collection and reporting
HIS
202,200,000
2,696,000
Sub- total
250,349,400
3,337,992
25
Expected Output/ Results
Strategies
Main Activities
Responsibility
Verifiable Indicators
Time Frame (Implementation Period) 2009/2010 2010/2011 2011/2012 2012/2013 2013/2014
Total Budget Kshs US$
Source of Funds
Report of key subsystems and linkages
Determine the need for key subsystems and the linkages in the health sector
Assess plan and link the sub systems:Master health facility, Finances, Drugs, and logistic management, Human Resources, Assets, Vital registration. Print other health systems data collection forms Develop the integrated CHIS (Community Health Information Systems) tools Pre-test the CHIS tools in 6 selected sites in the provinces Hold consensus workshops Print CHIS tools Procure and synchronize PDAs for CHIS
Ministries of Health (HIS)
Needs Assessment Report (s) & Centralized database linked to sub-systems in place X X 3,058,050 40,774
Ministries of Health (HIS) HIS,DCH, All Stakeholders
Health Systems data collection tools printed and utilized Number of CHIS tools developed
21,500,000
286,667
Functional CHIS
Establish a manual integrated community Health Information System (CHIS)
80,000
1,067
HIS,DCH, All Stakeholders HIS HIS All stakeholders
Reports on pre-tested CHIS tools Number of consensus workshops held CHIS tools in place
X X X
X X X X X X X X X X
3,810,000 750,000 122,000,000 95,740,000
50,800 10,000 1,626,667 1,276,533
Number of PDAs for CHIS procured List of participants attending the workshops
26
Expected Output/ Results
Strategies
Main Activities
Responsibility
Verifiable Indicators 2009/2010
Time Frame (Implementation Period) 2010/2011 2011/2012 2012/2013 2013/2014
Total Budget Kshs US$ 23,167
Source of Funds
Developed functional electronic CHIS
Establish a robust integrated electronic community Health Information System
Design and develop a CHIS system for data management Hold consensus workshop for CHIS Technical support to the system Establish and equip CHEWs and resource centers in each administrative division for information sharing
HIS/DCH
Integrated electronic CHIS in place Number of consensus meeting held Technical support provided Community Resource Centers established
1,737,500 650,000 1,400,000
8,667 18,667
HIS,DCH, CDF Committee
297,000,000
3,960,000
Sub- total
547,725,550
7,303,008
27
Expected Output/ Results Developed integrated electronic data management and Information health facility system
Strategies
Main Activities
Responsibility
Total Budget Kshs 2,224,000 US$
Source of Funds
Review and develop Facility data Management and Information Systems
Design and develop a robust facility management information system Rollout the facility system in the 400 hospitals Maintenance of facility system Develop an Electronic Health Records System (EHRS) EHRS rolled out in all the 400 hospitals Maintenance reports M&E Reports in operations of HER system
HIS
Robust facility MIS in place and functional X X
29,653
System rolled out in the 400 hospitals Maintenance report
X X
X X X X X
11,760,000 20,000,000 13,843,000
156,800 266,667 184,573
EHRS in place and operational EHRS rolled out in the 400 hospitals Maintenance report
X X
X X
34,580,000
461,067
8,300,000
110,667
Sub-Total Total
90,707,000 888,781,950
1,209,427 11,850,427
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Strategic Objective: 2 To Improve National Vital Registration System

Expected Output/ Results Raised registration coverage of births from 46% to 80% and Deaths from 50% to 90% by 2014 Strategies Main Activities Responsibility Verifiable Indicators 2009/2010 i) Civil Registration awareness campaigns and social mobilization Conduct social mobilization campaigns at national, provincial and district levels. Sensitize the community through media ii) Capacity building Capacity Building of registrars and registration agents on vital registration Train 21,600 Chiefs and sub-chiefs on causes of deaths Train VR staff on short course Train 800 clinicians and nurses on vital registration, causes of deaths ,basic coding of diseases and use of vital information Improved transport for Vital Registration Enhance transport for Monitoring Provision of transport (vehicles and motorcycles) VR, DCR, HIS Registration Coverage of births increase from 40% to 80% and coverage of deaths increased from 50% to 90% by 2014 Number of Aired programmes and proportion of communities reached No of staff trained an Vital Registration and use of information No of chiefs trained Number of staff trained Number of clinician and nurses sensitized X VR Number of vehicles and motorcycles purchased X X X X 1,280,000 17,067 Time Frame (Implementation Period) 2010/2011 2011/2012 2012/2013 2013/2014 Total Budget Kshs US$ Source of Funds
35,223,000
469,640
VR
X X
X X
3,850,000 4,495,000
51,333 59,933
VR
VR, DCR, HIS VR HIS, VR
X X X
X X
13,865,000 5,662,000
184,867 75,493
37,500,000
500,000
29
Expected Output/Result s Developed integrated electronic Vital Registration data management and information system
Strategies
Main Activities
Responsibility
Source of Funds
Review and develop, a Vital Registration Information Systems (VRIS)
Data Conversion Design and develop a robust vital registration information system Train district registrars on use of the software database system Roll out the software system in all district Monitor implementation of the system
VR VR
Number of Records entered/converted Integrated electronic vital data management and information system developed and in place Number of registrars trained Number of Districts installed the system
50,000,000
666,667
1,499,000
19,987
VR
5,759,800
76,797
VR VR
X X Total X X X
825,000 7,250,000 167,208,800
11,000 96,667 2,229,451
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Strategic Objective 3: To Enhance Capacity of HIS

Expected Output/ Results Improved institutional capacity Strategies Main Activities Responsibility Verifiable Indicators Time Frame (Implementation Period) 2009/2010 2010/2011 2011/2012 2012/2013 2013/2014 Total Budget Kshs US$ Source of Funds
i) Develop focused pre and in-service training program for health professionals ii) Strengthen human resource capacity at all levels by undertaking focused practical training program on HIS
Mainstreaming HIS in the regular preservice training of health workers and Review curricula for health records professionals Orientate 100 lecturers/ Trainers on curricula
HIS & Training institutions
HIS mainstreamed in the medical Training curricular Number of lecturers oriented
1,665,000
22,200
Training institutions
2,966,000
39,547
Study tour report
Organize best practice tours in areas within Kenya and outside with the best performance
Develop a training manual in information management for health workers Train managers on information management and use Train Health care workers on data management and use On Job Training on data management for health workers Conduct five exchange programmes in country by provinces/ districts Conduct exchange programme in 3 best countries in the region (AFRO)
HIS
Training manual in place
1,935,000
25,800
HIS HIS/province/Dist rict District/Province HIS
Number of managers trained Number of health care workers trained Number of health care with proficiency Number of exchange programmes conducted Exchange programmes reports Exchange programme reports
X X X
X X X
X X X
X X X
5,410,000 33,530,000 6,500,000
72,133 447,067 86,667
1,350,000
18,000
HIS
X Sub-Total
3,295,000
43,933
56,651,000
755,347
31
Expected Output/ Results 60% 0f staff developed
Strategies
Main Activities
Responsibility
Source of Funds
Enhance HIS staff career development
Number of staff employed and deployed
i) Employ, deploy and retain appropriate health records and information personnel at all levels
Develop curricula for pre-service training program for HIS staff Sponsor HIS staff for short term courses in-post (statistical software, Planning, M&E, GIS, ) Train Health records and information officers and clinicians on ICD 10 use Support long term trainings for HIS (Medical demography, Epidemiology, Medical statistics, Informatics, Health Records and Information Management) Review, Develop and implement norms and standard for staffing at various levels of HIS Develop and pilot retention scheme of service for Health Records and Information Officers
Training institution
Curricula for preservice training developed Number of staff sponsored
300,000
4,000 392,000
HIS
X HIS Number of health records and information officers and clinicians trained on ICD 10 use Number of officers supported for training.
29,400,000
14,410,000
192,133
HIS/ development partners
20,000,000
266,667
HRD,HIS
Norms and standards developed and implemented
2,670,000
35,600
HRD,HIS
Scheme of service developed and piloted
64,000
853
32
Expected Output/Results
Strategies
Main Activities
Responsibility
Verifiable Indicators Number of Positions advertised Number of HRITs of staff employed and deployed Number of HRIOs of staff employed and deployed Number of Degree/Masters holders employed and deployed Number of ICT officers employed and deployed Number of statistical officers employed and deployed Number of vehicles and motorcycles provided to all levels Number of offices renovated
Source of Funds
ii)Employ and deploy HIS staff appropriately
Advertise the positions Employ and deploy 750 health records and information technicians Employ and deploy 750 health records and information Officers Employ and deploy 200 Health records and information degree/masters holders Employ and deploy 20 ICT officers in all provinces to give technical support Employ and deploy 10 statistical officers for national and provincial levels Provision of transport (vehicles and motorcycles) at all levels Renovate the office buildings in selected sites. Equip one resource centre at the national level Procure office supplies at all levels
PS PS
X X
X X
X X
X X
X X
1,500,000 15,000,000
20,000 200,000
PS
26,250,000
350,000
PS
9,000,000
120,000
PS
900,000
12,000
PS
180,000
2,400
Enhanced transport for HIS activities Improved infrastructure, office supplies and general equipment
Enhance transport for HIS operations Improve general office supplies and equipment
Development partners and HIS
42,000,000
560,000
HIS
2,000,000
26,667
HIS/ Administration
National resource center equipped Register of office supplies procured at all level X
X X
X X Sub- Total Total X X
10,500,000 6,125,000 180,299,000 236,950,000
140,000 81,667 2,403,987 3,159,333
33
Strategic Objective 4: Improve Financial Resources

Expected Output/Results Strategies Main Activities Responsibility Verifiable Indicators 2009/2010 Increase allocation of GOK funds for implementing HIS interventions Lobby for more GOK funds Lobby for at least 10% funds from donor/ partners funding for every project in the health sector towards M&E and HIS Support one M&E framework PS/HIS 10% of the funding are allocated to HIS and M&E 10% of the fun ding are allocated to HIS and M&E. X X X X X 320,000 4,267 Time Frame (Implementation Period) 2010/2011 2011/2012 2012/2013 2013/2014 Total Budget Kshs US$ Source of Funds
At least 10% of total budgets allocated for M&E/HIS activities at all levels
DP/PS/HIS
Improved Financial Resources
Consolidated funds geared towards HIS/M&E activities Strengthening Financial Information System (FIS)
DP/PS/HIS
one M&E framework X X X X X 2,655,000 35,400
Support and generate Financial information on allocations and expenditures Train managers and system operators on financial information system Support districts, provinces and national level by allocation of funding at all levels.
HIS/HCF/DPs
Strengthened financial information system in place
2,150,000
28,667
HCF/HIS
Increase financial flow and funding at all levels
PS
Number of managers and system operators trained on financial management Number of provinces and districts supported/allocated with funds
9,517,000
126,893
590,000
7,867
Total
15,232,000
203,094
34
Strategic Objective 5: To Strengthen use and application of Information and Communication Technology in Data Management
Expected Output/Results Strategies Main Activities Responsibility Verifiable Indicators Time Frame (Implementation Period) 2009/2010 2010/2011 2011/2012 2012/2013 2013/2014 Total Budget Kshs US$ Source of Funds
Developed Functional Integrated data warehouse
Develop user friendly integrated web-enabled database system.
Develop a user friendly integrated, web-based database that can link multiple data sources and ensure controlled access by users. Pre-test the integrated system Hold stakeholders consensus workshop Develop system manuals
HIS/ICT
Web based data warehouse established and integrated Pre testing report Consensus report System/operational manual in place System roll out in all 8 provinces FTP mechanism for data transfer is maintained and operational Number of equipment (computers, accessories and printers) acquired Number of PDAs/Laptops procured Number of managers trained on use of PDA and training reports
3,635,000
48,467
HIS/ICT HIS HIS/ICT HIS/ICT HIS
X X
825,000 535,000 400,000
11,000 7,133 5,333
Roll out the integrated system at all levels Support data flow (FTP) and information use or sharing Improved use of ICT and computers Procure hardware and software to support data management
Roll out the system in 8 provinces Support and develop capacity on use of File Transfer Protocol (FTP) as a mechanism of data transfer Procure computer hardwares and its accessories and printers for data management Procure PDAs and Laptops for data management Train managers at district, province and national level on use of PDAs
6,740,000
89,867
20,880,000
278,400
HIS/ICT
64,000,000
853,333
HIS/ICT
X X
X X
X X
X X
X X
31,500,000 3,700,000
420,000 49,333
35
Strategies
Main Activities
Responsibility
Source of Funds
Number of HRIOs and other healthcare managers capacity in ICT developed
Maintained and up to date system Established data security guidelines, remote sites and backups (storage)
Develop capacity for Health Records and Information Officers, ICT personnel and managers on use of the software for data management System maintenance and sustainability Data security and backup
Train Users on use of the hospital software model Train Users on use of the integrated district HIS database Orientate managers on use of integrated HIS software Support maintenance of hard and software, including in-house capacity Establish remote sites for data backup and procure backup devices Develop data security guidelines and SOPs on data recovery
HIS HIS HIS
Number of HRIOs train and training report Number of DHRIOs trained and training report Number of managers orientated train and training report Number of district supported Number of backup and remote site established Data security guidelines and SOPs disseminated and in use
X X X
X X X X
11,790,000 5,386,000
157,200 71,813
4,170,000
55,600
HIS/ICT
X X
X X
730,000 5,900,000
9,733 78,667
HIS/ICT/eGovernment HIS/ICT
X Total
1,232,000 161,423,000
16,427 2,152,306
36
Strategic Objective 6: To Improve Monitoring, Feedback, Reporting, Supervision, use of Data and Data Audits
Expected Output/Results Strategies Main Activities Responsibility Verifiable Indicators 2009/2010 Strengthen Effective marketing of HIS products and empowering the managers and public Produce IEC materials on HIS HIS Types and quantities of IEC materials developed and distributed Number of radio and TV programmes developed and communicated Up to date Health information and Operational MOH website Conference reports x x 4,300,000 57,333 Time Frame (Implementation Period) 2010/2011 2011/2012 2012/2013 2013/2014 Total Budget Kshs US$ Source of Funds
Increased awareness, access and use of information
2,000,000
26,667
Conduct local radio and TV programmes
HIS and Community
5,000,000
66,667
Support, maintain and market the MOH website Organize forums for producers, researchers and users of health statistics Conduct Health statistics symposiums/ conference Support the membership in East Africa Community and international health information networks
ICT
3,200,000
42,667
HIS and all stakeholders
HIS
Membership of the health information Network (s) x x x x x 100,000 1,333
Sub-Total
14,600,000
194,667
37
Strategies
Main Activities
Responsibility
Source of Funds
Increased use of available information
Promote research
Strengthen research and survey capacity at all levels
HIS, KNBS, KEMRI
Reports on strengthened research and survey capacity, coordination of HIS activities; and integration of data collection and reporting tools
20,195,000
269,267
Improved governance, coordination and enhanced linkages
Improve coordination of data sources
Support TWGs Administration and Coordination of quarterly review. Participate in quarterly Review Meetings Provincial and National levels Joint Monitoring and Evaluation
HIS TWG
Number of TWG meetings held and shared Regular reports
1,350,000
18,000
HIS, Province and stakeholders
Number of quarterly meetings held and shared Regular reports
3,360,000
44,800
HIS TWG HIS TWG
Regular reports Minimum data sets and indicators
6,200,000
82,667
Established standards and SOPs for data collection, collation, analysis and dissemination
Establish standardized method of data collection, collation, analysis and presentation
Harmonize and integrate data collection and reporting tools Develop medical data dictionary Establish and maintain data coding and Master Health facility
1,290,000
17,200
HIS TWG HIS and Districts
Standard medical data dictionary Updated Master health facility list and Established criteria for coding Updated Dashboards at all levels and regular reports
4,110,000
54,800
13,398,000
178,640
Increase use of existing data at all levels
Develop dashboards at different levels of service delivery and use of data
HIS TWG
192,000
2,560
38
Expected Output/Results Enhanced and published HIS reports
Strategies
Main Activities
Responsibility
Source of Funds
Increase capacity to Produce regular reports
Train Health records and information officers on data analysis, presentations and use Train district registrars on data analysis, presentation and use Develop annual health statistical reports Develop quarterly bulletins Develop annual Health data sheet Develop MDG progress report and other relevant record reviews and surveys
HIS
Number of health records and information officers trained
13,045,000
173,933
HIS/ VR
Number of district registrars trained
3,945,000
52,600
HIS TWG
Number of annual reports produced and disseminated Number of quarterly reports produced and disseminated Number of health fact sheets produced and Disseminated Number of reports disseminated
18,615,000
248,200
HIS TWG HIS and Districts
x x
x x
x x
x x
x x
4,735,000 8,260,000
63,133 110,133
HIS TWG
3,114,000
41,520
Sub-Total
101,809,000
1,357,453
39
Strategies
Main Activities
Responsibility
Source of Funds
R-HFA and SAM reports
Conduct Rapid Health Facility Assessments (RHFAs) Conducting Service Availability Mapping (SAM)
Conduct RHFAs in specific areas of service delivery Conduct SAM
HIS/ KNBS
Reports on RHFAs conducted
6,016,000
80,213
HIS/ KNBS/ planning and policy HIS/ RCMRD
Reports on SAM conducted Reports on SAM and GIS focal persons trained Number of AOP reports produced and disseminated Number of Performance contracts signed and monitored Regular management support reports on progress HIS indicators One M& E framework for the health sector x x
8,280,000
110,400
Train SAM focal persons on GIS and use of information Performance monitoring of health sector, HIS strategic plan, Legislation and other statistical constituencies Strengthening Performance monitoring of the Health sector Strengthen monitoring of the health sector AOPs Strengthen performance monitoring of performance contracts Monitor implementation of the HIS strategic plan
11,500,000
153,333
HIS
59,443,000
792,573
HIS/ MMU
240,000
3,200
HIS TWG
174,550,000
2,327,333
Ensure vertical programs and service managers using HIS format for feedback and reports to respond to and report on health events/ management support
DMS/ PS
240,000
3,200
40
Strategies
Main Activities
Responsibility
Source of Funds
Strengthen HIS and other statistical constituencies including legislation
Data quality audits
Improve data Quality Total
Conduct a joint Support supervision of health information activities Develop the health information legislation Conduct Data quality audits
HIS TWG
Number of support Supervisions conducted HIS legislation in place Improved data quality and DQA reports
x 7,600,000 101,333 29,333
HIS TWG
2,200,000
HIS TWG
17,550,000
234,000
Sub-Total
287,619,000
3,834,920
Total
404,028,000
5,387,040
41
Strategic Objective7: To Enhance Governance, Partnership Collaboration and Coordination

Expected Output/Results Strategies Main Activities Responsibility Verifiable Indicators 2009/2010 Enhanced mechanisms for effective communication, collaboration and coordination Establishment of intra and inter sectoral linkages Develop strategies for effective communication between data providers and data users at different levels, including the provision of regular feedback mechanisms Strengthen intra and inter sectoral linkages and partnership Coordinate and link with other statistical constituencies Enhancement of governance structures at all levels Conduct Quarterly HIS coordinating committee meetings at all levels Conduct quarterly TWG regular meetings Conduct Mid and End Term evaluation of HIS strategic plan HIS TWG and HIS coordinating committee Data Base of all stakeholders at all levels available Quarterly HIS Coordinating Committee reports and Quarterly TWG meeting reports Time Frame (Implementation Period) 2010/2011 2011/2012 2012/2013 2013/2014 Total Budget Kshs US$ Source of Funds
1,250,000
16667
HIS TWG and HIS coordinating committee HIS TWG and HIS coordinating committee HIS coordinating committee
Good collaboration, harmonization and alignment Number of Meetings and linkages among the statistical constituencies Number of quarterly meetings
6,550,000
87,333
2,660,000
35,467
x Number of quarterly TWG meetings held HIS TWG Reports on external evaluation of Strategic Plan implementation (mid-term and end of period)
2,750,000
36,667
HIS Evaluation Report
Evaluate the implementation of the HIS strategic plan
5,785,000
77,133
Total
18,995,000
253,267
42
ANNEX 1: LITERATURE REVIEWED 1) 2) 3) 4) 5) 6) 7) 8) 9) 10) 11) 12) 13) 14) 15) 16) 17) 18) 19) 20) 21) 22) 23) 24) 25) Republic of Kenya: - Health Sector Health Information System Republic of Kenya- Ministry of Health Republic of Kenya Republic of Kenya 2008 2012 Health Sector: Indicator and Standard Operating Procedures Manual for Republic of Kenya Health Workers 2008 Health Metrics Network Manual Ministry of Health: Strengthening District Level M&E and HIS in Phase I Districts Republic of Kenya Health Sector: From Data Production to Data use Strengthening of the Zambian Health Management Information System Plan of Action Cordaid IICD Health Programme Uganda Health, Management Information Systems 2003 2010/11 DFID Health Resource Centre Pepela Wanjala 2008 Sanitation Strategic Plan 2008 -2012 Ministry of Medical Services:- Draft Ministry of Medical Services Strategic Plan Assessment Report June 2008
Annual Health Sector Status Report 2005-2007
Ministry of Public Heal and Sanitation Draft Ministry of Public Heal and
The HIS in Zambia: A Trace on the implementation steps The Role of HIS in SWAP and M&E
National Bureau of statistics, Dares-Salaam: Strategic Plan 2008/09 Republic of Uganda, Ministry of Health Kenya Vision 2030 Needs Assessment Report for HIS 2004
Assessment of the Health Information System in Uganda
George W. Odhiambo-Otieno: Evaluation of existing District Health Management Information Systems in Kenya Ghana- Health Information Management Strategic Plan 2007-2011 George W. Odhiambo-Otieno: Evaluation Criteria for District Health Management Information Systems HMN MOH MOH 2010) Ministry of Industrialization: Strategic Plan 2008 2012 Government of Malawi: Health Information System: National Policy and Strategy - 2003
43
Guidance for the Health Information Systems (HIS) Strategic Planning Process Strategy for the Delivery of Level one Services
Feb. 2009
Reversing the trends: The Second National Health Sector Strategic Plan (NHSSP 11- 2005-
ANNEX II LIST OF TECHNICAL WORKING GROUP FOR THE PREPARATION OF THE STRATEGIC PLAN
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23.
Dr. Kibet Sergon Sophia Karanja Nancy Amayo J.M. Kavale Rose Ayugi Dr Martha Muthami Hannah Gitungo Julius Mutiso Olum Gondi Duncan Ochoro Dr. Odhiambo-Otieno Francis Gikunda Faith Ikiara Dorcas N. Nguyo Jedida Obure Boniface Isindu Dr Koki Kinagwi A N Mutua Pepela Wanjala Samuel Cheburet Dr. Maina W. I. Benadette Ajwang John Mwihia
Head, HIS HIS HIS Vital Registration T/Planning HIS HIS NASCOP PTC PTC PTC HIS ICT HIS DCH DMC AFRIAFYA Vital Registration HIS HIS Tech/Planning Opthalmic Services NPHLS
0722659568 0722436048 0721991652 0722618623 0722710176 0722246717 0722849123 0728968515 0720677189 0720716770 0722299309 0722990749 0720265846 0722831629 0722493307 0722875171 0721298811 0722375633 0721624338 0722710176 0726773870 0722918272
his@health.go.ke sopka006@yahoo.com amayonancy@yahoo.com joskavale@yahoo.com iwmaina@health.go.ke muselu2006@yahoo.com wanguwa@yahoo.com molusimutisyo@yahoo.co.uk ptcjambo@yahoo.com ptcjambo@yahoo.com george.odhiambootieno@gmail.com beremutuambugu@yahoo.com Ikiara_faith02@yahoo.com njeri20002000@yahoo.co.uk jedobure@yahoo.com bfaceisindu@yahoo.com. kkinagwi@afriafya.org Stacy_mutua@yahoo.com Wanjala2p@yahoo.com samuelcheburet@yahoo.com iwmaina@health.go.ke beajwa@yahoo.co.uk johnmwihia@yahoo.com
44
ANNEX III HIS POLICY AND STRATEGIC PLAN STAKEHOLDERS WORKSHOP AT BONTANA HOTEL, NAKURU ON 30TH MARCH TO 3RD APRIL 2009 ATTENDANCE LIST
S/No . 1. 2 3. 4. 5 6. 7. 8. 9. 10. 11. 12. 13. 14. 15. 16. 17. 18. 19. 20. 21. 22. 23. 24. 25. 26. 27. 28. 29. 30. 31. 32. 33. 34. 35. 36. 37. 38. Name Stella Alusiola Christine Ayuyo Patrick Kisabei Geoffrey Kimani Lisha Lala Dr. Akanga Zebedee Christopher Ziro Naomi Choge David Wambua Robert Kinoti Dr. James Gitonga Mathews Odongo Raphael Kimeu Rankesh Mutisya Joseph Onwong a Tecla J. Kogo Dr. Ruth Kitetu Dorcas Mugure Mkaya Gifton J.M. Kavale Douglas Ngaira Titus K. Waita Francis G. Mwangi Felix A. Agoi Mercy K. Ndemo Benadette A. Ajwang Jedidah Obure Peter Wainaina Naftal Chweya O. Viterlis W. Sitati Dr. S. M. Irungu Beatrice Adieri Dr. Kibet Sergon Gideon Emukule Faith K. Ikiara Diana Kamar Rose Ayugi Dr. Amyn Lakhani Organization/ Affiliation MOPHAS Western Johpiego NPHLS Planning & Policy (MOMS) Ext. 45145 Aga Khan Foundation DMOH Kaloleni PHRIO Coast NHIF Nursing Council DHRIO Imenti North DMOH Imenti North MOPHAS Nyanza KEMSA CNO s Office DEH-MOPHS PMO - Nairobi MOPHS Afya House- DOCs MOMS Afya House Vital Registration MOMS (Tech P/C) MPHS Human Resources KNADS AKHSK CHD AKHSK CHD DDS DCAH/MOPHS MOMS RVP National Archives KULTTB MOMS/Surgical/ Dental MOMS/Human Resources Head, HIS FHI MOMS DRH Technical Planning Aga Khan Tel/Cell Phone 0729-080966 0726-429663 0722-249282 0721-854492 +255-784-221887 0722-936230 0722-653387 0722-703084 0733-622593 020-2114942 0722-916765 0721-551318 0722-700465 0724-172158 0722-468500 0721-284216 0729-344256 0720-475522 0722-617608 0722-618623 0721-828395 0735-544863 0722-785604 0721-250628 0736-193999 0726-773870 0722-831629 0722-336582 0722-835584 0723-867898 0722-637655 0722-578219 0722-659568 0721-323749 0722-990749 0722-674998 0728023414 0736-397840 E-mail Address/phone salusiola@yahoo.com cayuyo@jhpiego psabei@yahoo.com gn_kimani@yahoo.com lisha.lala@akdn.org. dmohkaloleni @yahoo.com cziroh@yahoo.com nchoge@nhif.or.ke david.wambua@gmail.co robkin04@yahoo.co.uk gitongaj2003@yahoo.co.uk mathews.omango@gmail.com mumo.kimeu@kemsa.co.ke rankwill2002@yahoo.com Joseph.onwonga@yahoo.com teclarkogo@yahoo.com kitetu@helth.go.ke mugured@yahoo.com mkayaton@yahoo.com joskavale@yahoo.com busieka@yahoo.com tituswt@yahoo.com francisgmwangi@yahoo.co.uk agoifelix@gmail.com Merch.ndemo@yahoo.com atienodetty@gmail.com jedobure@yahoo.com Pwynes6z@yahoo.com nafcochweya@yahoo.com vwsitati@africaonline.co.ke smirungu@yahoo.com baagoi@yahoo.com his@health.go.ke gemukule@fhi.org Ikiara_faith02@yahoo.com didkamar@yahoo.com Rose_ayugi@yahoo.com Amyn-lakhani@akn.edu
45
S/No . 39. 40. 41 42. 43. 44. 45. 46. 47. 48. 49. 50. 51. 52. 53. 54. 55. 56. 57. 58. 59 60. 61. 62. 63. 64. 65. 66. 67. 68. 69. 70. 71. 72. 73. 74. 75. 76. 77. 78. 79 80. 81.
Name Dr. J. Gitonga Dr. Paul Dielemans Dorcas Wandera Linda N. Muyumbu Gideon Emukule Onesmus M. Kamau Washington Omwomo Job Ollongo Ambrose Rotich Franklin Songok George Onguru John Odira Paul Malusi Edward Odhiambo Peter Opondo Duncan Ocholo Olum Gondi Odhiambo Otieno Dorcas Nguyo Nancy Amayo Sophia Karanja Samuel Cheburet Pepela Wanjala Hannah Gitungo David Mwangi Tumo Kimeto Dariah Sikolia Mrs. Margaret Kungu Hannington O. Onyango Anna Nduku Mutua J.M. Kavale Catherine Njogu Nduta Waweru Dr. Koki Anagwi Charles Chiuri Karuga Wachira Awes Amin Dr. Ali A. Swaleh Racheal Wanjiru Patrick Musyoki Doreen Imanyara Julius Mutisyo Francis Gikunda
Organization/ Affiliation MOPHS EHS/DRH MOMS APHIA II R.V. APHIA II R.V. DNCD-Afya-House USAID/K PHRIO Nyanza Province DMOH Kericho DHRIO Kericho DDSC - Migori DHRIO Migori DLTLD PTC PTC PTC PTC PTC HIS Secretary HIS HIS HIS HIS HIS DDSR DHRIO Kaloleni KMTC Kenyatta University NACC South Rift Vital Registration Vital Registration NASCOP DLTLD AfriAfya Central PHRIO HRIO-PDMS- Central KNBS SUPKEM ICT MOMS HRIO Eastern PHRIO Eastern NASCOP HIS
Tel/Cell Phone 0722-916765 0723-777963 0722-233265 0720-200536 0721-323749 0721-670730 0721-739435 0734645684 0722-884603 0722-839011 0722-379424 0734-735206 0721-359910
E-mail Address/phone Gitongaj2003@yahoo.co.uk pdielemans@liverpoolvct.org dorrywandera@yahoo.com lmuyumbu@aphiarift.org gemukule@afhi.org omkamau@yahoo.com womwomoAusaid.gor job-yob@yahoo.com dmohker@africaonline.co.ke dmohkericho@yahoo.com fsongok@yahoo.com eddygmusa@yahoo.com johnodira30@yahoo.com malusitb@yahoo.com ptc@jambo.co.ke ptc@jambo.co.ke ptc@jambo.co.ke ptc@jambo.co.ke ptc@jambo.co.ke njeri20002000@yahoo.co.uk amayonancy@yahoo.com sopka006@yahoo.com samuelcheburet@yahoo.com wanjala2p@yahoo.com wanguwa@yahoo.com davekaroko@yahoo.co.uk rkimetto@yahoo.com deidresco@yahoo.com magkungu@yahoo.com honyango@nacc.or.ke Stacy-mutua@yahoo.com joskavale@yahoo.com catewamahiu@yahoo.com ndwaweru@yahoo.com kkinagwi@afriafya.org cchiuri04@yahoo.com lkaruga23@yahoo.com msaaddo@yahoo.com Ghalgan57@yahoo.com rwanjiru@health.go.ke patmusyo@yahoo.com dimanyara@yahoo.com mmlonzi@yahoo.com beremutuambugu@yahoo.com.
0720-265846 0721-991652 0722-436048 0721-624338 0722-375633 0722-849123 0722-988395 0722-998582 0724-666180 0722-586713 0722-275478 0721298811 0722618623 0713-911994 0721-851116 0722-875171 0722-605184 0722-379391 0722-836503 0726-231636 020-2519044 0724-224037 0733-539089 0728-968515 0722-299309
Quarterly TWG reports Quarterly TWG reports
46
ANNEX IV: - BUDGET SUMMARY FOR PLAN IMPLEMENTATION

Budget per financial year in US $ (Dollars) 2009/10 2010/11 2011/12 2012/13 2013/14 1,184,960 Improved policy, procedures and institutional capacity Report of key sub-systems and linkages To Improve data management Functional CHIS Developed functional electronic CHIS Developed integrated electronic data management and communication health facility system Raised registration coverage of births from 46% to 72% and Deaths from 50% to 90% by 2014 Improved transport for Vital Registration Developed integrated electronic Vital registration data management and communication system Improved institutional capacity Study tour report To enhance capacity of HIS 60% 0f staff developed 53,333 Number of staff employed and deployed 36,453 Enhanced transport for HIS activities 133,333 Improved infrastructure, office supplies and general equipment 80,000 195,973 133,333 29,306 80,000 29,306 133,333 20,417 42,000,000 20,625,025 560,000 275,000 704,400 55,564,000 740,853 315,378 315,378 117,378 53,333 64,110,000 854,800 578,387 606,573 442,950 To Improve National Vital Registration system 139,617 170,000 133,333 245,320 22,200 Total cost in KSHS Amount US$ (KSHS. 75) 11,850,426 3,337,992 327,441 2,965,067 4,010,500 1,209,427 2,229,451 858,333 500,000 871,117 3,159,333 693,413 61,933
Strategic objectives
Out put
2,826,895 2,709,528 2,447,260 2,681,784 888,781,950 557,739 163,720 616,573 1,040,500 448,362 543,352 215,800 111,667 215,885 1,497,890 184,140 18,000 556,459 163,720 580,640 990,000 418,709 534,366 215,800 111,667 206,899 706,090 184,140 43,933 628,597 580,640 990,000 248,022 407,725 143,558 106,667 157,500 378,150 151,467 1,016,811 250,349,400 580,640 990,000 94,333 301,058 143,558 157,500 358,550 151,467 24,558,050 222,380,000 300,787,500 90,707,000 167,208,800 64,375,000 37,500,000 65,333,800 236,950,000 52,006,000 4,645,000
47
Strategic objectives Improve financial resources
Out put At least 10% of total budgets allocated for M&E/HIS activities at all levels Improved Financial Resources Developed Functional Integrated data warehouse Improved use of ICT (PDAs and computers) Number of HRIOs and other healthcare managers capacity in ICT developed Maintained and up to date system Established data security guidelines, remote sites and backups (storage) Increased awareness, access and use of information Increased use of available information Improved governance, coordination and enhanced linkages Established standards and SOPs for data collection, collation, analysis and dissemination Enhanced and Published HIS reports R-HFA and SAM reports Performance monitoring of health sector, HIS strategic plan, legislation and other statistical constituencies Data quality audits
Budget per financial year in US $ (Dollars) 2009/10 2010/11 2011/12 2012/13 2013/14 40,619 40,619 40,619 40,619 40,619 7,933 32,685 402,549 7,933 32,685 531,564 98,102 271,111 121,071 1,947 39,333 1,074,021 38,933 29,093 63,640 129,600 131,867 680,888 7,933 32,685 509,523 85,636 271,111 111,496 1,947 39,333 1,226,048 38,933 89,756 29,093 72,240 150,360 78,711 649,955 117,000 7,933 32,685 393,536 85,636 271,111 32,896 3,893 1,204,755 38,933 89,756 29,093 44,840 150,360 93,263 641,510 117,000 7,933 32,685 315,134 55,680 254,667 4,787 988,350 38,933 89,756 29,093 36,240 129,600 40,107 624,621 -
Total cost in KSHS 15,232,000 2,975,000 12,257,000 161,423,000 33,015,000 99,200,000 21,346,000 730,000 7,132,000 404,028,000 14,600,000 20,195,000 10,910,000 18,990,000 51,714,000 25,796,033 244,273,008 17,550,000
Amount US$ (KSHS. 75) 203,093 39,667 163,427 2,152,307 440,200 1,322,667 284,613 9,733 95,093 5,387,040 194,667 269,267 145,467 253,200 689,520 343,947 3,256,973 234,000
To Strengthen use and application of Information and Communication Technology in data management
115,147 254,667 14,363 1,947 16,427 893,866 38,933 29,093 36,240 129,600 659,999 -
To Improve monitoring, feedback, reporting, supervision and data audits
48
Strategic objectives To Enhance Governance, partnerships, collaboration and coordination Grand Totals
Out put Enhanced mechanisms for effective communication, collaboration and coordination
Budget per financial year in US $ (Dollars) 2009/10 2010/11 2011/12 2012/13 2013/14 35,227 35,227 35,227 35,227 73,793 73,793 73,793 73,793 35,227 35,227
Total cost in KSHS 18,995,000 18,995,000
Amount US$ (KSHS. 75) 253,267 253,267
3,245,491 6,549,568 5,799,966 4,945,837 4,720,721 1,892,618,750
25,234,917
49

HIS Strategic Plan 2009-2014, 05.08

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REPUBLIC OF KENYA

MINISTRY OF MEDICAL SERVICES AFYA HOUSE P.O. BOX 30016- NAIROBI

CHAPTER 4: STRATEGIC MODEL AND ANALYSIS OF STRATEGIC ISSUES............................................................ 10

CHAPTER 5: STRATEGIC IMPLEMENTATION ............................................................................................................ 15

HIS Strategic Plan 2009-2014

HIS Strategic Plan 2009-2014

Evaluation: End term Evaluation: Goals:Guiding Principles:HIS: -

Health Metrics Network:Inputs:

Mission Statement:Main (Core) Activities:-

HIS Strategic Plan 2009-2014

Mid-term Evaluation:Needs Assessment:Operational Planning:Objectives:Outputs/Results:Strategy:Strategic Planning:-

HIS Strategic Plan 2009-2014

Prof. James L. Ole Kiyiapi, CBS,

Mr. Mark K. Bor, EBS

HIS Strategic Plan 2009-2014

HIS Strategic Plan 2009-2014

HIS Strategic Plan 2009-2014

HIS Strategic Plan 2009-2014

HIS Strategic Plan 2009-2014

HIS Strategic Plan 2009-2014

HIS Strategic Plan 2009-2014

Health and Disease Records

Health and Disease Records

HIS Strategic Plan 2009-2014

HIS Strategic Plan 2009-2014

HIS Strategic Plan 2009-2014

HIS Strategic Plan 2009-2014

HIS Strategic Plan 2009-2014

4310 (88.3%) 227 (96.6%) 221 (100%) 10 4 2 4774

HIS Strategic Plan 2009-2014

Organogram of Health Information System

Facility based Health statistics

Population-based health statistics and Research

Support management e.g. transport,

Morbidity, mortality and service statistics

Workload/Hospit al administrative statistics

Infrastructure and fixed assets e.g. Health facilities

Commodities and suppliers e.g. drugs

Source: - HIS Division

HIS Strategic Plan 2009-2014

Fig 4.2 Governance Structure HIS MANAGEMENT STRUCTURE

NATIONAL COORDINATING COMMITTEE TECHNICAL WORKING GROUP

PROVINCIAL COORDINATING COMMITTEE

DISTRICT COORDINATING COMMITTEE

COMMUNITY COORDINATING COMMITTEE

HIS Strategic Plan 2009-2014

HIS Strategic Plan 2009-2014

Total Cost in Kshs

Amount US $ (Kshs. 75)

HIS Strategic Plan 2009-2014

HIS Strategic Plan 2009-2014

HIS Strategic Plan 2009-2014

Strategic Objective 1: To improve data management

Improved policy, procedures and institutional Capacity

Ministries of Health (HIS)

HIS TWG HIS

HIS Strategic Plan 2009-2014

Expected Output/ Results

Time Frame (Implementation Period) 2009/2010 2010/2011 2011/2012 2012/2013 2013/2014

Total Budget Kshs US$

Report of key subsystems and linkages

Ministries of Health (HIS)

Ministries of Health (HIS) HIS,DCH, All Stakeholders