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An Urgent Call to Improve Health Information Systems

on Mon, 06/15/2015 - 04:56

Many health information systems around the world struggle to meet current data demands, and in the context of the sustainable development goals, are ill-equipped to meet forthcoming data requirements.

Global health leaders from governments, multilateral, academia, research institutions and civil society gathered from June 9 to 11, 2015 at the Measurement and Accountability for Results in Health Summit (MA4Health)  – co-hosted by the World Bank Group, USAID and the World Health Organization (WHO) – to improve and sustain country measurement and accountability systems for health results through 2030, including national health goals and the health-related Sustainable Development Goals (SDGs). The program included keynote addresses, presentations, DevTalks and panel discussions examining the post-2015 agenda and priorities, and recommendations for health measurement.

During the first session of the summit, Dr. Chan, Director-General of the World Health Organization (WHO) emphasized the relevance of data and health information systems to build transparency and accountability. 

Over 100 countries, representing more than two-thirds of the world’s population, do not have systems for civil registration and vital statistics that produce reliable data on causes of death, according to Dr. Chan.

"Without these data, countries and their development partners are working in the dark, throwing money into a black hole" Dr. Chan said.

The chart visualizes the Vital Statistics Performance Index (VSPI), a composite index derived from the assessment of the civil registration and vital statistics systems from 148 countries of the world [1]. VSPI goes from from zero to one hundred, where a score close to zero represents rudimentary and inadequate performance and a score close to one hundred means satisfactory performance of the vital statistics system.

88 out of 144 countries of the world have a score of the vital statistic systems performance lower than 74 what is consider low-medium performance, meanwhile 60 of them exhibits an acceptable situation. 

"Accurate and complete data is essential for good decision making on health spending" stated Dr. Ties Boerma, WHO Director of the Department of Health Statistics and Information Systems in a recent commentary "A global commitment to improve health data" published in the WHO web site.

“If we are going to ensure that people everywhere have access to quality health care, and that no one is impoverished paying for the health care they need, we need to invest in high-quality, timely, and accurate data and statistics so that countries can measure and monitor their progress,” said Jim Yong Kim, President of the World Bank Group, in swesion 1 of MA4Health summit. “Today’s investments in country health information systems will lead to a better tomorrow for billions of people.”

During the three days of the summit, emphasis was put on health data collection and the imperative need for using and transforming health data in understanding and knowledge. A workshop was devoted to create data visualization applying simple tools and effective design and communication principles and techniques. My recent talk  "Data Visualization: Adding New Value to Health Data" at Health Datapalooza 2015 highlighted the need of analyzing and transforming data in information and insights, and share not only data but information visualizations for facilitating data exploration and understanding.  

Participants in the summit endorsed The Roadmap for Health Measurement and Accountability and a Five-Point Call to Action, which outline a shared strategic approach and priority actions and targets that countries and development partners can use to put effective health monitoring plans in place to strengthen health information systems.  

Urgent investments should be allocated and priority actions should be implemented in order to transform and improving health information systems. High prioritizing have to be put on those 46 countries with rudimentary vital statistics systems and a special attention should be given to countries with VSPI score in the ranges of 25-49 and 50-74. International organizations, ministry of health and national health authorities, and development partners share a high responsibility and key role in this effort. Much more need to be done in the face of the post-2015 sustainable development goals


  1. Lene Mikkelsen et al. 2015. A global assessment of civil registration and vital statistics systems: monitoring data quality and progress. The Lancet. DOI: Published Online: 10 May 2015
  2. David E Phillips, Rafael Lozano, Mohsen Naghavi, Charles Atkinson, Diego Gonzalez-Medina, Lene Mikkelsen, Christopher JL Murray and Alan D Lopez. A composite metric for assessing data on mortality and causes of death: the vital statistics performance index. Population Health Metrics 2014, 12:14  doi:10.1186/1478-7954-12-14. Available online:


Amanda Makulec's picture

I think your comments on the value and importance of visualization as we think about strengthening routine health information systems are spot on. Open source tools like DHIS2 and their dashboard features have great potential for value add, if thought and time is given to building capacity to customize and use those tools. We also shouldn't discount the value of hand drawn visualizations (like the WHO immunization monitoring charts) that can be used even where technology is limited.

Our workshop on simple best practices for improving data visualizations and helping them communicate more effectively went very well, and the opening presentation shared before our activity is available on slideshare:

martiner's picture

Thanks Amanda for adding your valuable comment and sharing your presention. 

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