national health observatories network as an instrument for strengthening health systems in sids

3rd SIDS Meeting, Moroni 9-11 March 2011 1 |

National Health Observatories National Health Observatories Network as an Instrument for Network as an Instrument for

Strengthening Health Systems Strengthening Health Systems in SIDSin SIDS

WHO\AHO


Presentation OutlinePresentation Outline

• Background and ContextBackground and Context

• Seychelles and Cape Verde DeclarationsSeychelles and Cape Verde Declarations

• Health ObservatoriesHealth Observatories

• Why in WHO? Why Now?Why in WHO? Why Now?

• AHO Objectives and ComponentsAHO Objectives and Components

• National Health ObservatoriesNational Health Observatories

• NHO Objectives and Major ComponentsNHO Objectives and Major Components

• SIDS NHO’s Virtual Community NetworkSIDS NHO’s Virtual Community Network

• Cape Verde NHO ExperienceCape Verde NHO Experience

• ICT Challenges in SIDSICT Challenges in SIDS

• Next Steps and Expected OutcomesNext Steps and Expected Outcomes


• SIDS Ministers of Health: (6) need for collaboration between the SIDS with special reference to best public health practices including health information systems.

• Commit to (15) Redesign health systems to make them more relevant to the specific context of Small Island States.

• Request from WHO: (22) Disseminate reliable evidence of health situation and health risks facing SIDS and sensitize the international community to contribute to sustain health services and improve progress towards health MDGs.

The Seychelles DeclarationThe Seychelles DeclarationMahé, 24th of October 2006Mahé, 24th of October 2006


• SIDS Ministers of Health: (2) Considering the Ouagadougou Declaration on Primary Health Care and Health Systems in Africa and (3) Considering the Algiers Declaration on Research for Health and the Bamako call to Action.

• Commit to (10) set up mechanisms for documenting and sharing best practices by using modern communication technologies including the creation of a website and drawing upon the specific expertise existing in each country.

• (11) Selected areas of cooperation by country: Mauritius - Establishment of databases on communicable diseases and noncommunicable diseases.

Cape Verde DeclarationCape Verde DeclarationPraia, 19th of March 2009Praia, 19th of March 2009


• Observing the heavens Observing the heavens (Astrology, Astronomy...)(Astrology, Astronomy...)

• 11stst Health Observatory in France - Health Observatory in France - 19741974

• Numerous now, but mostly in Numerous now, but mostly in Europe & USAEurope & USA

• One-stop shop for high quality One-stop shop for high quality information and evidenceinformation and evidence

• Some also strive to improve the Some also strive to improve the use of information, evidence, use of information, evidence, knowledgeknowledge

From Astronomical to Health From Astronomical to Health ObservatoriesObservatories


• Ouagadougou & Algiers Declarations (2008)

• GPW 2006-2015– Gaps in Social Justice– Gaps in Knowledge

• WHO-Core functions on IEK

• AFRO’s Strategic Orientations

Why in WHO?Why in WHO?


• Reforms are required to strengthen health systems

• An observatory can assist:1. NHIS Fragmented

• Under-resourced• Extra burden on

collectors 2. Limited clients3. Narrow scope of inquiry4. Old architecture

Why Now?Why Now?


• Bridging the Knowledge Gap

– Relevant, timely, valid & reliable IEK

– Shared & used for policy & decision

• Multitude of Clients

– Public & private; multi-disciplinary; Multi-sectoral;

• Broader Scope

– Systems in addition to outcomes;

– social goals plus health goals;

– quantitative plus qualitative sources

• Better Information Architecture

– Transparent; Collaborative; Communities of practice

AHO is an Instrument for Strengthening AHO is an Instrument for Strengthening National Health SystemsNational Health Systems


3. Data and Statistics3. Data and Statistics 4. Regional and Country 4. Regional and Country ProfilesProfiles

5. Publications5. Publications 6. National Observatories6. National Observatories

2. The Regional Director’s Blog2. The Regional Director’s Blog

7. Networks / Communities of Practice 7. Networks / Communities of Practice

1. Collaborative Web Portal1. Collaborative Web Portal

AHO Seven Major ComponentsAHO Seven Major Components


3. Raw data, statistical 3. Raw data, statistical tables, graphs, maps, tables, graphs, maps, and factsheetsand factsheets

4. Comprehensive and 4. Comprehensive and Analytical Regional and Analytical Regional and Country ProfilesCountry Profiles

5. Thematic & country-5. Thematic & country-specific publicationsspecific publications

6. Support the 6. Support the development of national development of national observatoriesobservatories


7. Networks / Communities of Practice 7. Networks / Communities of Practice

1. Collaborative Web Portal1. Collaborative Web Portal

AHO Seven Major ComponentsAHO Seven Major Components


(Blog is an abbreviation of Web-log)



Raw data for download or for creating tables & figures

Country & Regional statistical factsheets

Ready-made statistical tables on major areas & themes

Metadata, guides & reference publications & links

3. Data and Statistics3. Data and Statistics


• Employ Wiki for better collaborative effort

• Analysis based on the latest evidence

• Focus on systems as well as outcomes

• Involve stakeholders, including policy makers

• Built in equity gauge: gender, location, income, etc

• Combination of narrative text, tables, & figures

• Contents accepted as own by country

4. Country and Regional Profiles4. Country and Regional Profiles


1. Brief introduction to the Region / country & people

2. Health status & trends3. Health systems4. Specific programs &

services5. Key determinants6. Progress on health

MDGs & other goals (Ouagadougou, Algiers, Libreville etc)

Structure of ProfilesStructure of Profiles


• Relevant, high-quality publications Relevant, high-quality publications on thematic, Regional, sub-on thematic, Regional, sub-regional & country-specific issuesregional & country-specific issues

• Statistical factsheets & atlasStatistical factsheets & atlas• Country & Regional profilesCountry & Regional profiles• Case reports Case reports • Best practicesBest practices• Progress reportsProgress reports• Policy papersPolicy papers• Evaluation reports Evaluation reports • Research papersResearch papers• Systematic reviews, etc… Systematic reviews, etc…

• Produced by Working Groups or Produced by Working Groups or commissioned to consultantscommissioned to consultants

5. Observatory Publications5. Observatory Publications


Data and StatisticsData and Statistics Country and District ProfilesCountry and District Profiles

PublicationsPublications District ObservatoriesDistrict Observatories

The Target: Support all countries to establish national observatories - Regional model adapted to country settingsCurrently: On going work with 3 countries to establish national observatories (1 English, 1 French, 1 Portuguese speaking)

National Observatory PortalNational Observatory Portal

Networks / Communities of PracticeNetworks / Communities of Practice

6. National Observatories6. National Observatories


At All LevelsAt All Levels Regional Office Regional Office

& IST level (e.g. & IST level (e.g. Working groups)Working groups)

WCO level (e.g. WCO level (e.g. 46 IER focal 46 IER focal points)points)

Sub-regional Sub-regional ((SIDS NetworkSIDS Network))

Country (e.g. Country (e.g. National National observatories)observatories)

Working Groups established at the Regional Office

1. Health systems

2. HIV/AIDS, TB, malaria

3. Family & reproductive health

4. Communicable diseases, chronic diseases, mental disorders & injuries

5. Key determinants (Risk factors, food & nutrition, physical environment, social determinants)

6. More as needed

7. Networks/working groups7. Networks/working groups


1. Produce Regional and country profiles on their specific area

2. Generate high-quality publications

3. Promote & maintain the relevant datasets in the integrated database

4. Create & maintain networks at all levels of AFRO & countries

5. Assist in the forecast of events as part of an early warning system (e.g. as part of the SHOC)

6. Support national observatories

Functions of Observatory Functions of Observatory Working GroupsWorking Groups


• Comprehensive & analytical regional and country profiles

• Network of 46 national observatories supporting national IEK systems

• Sub-national (e.g. district) level data, statistics & profiles

• Networks of health workers, researchers and policy makers working & learning together to improve health systems

• Modern management systems & infrastructure

• Constitutional mandate on IEK

• Commitment to social justice

Unique Features of AHOUnique Features of AHO


• Is an instrument that assists efforts on strengthening health systems by its broader client base, scope or domain & improved architecture; and

• Is a repository or ‘one-stop-shop’, a tool & a collaborating platform for acquiring, generating, sharing, and applying IEK for policy & decisions

Provides or support:• High quality

data/statistics• Comprehensive &

analytical Regional & country profiles

• High-quality thematic publications

• Dynamic & vibrant networks and Communities of Practice

• 46 national observatories

In SummaryIn SummaryThe African Health ObservatoryThe African Health Observatory::


Data and StatisticsData and Statistics Country and District ProfilesCountry and District Profiles

PublicationsPublications District ObservatoriesDistrict Observatories

• NHOs similar in structure to AHO

• Modified / adapted for country situation

• National, regional, district observatories...

National Observatory PortalNational Observatory Portal

Networks / Communities of PracticeNetworks / Communities of Practice

National Health ObservatoriesNational Health Observatories


1.To provide easy access to high quality data, information, evidence and knowledge (IEK)

2.To facilitate the generation of IEK

3.To promote the application of IEK for policy & decision

NHO Major ObjectivesNHO Major Objectives


NHO FunctionsNHO Functions

• A descriptive function that provides for an easily accessible database;

• An analytical function that draws lessons from successes and failures that can assist policy makers in the formulation of strategies;

• A prediction function to forecast potential outcomes;• A prescriptive function that brings forward

recommendations for action;• A monitoring and evaluation function that focuses on

aspects that can be improved;• A capacity strengthening function that aims to develop

partnerships and share knowledge both within the country.


SIDS NHO’s StakeholdersSIDS NHO’s Stakeholders

• Ministry of Health• WHO-AFRO• Government Institutions• Health Care Facilities• Universities & Research

Institutions• Private sector & NGOs• African Regional Organizations• Other Organizations &Institutions


SIDS NHO’s Virtual Community SIDS NHO’s Virtual Community NetworkNetwork

• Advantages of using a network approach:• Weaving Community;• Enabling Diverse

Perspectives;• Building and Sharing

Knowledge (best practices);

• Coordinating Resources and Action.


• Groups, networks or communities of practice (COPs)

• National level and District level• Come together on a regular or ad-hoc

basis– To acquire, create and share

information, evidence & knowledge; and – To collaborate on particular projects

• Essential to any modern society– Bring together people to share insights

& foster good practice– Build specific capacity in the society– Ensure that this capacity is retained in

the agency as people move on

Collaborative Work, Learning and InnovationCollaborative Work, Learning and Innovation

SIDS NHO’s Virtual Community SIDS NHO’s Virtual Community NetworkNetwork


Cape Verde NHO ExperienceCape Verde NHO Experience

• OMS CV and CV MoH initiative in collaboration with, NOSI, INE and MCA to set 9 District Health Observatories.

• Complete the Cape Verde Country Analytical Profile.

• Country ownership and motivation.• Try to replicate the good

practices/experience acquired in CV in other African countries.


Cape Verde NHO ExperienceCape Verde NHO Experience

Pilot


Percentage of population - telephone (fixed and mobile) subscribers, African Region, 2007

ICT Challenges in SIDSICT Challenges in SIDS

Challenges:

• Develop and implement Policies

• Limited infrastructure and services

• Limited human capacity

• High costs of development and maintenance of a proper ICT infrastructure


ICT Challenges in SIDSICT Challenges in SIDS

Percentage of population using the Internet, African Region, 2007.

Challenges:

• Weak ICT infrastructure and services within the health sector

• Inadequate financial resources

• The Digital Divide

• Weak M&E systems


• for Leaders:for Leaders:• Have at hand the IEK of the district / community Have at hand the IEK of the district / community • Know where to go to find itKnow where to go to find it• Leverage / use others’ IEK to improve performanceLeverage / use others’ IEK to improve performance• Have competent, satisfied & continuously learning staffHave competent, satisfied & continuously learning staff• Retain / sustain IEK when staff leaveRetain / sustain IEK when staff leave• Official health information trusted and appreciatedOfficial health information trusted and appreciated

• for Health Workers:for Health Workers:• Improve competence by continuous learningImprove competence by continuous learning• More satisfaction More satisfaction • Consider IEK work as essential instead of extra taskConsider IEK work as essential instead of extra task• Widely share & use IEKWidely share & use IEK• Identify useful IEKIdentify useful IEK

Expected OutcomesExpected Outcomes


Expected OutcomesExpected Outcomes

• for a District or Community:for a District or Community:• Public health needs are anticipated & described timelyPublic health needs are anticipated & described timely• Improved transparency & accountability by leadersImproved transparency & accountability by leaders• Limited subjectivity / bias in decisions by leadersLimited subjectivity / bias in decisions by leaders• Evidence used more effectively in policy & decisionsEvidence used more effectively in policy & decisions

• for Citizens:for Citizens:• EmpoweredEmpowered

• Increased awarenessIncreased awareness• Change in behaviorChange in behavior• Better participation in community affairsBetter participation in community affairs


SIDS NHO’s Next StepsSIDS NHO’s Next Steps

• AHO AHO • Development of Analytical country profile (part of Development of Analytical country profile (part of

the AHO work)the AHO work)• Designation of a focal personDesignation of a focal person• Identification of a working groupIdentification of a working group• Establish SIDS Virtual Community NetworkEstablish SIDS Virtual Community Network

• NHONHO• Designation of a focal personDesignation of a focal person• Identification of a stakeholder groupIdentification of a stakeholder group• Develop a frameworkDevelop a framework


Thank you

national health observatories network as an instrument for strengthening health systems in sids

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