THE UNITED REPUBLIC OF TANZANIA HEALTH DATA COLLABORATIVE (THDC) LAUNCH MEETING Update of M&E Strengthening Initiatives (M&E SI) A Tanzanian Platform for Health Information and Accountability 11-12 September 2017 By: Claud John Kumalija M&E Policy and Planning Ministry of Health - CDCEC Slide 1
Background: Situation of Health Data between 2004 Slide -2008 2
Monitoring and Evaluation Strengthening Initiatives (M&E SI) In year 2009, the Health Strategic Plan III (2009 2015) recognized the importance and established Monitoring and Evaluation Strengthening Initiatives (M&E SI) Strengthening of Monitoring and Evaluation is regarded as the pillar for improving the quality of health care and health service delivery. Slide 3
Responsibilities of Monitoring and Evaluation Monitoring and Evaluation Section of the Ministry of Health CDGEC is the custodian of Health Statistics It is Mandated and work under the umbrella of the National Bureau of Statistics (NBS) It is responsible to ensure smooth implementation of data collection, analysis, dissemination and use among health partners It is responsible to collect routine data, conduct demographic health surveys, health facility assessment and surveillances It is responsible to generate key health indicators and publication of Slide 4 core health reports
Key Health indicators generated to measure the Health Sector and interventions Sustainable Development Goals (SDGs) Health Sector Strategic plan (HSSP IV) Comprehensive Council Health Plan (CCHP) Government Health Budget implementation Health Basket Fund (HBF) Results Based Financing (RBF) Vertical Programs (HIV, TB and Malaria) Human resource for Health (HRH) Reproductive Maternal and New Born Child Health (RMNCH) Tracer Medicine Integrated Disease Surveillance and Respond (IDSR) Health facility Star Rating Ruling Party Manifesto Other Government, Funding and Implementing Partner s indicator needs etc Slide 5
Annual Health Statistical Publications Slide 6
Periodic Health Demographic and Facility Heath Surveys Slide 7
Evaluation of the Health Sector and programs Slide 8
Example: Analysis of the Regional Ranking of the Health Strategic Plan (HSSP III) indicators 2015 Kagera 17 Mara 9 Mwanza 16 Arusha 14 Simiyu 21b Geita 16b Shinynga 21 Kilimanja ro 1 Regional Ranking on Health System Strengthening Kigoma 18 Katavi 19b Tabora 20 Singida 12 Dodom 11 Manyara 13 Tanga 6 Pwani 5 DSM 8 Rukwa 19 Mbeya 10 Iringa 2 Morgoro 7 Top regions Njombe 2b Lindi 3 Upper middle Lower middle Lower Ruvuma 4 Mtwara 15 Slide 9
Example: Analysis to track Millennium Development Goals (MDGs) year 2000-2015 Childhood Mortalities(per 1,000 live births Slide 10
International Classification of Diseases (ICD -10) Since year 2013 Tanzania has been Producing and submit ICD -10 data to the World Health Organization (WHO) Slide 11
Example: Trend Analysis of Hospital Mortality and Cause of Death in Mainland Tanzania Year (2006 2015) Slide 12
Tanzania HMIS(MTUHA) and DHIS2 Currently, data in the Health Sector is neither purely electronic nor purely manually rather it is a mix one that is manual and electronic. Data system is paper based at facility levels (Dispensary - 6259, Health Centre - 768 and Hospitals -257) where HMIS/MTUHA is in use Data system is computerized at District/Councils levels with (DHIS2 application) to all 184 Councils, 26 Regions and through web based up to Central level with full access day and night Slide 13
HMIS/MTUHA Facility Data Tools (Register, Tally Sheets, Monthly Summary) Forms) 14 Slide 14
Web Portal Dashboard Data from Mobile devices Data warehouse DHIS 2 -Analytics -Meta data -Visualising tools Graphs Maps LMIS HR EMR Mobile DHIS2 Applications at District and above Slide 15
Currently 46 countries, 25,000 users monthly access DHIS2 National coverage Partial/Small scale Under pilot Not implemented Slide 16
OVERVIEW OF TANZANIA ROUTINE HEALTH DATA Google: Tanzania HMIS Slide 17
Tanzania DHIS2 Dash Board/Web Portal Slide 18 18
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Health Programs Currently using DHIS2 No Organization Software (Database) 1 Health Management Information System (HMIS) DHIS 2 Comprehensive Council Health Plan (CCHP) DHIS 3 National Tuberculosis and Leprosy program (TBLP) DHIS 4 Health System Strengthening ( HSS) DHIS 5 IVD DHIS-VIMS 6 National Malaria Control Program (NMCP) DHIS 7 National AIDS Control Program (NACP) DHIS - CTC2 Database 8 Global Fund Coordination Unit DHIS 9 Reproductive Maternal New Borne Child Health (RMNCH DHIS 10 Human Resource for Health Information System (HRHIS) DHIS, TIIS 11 Integrated Disease Surveillances and Response (IDSR) DHIS- IDSR 12 Health Facility Star Rating DHIS 13 Health Basket Fund (HBF) DHIS 14 Results Based Financing (RBF) DHIS Slide 20
Areas where you can find heath data, Indicators and Reports and other health information Health data, information and reports are currently available at:- www.opendata.go.tz www.moh.go.tz https://hmisportal.moh.go.tz www.hfrportal.ehealth.go.tz These websites link to national websites including the National Bureau Statistics (NBS), ega, Heath Universities etc. Slide 21
Existing Key Challenges to the Tanzania data Systems Management of Data at facility levels (Dispensary - 6259, Health Centre - 768 and Hospitals -257) is paper based and tedious (Call ICT for paperless innovations) Quality of routine data collected from the health facilities is a challenge (Develop and operationalize data quality assurance plan) Low capacity of health staff at data collection point on data analysis, interpretation, dissemination and use (Mentoring and on job, Introduce training to health training institutions, propagate the culture of data friendly) Infrastructure and limited budget at data collection points for enabling data system strengthening (The Government and Funding Partners to allocate recommended funds to M&E) Slide 22
Key challenges facing M&E Fragmentation and multiple data initiatives across the Health Sector i. Parallel funding to program data, existing of Parallel routine reporting systems such as IVD, HIV PEPFAR - DATIM is a challenge ii. Un coordinated National surveys such SPA (USAD), SARA (Global Fund), SDI (World Bank) collecting almost same indicators iii. Existing of databases which operate in parallel to DHIS2 National database such as Laboratory Information System (LIS) Slide 23
Acknowledgement Members of the M&E Technical working group across the Health Sector under TC-SWAp M&E Funding partners lead by the Global Fund, The Royal Embassy of Netherlands and PEPFAR (CDC) - Tanzania Implementing partners lead by the PEPFAR(USAID) - Tanzania, International Technical Assistant lead by WHO and PEPAR(CDC) Tanzania University of Dar es Salaam working with the Oslo University of Norway on DHIS2, MUHAS, NIMR, IHI, Mzumbe, OUT and Muhimbili National Hospital National Bureau Statistics (NBS) working with International Technical Assistances such as MEASURE, MACRO, ICAP etc FBO, Parastatal, NGOs and CSCOs Slide 24 Health Facility Staff, Councils, Regions and the General Public
Thank You Slide 25