1. Assessment Training Session 9: Assessment Analysis
Performance of Routine Information System Management (PRISM)
Assessment Training
Session 9:
Assessment Analysis
MEASURE Evaluation
Date:

2. Session objectives Explain how to analyze PRISM assessment data
Become familiar with the types of analyses performed in several countries
Describe examples of strengthening interventions based on PRISM assessment findings

3. Some examples of analyses
Percentage of districts, health facilities meeting data accuracy, completeness, and timeliness standards
Average scores for use of information (scale of 0−100)
Level of RHIS data use; percentage of districts, health facilities having active RHIS data use mechanism(s)
Performance Diagnostic Tool
Site- level average scores for critical HIS functions
MAT
Knowledge, confidence, and competence levels
Personal staff feelings about motivation and reward systems
Staff views on promoting the culture of information
OBAT
Proportion of sites having RHIS materials available and/or experiencing stockouts
Mean numbers of specific health staff
Proportion of staff who benefited from RHIS training
Facility/Office Checklist

4. RHIS Performance Diagnostic Tool
Analysis
RHIS Performance Diagnostic Tool

5. RHIS performance summary table
Data quality
Use of information
Weak
Improving
RHIS does not produce quality data and managers make little use of the information
RHIS produces data of an acceptable quality but managers make little use of the information
RHIS does not produce quality data but information is used by managers
RHIS produces data of an acceptable quality and information is used by managers

6. Data quality analysis

7. Use of information analysis
Describe information use at the site visited:
Display of updated information
Feedback mechanism(s)
Discussion based on RHIS data
What kinds of decisions are made?
Which steps in the process of using information are performing well and which ones have weaknesses?
Compilation of data, display, analysis, interpretation, discussion, decision making
What kinds of decisions are made?
Day-to-day program management
Planning
Budgeting
Medical supply and drug management
Human resource management
Monitoring of key objectives, e.g., service improvement
Identification of emerging issues, such as emerging epidemics

8. Use of information analysis

9. Level of use of information at the province level (Mali)

10. RHIS data displays and update status at the province level (Mali)

11. Diagnostic tool results (Ivory Coast)
RHIS performance
Health facilities
Districts
2008
2012
Status
Data quality
43%
60%
40%
81%
Data use
38%
44%
70%
Regional level was not assessed in 2008; data quality was at 50% in 2012 for the regional level.
Note: From 2009 to 2011, facilities were trained on the HIV data collection tool and not on data use.

12. Management Assessment Tool (MAT)
Analysis
Management Assessment Tool (MAT)

13. RHIS Management Assessment
Identify which elements of RHIS management are performing well and which are exhibiting problems
Governance
RHIS operations
Information infrastructure
Human resources
Financial resources
Other resources
RHIS operations: planning, quality standards, supervision
Information infrastructure: information and communications technology (ICT)
Other resources: RHIS materials, equipment, transportation

14. Data management processes
Describe the strengths and weaknesses of data management processes at the site you visited:
Data recording
Data transmission
Data processing and analysis
Data presentation

15. Mean scores for the RHIS management functions (Mali)

16. Organizational and Behavioral Assessment Tool (OBAT)
Analysis
Organizational and Behavioral Assessment Tool (OBAT)

17. Perceived confidence levels and observed HIS task competence (Mali)

18. Perceived confidence and observed HIS task competence, by level (Ethiopia)

19. Facility/Office Checklist
Analysis
Facility/Office Checklist

20. Percentage distribution for the cluster
Availability of resources at health facilities and woreda (Ethiopia)
Resources
Availability
Percentage distribution for the cluster
Health
posts
Health centers
Hospitals
Woreda health offices
Computer 83 56 6 1 17 28
≥ 2 11
100 66
Printer 86 58 32 67 52
Internet
Yes 20 33 2
Electricity 3
A woreda is the equivalent of a district in Ethiopia.

21. Analysis
Overview of
PRISM results and interventions

22. Overview of the PRISM results
HMIS overview and major findings (N= 6 provinces)
INPUTS
PROCESSES
OUTPUTS
Technical Factors
Data collection forms, procedures 1
Information system integration 83
Computer software
100
IT complexity 67
Behavioral Factors
HIS forms content knowledge 52
Data quality checking skill 84
HIS problem solving skill 27
HIS task competence 64
HIS task confidence 81
Motivation 71
RHIS processes
Data transmission
n/a
Data completeness
Data accuracy
Data processing 83
Data analysis
100
Data presentation
Feedback
RHIS Performance
Data quality M1 M2 M3
Complete-ness 83 95
100
Timeliness 17
Accuracy 63 75 85
Information use 26
 Organizational factors
Governance 50
Planning 42
Training 25
Supervision 58
Quality assurance 56
Finance 1
Information distribution 83
Culture of information promotion
0-59
60-89
90-100

23. Comparison of results - Example

24. RHIS strengthening interventions (Examples from Ivory Coast)
Integrating HIV/AIDS indicators in the overall RHIS (Technical)
Organizing trainings in the use of information, including problem-solving techniques, at district and health facility levels (Behavioral)
Developing feedback bulletins for health offices at all levels (Organizational)

25. RHIS strengthening interventions (Examples from Liberia)
Building staff capacity in the use of the DHIS 2 health information software and in data verification, data analysis, and data use (Technical, Behavioral)
On-site mentoring of monitoring and evaluation (M&E) staff (Behavioral)
Building organizational capacity by establishing, organizing, and implementing routine performance review forums (Organizational)
Setting up data quality assurance mechanisms, such as desk review of data and data quality assessments (Technical)

26. How to access the PRISM Series
This slide deck is one of nine in the PRISM Series Training Kit, which also includes a Participant’s Manual and a Facilitator’s Manual.
Also in the PRISM Series is a Toolkit (the centerpiece of the series) and a User’s Kit.
The PRISM Series is available in its entirety on MEASURE Evaluation’s website, here:

27. MEASURE Evaluation is funded by the United States Agency for International Development (USAID) under the terms of Cooperative Agreement AID-OAA-L It is implemented by the Carolina Population Center, University of North Carolina at Chapel Hill, in partnership with ICF International; John Snow, Inc.; Management Sciences for Health; Palladium; and Tulane University. The views expressed in this presentation do not necessarily reflect the views of USAID or the United States government.