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      Sustainability of health information systems: a three-country qualitative study in southern Africa.

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          Abstract

          Health information systems are central to strong health systems. They assist with patient and program management, quality improvement, disease surveillance, and strategic use of information. Many donors have worked to improve health information systems, particularly by supporting the introduction of electronic health information systems (EHIS), which are considered more responsive and more efficient than older, paper-based systems. As many donor-driven programs are increasing their focus on country ownership, sustainability of these investments is a key concern. This analysis explores the potential sustainability of EHIS investments in Malawi, Zambia and Zimbabwe, originally supported by the United States President's Emergency Plan for AIDS Relief (PEPFAR).

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          Financing of global health: tracking development assistance for health from 1990 to 2007.

          Nirmala Ravishankar, Paul Gubbins, Rebecca J Cooley … (2009)
          The need for timely and reliable information about global health resource flows to low-income and middle-income countries is widely recognised. We aimed to provide a comprehensive assessment of development assistance for health (DAH) from 1990 to 2007. We defined DAH as all flows for health from public and private institutions whose primary purpose is to provide development assistance to low-income and middle-income countries. We used several data sources to measure the yearly volume of DAH in 2007 US$, and created an integrated project database to examine the composition of this assistance by recipient country. DAH grew from $5.6 billion in 1990 to $21.8 billion in 2007. The proportion of DAH channelled via UN agencies and development banks decreased from 1990 to 2007, whereas the Global Fund to Fight AIDS, Tuberculosis and Malaria, the Global Alliance for Vaccines and Immunization (GAVI), and non-governmental organisations became the conduit for an increasing share of DAH. DAH has risen sharply since 2002 because of increases in public funding, especially from the USA, and on the private side, from increased philanthropic donations and in-kind contributions from corporate donors. Of the $13.8 [corrected] billion DAH in 2007 for which project-level information was available, $4.9 [corrected] billion was for HIV/AIDS, compared with $0.6 [corrected] billion for tuberculosis, $0.7 [corrected] billion for malaria, and $0.9 billion for health-sector support. Total DAH received by low-income and middle-income countries was positively correlated with burden of disease, whereas per head DAH was negatively correlated with per head gross domestic product. This study documents the substantial rise of resources for global health in recent years. Although the rise in DAH has resulted in increased funds for HIV/AIDS, other areas of global health have also expanded. The influx of funds has been accompanied by major changes in the institutional landscape of global health, with global health initiatives such as the Global Fund and GAVI having a central role in mobilising and channelling global health funds. Bill & Melinda Gates Foundation.
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            Special delivery: an analysis of mHealth in maternal and newborn health programs and their outcomes around the world.

            Tigest Tamrat, Stan Kachnowski (2012)
            Mobile health (mHealth) encompasses the use of mobile telecommunication and multimedia into increasingly mobile and wireless health care delivery systems and has the potential to improve tens of thousands of lives each year. The ubiquity and penetration of mobile phones presents the opportunity to leverage mHealth for maternal and newborn care, particularly in under-resourced health ecosystems. Moreover, the slow progress and funding constraints in attaining the Millennium Development Goals for child and maternal health encourage harnessing innovative measures, such as mHealth, to address these public health priorities. This literature review provides a schematic overview of the outcomes, barriers, and strategies of integrating mHealth to improve prenatal and neonatal health outcomes. Six electronic databases were methodically searched using predetermined search terms. Retrieved articles were then categorized according to themes identified in previous studies. A total of 34 articles and reports contributed to the findings with information about the use and limitations of mHealth for prenatal and neonatal healthcare access and delivery. Health systems have implemented mHealth programs to facilitate emergency medical responses, point-of-care support, health promotion and data collection. However, the policy infrastructure for funding, coordinating and guiding the sustainable adoption of prenatal and neonatal mHealth services remains under-developed. The integration of mobile health for prenatal and newborn health services has demonstrated positive outcomes, but the sustainability and scalability of operations requires further feedback from and evaluation of ongoing programs.
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              Planning for the sustainability of community-based health programs: conceptual frameworks and future directions for research, practice and policy.

              M C Shediac-Rizkallah, Sarah Bone (1998)
              Attention to the sustainability of health intervention programs both in the US and abroad is increasing, but little consensus exists on the conceptual and operational definitions of sustainability. Moreover, an empirical knowledge base about the determinants of sustainability is still at an early stage. Planning for sustainability requires, first, a clear understanding of the concept of sustainability and operational indicators that may be used in monitoring sustainability over time. Important categories of indicators include: (1) maintenance of health benefits achieved through an initial program, (2) level of institutionalization of a program within an organization and (3) measures of capacity building in the recipient community. Second, planning for sustainability requires the use of programmatic approaches and strategies that favor long-term program maintenance. We suggest that the potential influences on sustainability may derive from three major groups of factors: (1) project design and implementation factors, (2) factors within the organizational setting, and (3) factors in the broader community environment. Future efforts to develop sustainable health intervention programs in communities can build on the concepts and strategies proposed here.
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                Author and article information

                Journal
                Journal ID (iso-abbrev): BMC Health Serv Res
                Title: BMC health services research
                Publisher: Springer Nature
                ISSN (Electronic): 1472-6963
                ISSN (Print): 1472-6963
                Publication date (Electronic): Jan 10 2017
                Volume: 17
                Issue: 1
                Affiliations
                [1 ] Department of Health Policy and Management, University of California Los Angeles Fielding School of Public Health, 650 Charles Young Drive South, Los Angeles, CA, 90095, USA. cmoucheraud@ucla.edu.
                [2 ] Centers for Disease Control and Prevention, Maseru, Lesotho.
                [3 ] Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
                [4 ] Centers for Disease Control and Prevention, Maputo, Mozambique.
                [5 ] Centers for Disease Control and Prevention Zimbabwe, Harare, Zimbabwe.
                [6 ] Division of Global HIV and TB, Centers for Disease Control and Prevention, Center for Global Health, Atlanta, GA, USA.
                [7 ] JSI Research and Training Institute, Inc, Lilongwe, Malawi.
                Article
                Publisher Item ID: 10.1186/s12913-016-1971-8
                DOI: 10.1186/s12913-016-1971-8
                PMC ID: 5223327
                PubMed ID: 28073361
                SO-VID: 7d3b039b-2a22-4e37-9755-412c1e0756bb
                History

                Keywords: Development assistance,Electronic medical record system,Health information systems,PEPFAR,Sustainability
                Data availability:
                Keywords: Development assistance, Electronic medical record system, Health information systems, PEPFAR, Sustainability

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