dr mark amexo , md. h ealth m etrics n etwork secretariat,

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Monitoring of Vital Events thro’ Leveraging Innovations including

Information Technology (IT) Advances.

7th Africa Symposium on Statistics Development (ASSD) 18-23 January 2012.

Cape Town, South Africa.

Dr Mark Amexo, MD.

Health Metrics Network Secretariat, W.H.O Headquarters. Geneva, Switzerland.

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Outline

1. Rationale for "MoVE-IT" 2. The 3 Work Streams: 3. MoVE-IT Africa Initiative4. Progress5. Next Steps

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Why MoVE-IT?

1. HMN: Global Network for Country HIS 2. The Health Imperative in CRVS System3. Information Needs: Evidence-based Decision &

Policy, Planning, Tracking, Results and Accountability

4. HMN Commissioned MoVE Series in The Lancet: Who Counts?; "Everybody Counts"

5. Needs for: MDGs, GF Impact Measurements 6. Advances and Availability of IT 7. Commission on Information and Accountability –

Mandate for Recommendation 1

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"Roadmap"HMN Framework

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MoVE-IT …..

Promoting Health Imperative in CRVS syst.Smarter ways to Capture, Record Vital Events;

have these Certified.Compile and Use Vital Statistics – "Real Time"Consistent with UNSD Principles and PracticesEmpower National Govt. to Act and Lead

Evidence-based Decision and ActionsImproved Health Outcomes, ImpactIT use: Evade barriers, Quality/Efficiency

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Collaboration Harmonization, Synergy

• Collaboration, Harmonised Action of Partners (UN Agencies, Bilateral & Multilateral Institutions, Academia and Research, Country Systems/Sectors

• National Government Departments & Sectors, Development Partners

• Local Authorities & Populations, CSOs, NGOs

• Promote and Link Health Sector Actions to Other Sectors in CRVS System.

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Provide Standards and Tools: Assessment, Quality Control, Mobile Devices for monitoring of vital events

Advocate for functional Civil Registration - Vital Statistics systems in CountriesRegional and Country Policy processes, Resource Mobilization

Generate Evidence on what works: working with countries and Partners by building upon existing work or systems

MoVE-IT: 3 Workstreams

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Standards & Tools

• Reporting Variables: Pregnancy Tracking, Birth, Death•Cause of Death (ICD, VAT)• Data Quality and Analysis• Data & Information Dissemination and Use•Resource Toolkit

Advocacy, Policy and Resources•Global and Regional Fora•National Stakeholders, Coordination Body, TWGs•Best Practices Lessons Learnt•Partners' Funds, Technical Resources

Evidence Generation/ Country Implementation •Community Events Reporting • Health Facility Reporting•Data Management and Quality Assurance•Data & Information Use •Country Case Studies •Knowledge, Skills & Best Practice Transfer•Lessons Learnt

Efficiency Better OutcomesAccountability

Standards(refined/improved)

Tools and Guidance (refined/improved)

Evidence

Policy, Law

MoVE ITStrategy

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TUNISIA

MOROCCO

SAHARA

ALGERIA

MAURITANIA MAL

I NIGER

LIBYA

CHAD

Sea

EGYPT

SUDAN

ETHIOPIA

DJIBOUTI

ERITREA

SOMALIAKENYA

TANZANIA

DEMOCRATIC

(ZAIRE)

CENTRAL

RWANDA

GABON

EQUATORIAL

ANGOLA

CONGO

NIGERIA

BENIN

DTVOIRE

SIERRA

SENEGAL

GHANA

THE

GUINEA

LIBERIA

CAMEROON

MALAWI

ZAMBIA

MOZAMBIQUE MADAGASCARZIMBABWE

BOTSWANA

SWAZILANDLESOTHO

NAMIBIA

ANGOLA

WESTERN

Rd

UGANDA

OF THE CONGO

REPUBLIC

BURUNDI

GUINEAREP. OF

TOGOCOTE

BURKINA

GUINEA

LEONE

GAMBIA

BISSAU

SOUTH

REPUBLIC

AFRICAN

THE

AFRICA

GeneralAssessment

General assessment

Communityreporting studySystem building

Case studySystem building & IT innovation

General assessment Cause of death reporting

Community reporting & IT

Lessons learnt SAVVYand district SRS

Analysisexisting data

Hospital reporting

PLUS> 10 DSS sites in 10 countriesAnalysis of existing data, withfocus on causes of death, andmaternal mortality & HIV

Africa "MoVE-IT" Initiative.

Global & Regional Partnership/Network, Advocacy – Ministerial Conference, ASSD, Country Partnerships.

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Implementation Updates.

1. Advocacy and Policy2. Standards Promotion and Tools

Development 3. Evidence Generation

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Update 1: Advocacy and Policy 1. National Level: National Stakeholders Forum2. Regional: EGM and Ministerial Confab 2010,

Mini, 6th ASSD, 7th ASSD now.3. Global Level: Commission on Information and

Accountability (Geneva, Tanzania, Canada etc), 4. Others: CDC-WHO Meeting on Maternal Mortality

Surveillance in Atlanta, USA.• International Expert Group on VA Instrument

Standardization (Item Reduction and Automation)• WHO-FIC (Cape Town, 2011)• Similarly in Asia-Pacific Region

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Variables ready for use.

Automated VAI March 2012

Data Collection

Technical Resources

Data Analysis

Birth, Death, Cause-of-Death

Pregnancy Tracking, VA-automation.

1. Mortality Data Quality Assessment,

2. Mortality Assessment from Census

MoVE-IT Resource Tool Kit,

HIS sub-Account in NHA

ANACOD available for use

In progress; by March 2012

Update 2: Standards and Tools

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Update 3: Evidence Generation

i. Surveillance Data Useii. Community Reporting Systemiii. Hospital Mortality Data Use iv. VR Data Use; even when less Perfect

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Update 3i: Surveillance Data Use

1. INDEPTH-ALPHA Networks Collaboration: 20 HDSS sites 14 Countries; (first ever)

Capacity Workshop for HDSS Experts on Analysis and Data to Policy and Action

Data Use Agreement Secured (All HDSS Sites)

Input to VA and IntervA Tools Revision Policy Paper on HIV and Maternal Mortality2. Tanzania: Analysis of HDSS Data and

SAVVY Experience and Lessons

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Update 3ii: Community Reporting System

Ghana, Ethiopia, Rwanda and Kenya:Design (Reporting Infrastructure, IT, Resource

Needs)Training of Workers (Community and Regular)Events Reporting Pathways and ResponsibilityApplications TWG, Coordination and OversightEnsuring Coordinated and Harmonized

Support for Country Strategies

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Update3iii: Hospital Mortality Data Use.

Mozambique: (CDC, PEPFAR and HMN support)Improved Coverage and Quality of Hospital Mortality

and Cause-of-Death Statistics (ICD-based) using SIS-ROH data mx system

1. Interagency Coordinating Group: MoH, Home Affairs, NSO and University.

2.Capacity Building: SIS-ROH system upgrade and Staff Training, and Study tour to South Africa Institutions

3. In progress: System roll-out to other major hospitals in provinces and districts

=> Improved Hospital Cause-of-Death Statistics, and Use

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Update 3iv: VR Data Use Even When Less Perfect

i. Botswana: Using Existing Country Data to Measure

Impact of HIV-TB programme intervention; GF, UNAIDS, WHO, MoH, NSO

ii. South Africa: Collaboration Home Affairs, NSO, MRC,

MoH, Universities etcVR Data Used for Health Impact

Indicators, Differentials in Health Status, 2nd National Burden of Disease.

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Next Steps

• 1st Interim Report; Review and Update Strategy and Plans, if Indicated

• Platform and Opportunities for PIs and Key Actors Knowledge Sharing, Guidance Update

• Coordination, Access to Resources and Capacity Building

• Hubs for Health Information System• Resource Kit; Act; Innovate; Update Kit• Empower for COIA "Recommendation 1"

www.healthmetricsnetwork.org04/22/2319

Thank you.