Konsep dan Strategi Penguatan

Sistem Informasi Kesehatan

(HMNFramework)

GuardianY.Sanjaya
gysanjaya.blog.ugm.ac.id
 Outline
Reviewhealthinformationsystems
Frameworkofstrengtheninghealth
informationsystems
Sixcomponentofhealthinformationsystems
ChallengesinstrengtheningHIS
Sistem Informasi sebagai subsystemskesehatan

WHOSEARO.2014.ReferencemanualonHealthInformationSystem 3
 HealthInformationSystems Framework

Asystem

Anycollectionofcomponentsthatwork
togethertoachieveacommonobjective.

Inthecaseof Toimprovehealthservicesmanagement
aHIS
throughoptimalinformation support

Ameaningful collectionoffactsordata

Sauerborn,R.,andLippeveld,T.,2000.WhyHealthInformationSystems?InDesignandImplementationofHealthInformationSystems,ed.T.Lippeveld,R.
4
Sauerborn,andC.Bodart.Geneva:WorldHealthOrganization.
HealthInformationSystemsFramework

Strategic planning and

Sauerborn,etal.
resource allocation
Reporting and planning
Facility management, Global/Regional
audits, planning, drug National
procurement District
Patient care Facility
Understanding population Patient
burden of disease and risk Household and
Monitoring and evaluation community

HealthMetricsNetwork,WHO.2008.Frameworkandstandardsforcountryhealth 5
informationsystems.2nd Ed.
 6componentsofstrongHIS

Input Process Output

Resources Data Information

Indicators management Product
Datasources Dissemination
andUseof
information
ComponentofHealthInformationSystems

.asystemthatprovides
specificinformationsupport
tothedecisionmaking
processateachlevelofan
organization
Informationprocess
Management
 PPSIKNo46tahun 2014

Input Process Output

Kebutuhan data Tatakelola dan Produk informasi

berdasarkan indikator pengorganisasian
Penyebarluasan
kesehatan (berbagai level)
Pendayagunaan
Instrumen pencatatan Pengolahan datadan
dan pelaporan informasi, Penggunan data
(pengumpulan data) penyimpanan,
keamanan dan
Sumber data(rutin,
kerahasiaan data
nonrutin)
Sumber Daya SIK
(hardware,software,
brainware,financing)
 1.Resources
Physical,structuralandnonstructural(policy,
legislation)requirementsthatneedtobeput
inplacebeforeastrongsystemcanbebuilt
Legislative,regulatory&planningframework
Personnel,financing,logisticsupport,ITand
communicationsystems
HISResources/Inputs

10
 2.Indicators
Tomonitorthesystemseffectiveness,setsof
measurabledataareneededtoreflectchange
overtime
Indicatorsmeasure determinantsofhealth,
healthsystem,andhealthstatus.
Indicatorsneedtobevalid,reliable,specific,
sensitiveandfeasibletomeasure
 HealthIndicators

HealthMetricsNetwork,WHO.2008.Frameworkandstandardsforcountryhealth
informationsystems.2nd Ed. 12
 HealthIndicators
Mortality and other
epidemiological indicators
Absolute numbers of deaths /
reported cases
Early age mortality rates
Maternal mortality ratio
Summary measures
Life expectancy
Years of Life Lost (YLLs)
Proportionate mortality by
cause
Incidence
Prevalence
Health system resources
Numbers of personnel /
facilities / beds
Personnel / facility density
rates
Expenditure rates /
proportions
Health expenditure indicators
are usually indirect estimates
rather than directly collected
data
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 HealthIndicators
Risk Factors Health services
Nutrition and coverage
anthropometry Reproductive health
Environmental exposure Contraception / Fertility
water supply / control / family planning
sanitation Antenatal care / delivery
Behavioral risks - Child health
tobacco / Alcohol / Immunization
unsafe sex Health care access,
knowledge, care seeking
behaviour for common
childhood illnesses
Access to TB / Malaria
control services

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 3.DataSources
Acombination ofdatasources,bothperiodic
andcontinual,providesthebestquality
informationmostefficiently
Populationbased sourcesEx:populationsurveys,
civilregistration,censuses.
Institutionbasedsourcesindividualrecords,
servicerecords,resourcerecords.
 DataSources

HealthMetricsNetwork,WHO.2008.Frameworkandstandardsforcountryhealth 16
informationsystems.2nd Ed.
 DataSources
Tomeasurehealthindicators

HealthMetricsNetwork,WHO.2008.Frameworkandstandardsforcountryhealth 17
informationsystems.2nd Ed.
 4.DataManagement
Togetbestcollection,storage,quality
assurance,processing,compilation and
analysis
Aminimumdatasetsimplifiescollectionand
improvesthequalityofdata.
Anintegrateddatarepositorycombinesdata
fromdifferentsources,andbothcollectsand
managesinformation,andenableswide
distributionofdata
 DataManagement
1. Storage/penyimpanan
Rekam medis,kertas maupun elektronik
Ruang penyimpanan
Aplikasi pendukung (database)
Keamanan data
Datarepositorynasional

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 Central

InformationSilos Database

WebApplication

Decentralizationinformation

PraktikSwasta
DirektoratJendral
Kementrian
Kesehatan

Puskesmas,RS,
Klinik
Dinas Kesehatan

20
IntegratedHealthInformationSystems

SET
DITJEN DITJEN ITJEN BADAN Ditjen Ditjen Setjen Badan
JEN Itjen

PUSDATIN
Pusdatin

TERINTEGRASI

RS DINKESPROV DinkesProv
MENUJU

RS DINKESKAB DinkesKab

RS

TERFRAGMENTASI Puskesmas
PUSKESMAS
LSM BPSwata
IntegratedHealthInformationSystems
 DataManagement
2. Menjagakualitasdata
Checkandrecheck
Menganalisasecarakritis

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Vanuatu HISMapping

24
25
 DataManagement
3. Memprosesdanmengkompilasidata
Statistiksederhana
Aplikasisederhana:Excel
Formatinformasi

26
 5.InformationProducts
Datatransformedintoinformationthatcanbe
usedtobydecisionmakerstoimprovehealth
care
Acycleofvalueaddingthroughcompilation,
analysis,interpretation,presentation,
influenceandimplementationresultsina
strengthenedHISandamoreeffectivehealth
system
 TransformingDataIntoInformation
Excelforsimpleanalysisandgraphics
EpiInfoorotherstatisticalpackages
Databasereports
Datacubes
Geographicmappingofinformation
Integratedhealthinformationtechnology

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 Member State Life expectancy at birtha (years) Healthy life Neonatal MDG 4
expectancy mortalit Infant mortality ratea
(HALE) at y rate (probability of dying by age 1 per 1000 live
c

birthb (years) (per births)

1000 live
births)

Both
Mal Fema
Male Female Both sexes Sexe Male Female Both sexes
e le
s
200 200 199 200 200 199 200 200 200 200
1990 2007 2007 2008 1990 2000 2008 1990 2000 2008 1990 2000
0 8 0 0 8 0 0 8 7 8
Afghanistan 42 41 40 44 44 44 43 42 42 36 36 36 50 175 172 172 160 158 158 168 165 165
Albania 66 68 71 71 73 74 69 71 73 64 64 64 4 39 22 13 36 19 12 37 21 13
Algeria 65 67 70 68 71 72 66 69 71 62 63 62 24 57 44 39 48 38 33 52 41 36
Andorra 74 76 79 81 83 85 77 80 82 72 76 74 2 8 4 3 6 4 3 7 4 3
Angola 38 41 45 45 47 48 42 44 46 44 47 45 47 161 148 136 147 134 124 154 141 130
Antigua and Barbuda 69 71 73 71 74 75 70 72 74 65 66 66 8 27 21 14 22 12 8 25 17 11
Argentina 69 71 72 76 78 79 73 75 76 64 69 67 9 27 19 14 21 15 11 24 17 13
Armenia 62 67 66 70 73 73 66 70 70 59 63 61 14 51 34 22 45 30 19 48 32 21
Australia 74 77 79 80 82 84 77 80 82 72 75 74 3 9 6 5 7 5 4 8 5 4
Austria 72 75 78 79 81 83 76 78 80 70 74 72 3 9 5 4 7 4 3 8 5 4
Azerbaijan 59 62 66 66 67 70 63 64 68 59 60 59 19 87 64 36 68 50 28 78 58 32
Bahamas 67 69 72 74 75 78 71 72 75 63 68 65 6 19 14 9 14 12 9 17 13 9
Bahrain 73 72 74 74 74 76 74 73 75 66 66 66 6 13 11 9 14 10 10 14 10 10
Bangladesh 55 61 64 54 61 65 54 61 65 56 55 56 33 110 71 45 97 63 40 103 67 43
Barbados 70 70 71 77 77 77 74 74 74 65 69 67 7 18 13 9 12 13 12 15 13 10
Belarus 66 63 64 75 74 76 71 69 70 58 66 62 7 24 18 13 17 13 10 20 15 11
Belgium 73 75 77 79 81 82 76 78 80 70 74 72 2 9 5 4 7 4 3 8 5 4
Belize 71 67 69 75 74 76 73 70 72 57 63 60 8 38 27 18 32 19 15 35 23 17
Benin 50 54 57 51 55 58 51 55 57 50 50 50 33 117 94 81 104 84 72 111 89 76
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HealthStatistics&Informatics 30
31
InformationProduct

32
InformationProduct

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 6.Disseminationanduse
Thevalueofinformationisenhancedbybeing
accessible todecisionmakersandbyproviding
incentivesforinformationuse
Countryinformationcanbemadeacorepartof
daytodaymanagementofhealthsystems.
Thiscanbeachievedbyplacingagreatervalueon
informationcollection,managementanduse
 DisseminationandUse
Prinsipnya menggunakan informasi/evidencesuntuk
manajemen,perencanaan dan evaluasi kesehatan
serta penelitian.
Mempermudah aksesibilitas
Merubah budaya praduga menjadi evidencebased
practice
Mekanisme yangefektif:
Menghubungkan antara data/informasi yangdibutuhkan
sesuai dengan resourcesyangada.
Membangun sistem kesehatan yangmemiliki indikator
jelas
Menggunakan data
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ChallengesofeffectiveHIS
Collectionaloneisnotenough!

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Informasiuntuksiapa?

MDG

38
 LingkunganPengambilKeputusan

Politicians Donors
Budgets
Peers
Health
workers

Information Processofdecisionmaking Decisions

Community
Boss(es)
Media
Special
interests Inertia NGOs 39
AdaptedfromLippeveldetalWHO2000