Informed decisions for actions in maternal and newborn health

District decision-making to strengthen maternal, newborn and child health services in low-income settings

District decision-making to strengthen maternal, newborn and child health services in low-income settings

2 September 2016
An IDEAS supplement in the Journal of Health Policy and Planning

Information systems and health planning are relatively neglected areas of health policy and system research.

Collecting high quality routine information and using this information to plan and evaluate health services is critical for health system strengthening.

Key message #1

To optimise the use of public resources in mixed health systems, it is vital to understand the activities of all the actors that are involved in producing health, bringing a vision of health that is aligned with a social determinants perspective and with multi-sectoral targets such as the sustainable development goals.

The research team, including staff from IDEAS, were originally interested in developing measures of implementation strength in each district, and in how these might be used to evaluate programmes across several districts.

Key message #2

This series of articles in Health Policy and Planning outline a model for a data-informed platform for health which would bring together routine information from the public and private sectors on health care inputs and processes including service delivery, that could inform decision making, priority setting and planning at the district level, and assist in the evaluation of maternal, newborn and child health (MNCH) services.

One innovation of the data-informed platform for health is its focus on the whole health system, including the private sector, which is an important provider of services in many settings; and in including non-health sectors, such as the department of women and child development in India.

The Articles

District decision-making for health in low-income settings: a feasibility study of a data-informed platform for health in India, Nigeria and Ethiopia
This paper defines the nascent concept of a data-informed platform for health, which is a structured and standardised process for local health teams to make use of existing data to plan, track, review and course-correct their programmes. In five districts across the three countries, IDEAS identified multiple barriers to the use of local data for health decisions at district level, and no standardised processes. The Indian state of West Bengal is the focus of a pilot phase in 2015–16.

District decision-making for health in low-income settings: a systematic literature review
This is a systematic literature review about processes to support the use of health data in decision-making at district level in low-income settings. It points to a general problem that much of the accumulated experience and knowledge about how to strengthen the collection and use of routine health information has been generated by projects and programmes that have not documented their lessons in a systematic or accessible way, making it difficult for others to learn from their experience.

District decision-making for health in low-income settings: a case study of the potential of public and private sector data in India and Ethiopia
This paper is a case study in Ethiopia and India showing untapped potential of Health Management Information System (HMIS) data for MNCH decision-making at district level. Although formal data sharing between public and private health sectors was minimal, these existing platforms give an opportunity for improved use of district-level data for decision-making through the data-informed platform for health approach.

District decision-making for health in low-income settings: a qualitative study in Uttar Pradesh, India, on engaging the private health sector in sharing health-related data
This paper presents prospects for engaging the private sector in health data sharing and collaborative decision-making at district level in India. It reminds us of the diversity of the private sector in many settings. The paper finds considerable willingness to engage in a data-informed platform for health among parts of the sector, but that this varies because of differences in capabilities, incentives and the level of trust between providers and the government.

The full journal supplement can be found at Health Policy and Planning