Implementing a routine health management information system in South Sudan
South Sudan has recently acquired statehood. Planning and management of the health care system, based on evidence, requires a constant flow of information from health services. The Division of Monitoring and Evaluation (M&E) of the Ministry of Health developed the framework for the health sector of the country in 2008. At that time data were collected through surveys and assessments.
Two health system assessments conducted in 2007 (1) and 2009 (2) highlighted the absence of a working routine Health Management Information System (HMIS). An M&E Scoping Mission conducted in March 2010 (3) noted the lack of tools and procedures for data collection, the inconsistent data flow and the limited capacity for analysis and use of data for action at all levels of the system. A plan to develop the system based on the ‘3-ones’ strategy (one database, one monitoring system, one leadership) was put in place under the leadership of the Ministry of Health (MOH). The MOH has since developed, tested and refined the tools and procedures for the routine HMIS, produced a comprehensive roll out plan and started the integration of health programmes into the system.
The design of the routine HMIS tools was followed by their pre-test in Jonglei and Upper Nile States. In these two states, the combination of appropriate tools, training and support resulted in health facilities, counties and states officers able to provide consistent and quality routine reports. While this happened in the two states, at central level tools were refined and explained to MOH programmes staff and partners staff; consensus was built on the need for collecting only the relevant data for action and the database for the South Sudan information system was developed in the District Health Information Software (DHIS). This joint approach provided the needed impulse for the health agencies to adhere to the MOH system. From February 2011, a flurry of activities happened to support M&E in states and counties including provision of equipment, printing and distribution of registers and manuals and training in HMIS and DHIS of MOH officers, partners and programmes staff.
This approach has started to pay off and the routine information system is progressing. This paper presents the path followed, challenges met, advances made, and the way forward in establishing an integrated routine HMIS in South Sudan.