Faculty of Public Health - Andalas University - OCS, 13th IEA SEA Meeting and ICPH - SDev

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Challenges and opportunities for HIS strengthening for sustainable development: a facility-level analysis in North Sulawesi, Indonesia
Rutler P Masalamate, Aprisa Chrysantina, Chreisye KF. Mandagi

Last modified: 2018-08-20



Targeted improvement national health status is the third goal in the sustainable development, measured by health program data and information from local level, with the health care facilities as the spearhead of health service providers and data sources. Health information systems (HIS) is a complex environment where data and information are collected, analyzed, disseminated, and used. Thus, it is critical to understand its current practices and challenges, particularly in the lowest level that feed to higher level data and decision making for sustainable development. Through an assessment, we explored HIS situation of low-resourced settings, represented by 4 districts in North Sulawesi, then built recommendation and actions to improve local HIS as a building block in health system.


Materials and methods

In March-July 2018, we conducted assessment to 52 public health centers in 4 districts in North Sulawesi Province, namely Manado City, Tomohon City, Minahasa District, and North Minahasa District. The study was a mixed method research with guided interview and direct observation. For the interview and observation process, we used a modified HMN assessment tool and an observation checklist, respectively.



The assessment covered 4 out of 6 HIS components that are contextual that to HIS in facility level. These include HIS resources such as policy and planning, human resources, and budget; indicators and data sources, and information dissemination and use. Both the interview and observation revealed that Manado and Tomohon Districts demonstrated the strongest potential in HIS resources, which include commitment and infrastructure compared to the other two. On the other hand, the indicators and data sources components of the facilities are mostly similar due to the top-down regulations and policies from district, province, and even national level.



Here we only present few examples of the results and recommendations that we will explore further in the paper. The way facilities managing their data and information does not reflect awareness of the importance for quality data for health program planning and decision making. This is the underlying cause of challenges found during the study, such as absence of HIS regulations, budget, lack of designated staff, insufficient data analysis competencies, lack of coordination between staff, low data quality, use, and dissemination. Based on those challenges, we recommend to prioritize improving the awareness of data quality and management through structured capacity building and close assistance for HIS strengthening including local regulation and policy development.



This research was made possible by support from Manado, Tomohon, Minahasa, and North Minahasa District Health Offices; as well as our colleagues from Faculty of Public Health University of Sam Ratulangi, Manado, Indonesia.


Keywords : Health information systems, health metric networks, informed decision making, health data management