Informacao sobre Saude MSP course March 2002

Information sobre Saude Information system as social system informacao – information organizational, social, political, ambiental Information as social resource use, purpose, communication, interaction Information as ‘artifact’ tools, media – meias, documents, systems

Informacao sobre saude Information mapping Mapping reporting systems Registry books, forms Reports, documents Information flows Information audit Quality and use of data Information systems for health management

Field research--always Who What Where When Why How

Field research Who What Where When Why How Quem? Qual? Onde? A --? De --? Quando? Porque? Como?

e.g. of a “system”: Activity system –individuals & teams in social practices, tools—artifacts, purposes, community, rules, division of labor TOOLS (eg, info systems, computers, Schedule+ etc) OBJECT-OUTCOME To act as a mediator between computer industry and clients SUBJECT CommArc RULES (inc. values, ethics) COMMUNITY OF PRACTICE (other CommArc staff members, suppliers, customers etc) DIVISION OF LABOUR

A chronology of important events in the HISP case.

  Figure 3: Hierarchy of standards where each level has freedom to define their own standards as long as they align with the standards at the level above.

Feedback Feedback Central level Reports Meetings Supervision Admn health program Statistic and planing dep Reports Meetings Supervision Provincial level statistic and planing dep. Reports Meetings Supervision District level District information officer Other community sources Health services HC D. Hospital. HP Standard forms Books Standard forms

District Hospital/HC/ Priv sector District level District information officer + 2 representative ( Nur or admin) Forms + Reports Reports Other community sources Health services Schools NGO Local Gov Unions Special intergroups Standard forms Books District Hospital/HC/ Priv sector Nurse chief Nurse, Doc, Lab men, or farmac HP Basic health worker Basic health worker

01-Adilabad 02-Karimnagar 03-Warangal 04-Khammam 05-East Godavari 06-Visakhapatnam 07-Vizianagram 08-Srikakulam 09-West Godavari 10-Krishna 11-Guntur 12-Prakasam 13-Nellore 14-Chittoor 15-Cuddapah 16-Anantpur 17-Kurnool 18-Mahbubnagar 19-Nalgonda 20-Rangareddi 21-Medak 22-Nizamabad

Health Centre 1 lab Health Centre 2 lab Health Centre 3 lab District lab data compiled in a Rural Hospital lab Nucleus for Planning and Statistics (Aggregation of health district data) Department for Planning and Statistics Community level District level Other relevant data from the community and health facilities Provincial level Provincial lab data compiled and analysed by the lab manager National level Health Information Department National Section for clinical labs Reporting system usually delayed Feedback reports and supervision less frequent Figure 1 – The vertical top-down approach of lab information system coupled to the complex health information system in the National Health System

Interplay of institutions   Central Government (Ministries/Departments) State Government Scientific Institutions District Administration --------------------------------------------------------------------------------- Line Departments Funds Policy Issues Feedback Prog. Priorities & Monitoring GIS S/W and data Beneficiaries, Local People, NGOs Technology Development & Related Policies

Figure 2: Comparison of the new tally sheet in the injection room on the left with the old reporting form on the right, reporting 66 and 59 ‘events’ respectively. Note the columns marked ‘E’, ‘C’, ‘B’ and ‘A’ in the old form, for European, Coloured, Black and Asian. These columns are not in use anymore, and the space is used for marking the categories of the events reported.