INFORMATION PRODUCTS THAT DRIVE IMPACT IN SWAZILAND’S HEALTH SECTOR
Comprehensive, up to date and precise health information is essential for formulating health policy, and for planning to meet the demand for appropriate health services to improve and promote the well-being of a nation. How does a nation ensure that it has such information? In 2011, Swaziland’s Ministry of Health published its first Health Statistics Report with the objective of presenting information on key health statistics from routine data collection systems and supplemented data at regional and national level. The reports became a feedback product to be used when developing the national health budget and used as a tool for tracking performance.
This activity was accomplished through the introduction of a strategic information partner to the Ministry of Health, Measure Evaluation who brought in IHM Southern Africa to provide technical assistance, funded by USAID through PEPFAR. The then M&E- HIV department built a solid and effective system to produce quality data. However, there was a need to improve data coming from the other departments like Health Management Information Management Unit (HMIS), and the Research Department.
The M&E department was collecting and analyzing all HIV data, and HMIS was collecting all other health-related data, and this created the tendency of having overlapped or duplicated data. Thereafter, a decision was made by Ministry of Health headquarters to create a strategic information department. Thus, birthing the Strategic Information Department (SID), encompassing the M&E Unit, HMIS Unit, Research Unit and Epidemiology Unit.
The objective of developing these reports was to provide consistent figures of various indicators that everyone could be able to reference to and quote. The first reports conducted in 2011 were the Annual Health Statistics, HTC and PMTCT reports. In 2012, the team expanded to include the TB report, making the total number of produced reports to four. In 2013, a combined annual health report was conducted inclusive of HTC, PMTCT and ART. In 2014, two new programme reports were conducted, namely, Sexual Reproductive Health (SRH) and Non-Communicable Diseases (NCD).
In 2015, not only did the M&E Unit conduct an additional programme report for Child Health, regional health reports for Hhohho, Manzini, Lubombo and Shiselweni were produced. These additions brought about the involvement of the regions in health reporting, resulting in the regions having accountability and ownership of this process.
In 2017, the M&E Unit conducted the Annual Health Reports for 2016 which was inclusive of the four regional health reports, SRH, TB, Child Health, HIV, and NCD. Once more, a new health report was produced for the Rural Health Motivators (RHM) Programme. From the inception of this activity, we can note that in 2011, 3 health reports were produced and have gradually increased to 10 health reports produced in 2016/2017.
This year’s annual health reports were launched to key stakeholders by the SID’s M&E Team, and the Directorate was represented by Deputy-Director Rejoice Nkambule who commended her team for their outstanding work, and highlighted that the Ministry is taking great strides in ensuring that it can devise and improve implementation strategies which are well informed using these reports.
The achievement of producing comprehensive regional and program health reports each year has been met through collaborative efforts from The Ministry of Health’s SID Unit, service providers, program managers and their teams, regional health managers and their teams, and the Directorate.
The Ministry has received technical and financial support from a number of development partners inclusive of the UN Family, Measure Evaluation; USAID and PEPFAR Swaziland have provided financial support for this activity since its inception, and regional implementing partners i.e. EGPAF, URC, and ICAP have provided technical support. IHM Southern Africa has played an integral role in the technical support provided to the Ministry in producing, launching and disseminating the annual health reports since 2011 to date.
Reaching the milestone of producing 10 reports has not been an easy task, with many challenges faced by the team. Such challenges have included insufficient participation from all stakeholders involved in the process of report writing. Ownership of the programs and regions of their respective reports is what the SID team would like to see in future.
The data sources used to develop the reports have also posed as quite a challenge in developing comprehensive reports. There are cases where a programme’s strategy has an indicator which needs to be measured, and you find that the current systems used by the team do not measure that indicator. For example, people tested for HIV, the current systems do not measure that indicator, however, the team looks forward to Client Management Information System (CMIS), a tool that will assist in addressing this challenge, as CMIS tracks individual patients as opposed to cases.
These information products have played a pivotal role in aiding programs to track their performance and achievements, as well as document challenge and gaps in areas that need further improvements. The products allow programmes to conduct evidence-based decisions to improve health outcomes in their various areas. Currently, the M&E Unit has developed 10 health programs, and the aim is to increase the number each year. The overall goal is to ensure that every health programme has an annual performance report produced with the effort to ensure all-inclusive evidence-based decision making for the Ministry of Health.
“The production of the health reports is a collaborative and inclusive effort. We meet with the programs, implementing partners, UN agencies, health care workers, supervisors, and ministry representatives to conduct the report writing. These key stakeholders play an essential role in producing the final product” – Sebe Myeni, M&E Manager, SID, Ministry of Health.
Sibongile Mndzebele, HC3 Chief of Party
Sebe Myeni, Ministry of Health, Monitoring and Evaluation Unit Manager
Muhle Dlamini, SNAP Program Manager