Lessons in Health Information System Strengthening: What Worked in Mali

Author(s): MEASURE Evaluation

Year: 2019

Abstract:

Since 2010, MEASURE Evaluation has worked with the United States Agency for International Development (USAID) mission in Mali to strengthen national- and community-level health information systems (HIS), with an emphasis on malaria monitoring and evaluation (M&E).

In collaboration with units and programs of the Mali Ministry of Public Health and Hygiene (MOH), MEASURE Evaluation streamlined data collection systems and strengthened governance and leadership and HIS management, to improve quality and use of health data. MEASURE Evaluation supported HIS strengthening by partnering with the MOH and working closely with United States Government (USG) implementing partners (IPs) and non-USG partners. The project also built MOH capacity to use and manage the HIS and use HIS data for decision making, by customizing electronic platforms, providing necessary hardware and software, and training and mentoring MOH staff. These approaches yielded the following gains:

• Nine parallel systems (on non-web-based platforms that were previously only available in electronic version above the site level) were combined into one streamlined system that is available at all levels of the health system on the DHIS 2 platform.
• HIS management and governance tools, resources, and coordinating bodies were established that have standard operating procedures, guides, steering committees, and technical working groups.
• More than 2,200 staff members and providers at all levels of the health system were trained in DHIS 2 use, data use, and other relevant topics through training of trainers and cascade trainings. Select staff at the central level were also trained in the customization of DHIS 2.
• One hundred percent of regional hospitals, 100 percent of district health facilities, and 98 percent of community health facilities reported in DHIS 2.
• Mechanisms for data monitoring (e.g., data review meetings, data competitions, a quarterly health management information system bulletin, and supportive supervision visits) were established.

These accomplishments can be quantified, but it is also important to understand HIS users’ experiences and the context in which the system was strengthened and improved. To do so, in 2019, we conducted stakeholder interviews to capture perceptions and experiences of MOH staff who interact with Mali’s HIS. An analysis of these interviews yielded common themes of what worked in HIS strengthening in Mali. The objective of this document is to summarize lessons learned and highlight effective HIS strengthening approaches and interventions and their outcomes.