Accurate Assessment for a Better National Health Information System; Bangladesh Experience

The health information system in most developing countries is weak, fragmented, isolated, hard-to-reach, unauthentic, understaffed, suffers from lack of analysis and utilization of data and is often inadequately resourced. Bangladesh is also characterized by a centralized and fragmented health information system. There is lack of awareness about the importance and utilization of health information. Since 2003 the government of Bangladesh is implementing one of the biggest sector wide programs in the world, called Health Nutrition and Population Sector Programme (HNPSP). This program has heightened awareness of the stakeholders and as a consequence there is increased demand from different sectors, interest from development partners. This has leaded the ministry of health and family welfare, to take positive initiatives to strengthen the national health information system.

The Health Metrics Network (HMN) of Bangladesh has started working since December 2007. It started with assessing the strengths and weaknesses of the country health information system. This was done however, by applying the HMN tools only. The HMN framework used by Bangladesh, was not enough to assess the HIS accurately and meaningfully. As an alternative several added attempts like: in-depth review of each system, Focus Group Discussion (FGD), field observation to key stakeholder organization, small scale survey, expert level review, and the agreed SWOT analysis on the basis of HMN framework were also conducted as a process.

It is evident that the assessment process has created new interest; recent sector programme reviews also appreciated the new avenue of collaboration and coordination. The planned improvement of this sector will enrich the monitoring and evaluation capacity of the government. This needs to be backed by strong commitment from the policy makers, formulating required strategy and policy. Only then decentralized, action-oriented, responsive, transparent and at the end quality health services by scare resources can be ensured.