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Peru’s decentralized Health Information System
Introducing HMN Diagnostic Tool and PRISM outcomes at the sub national level

The Health Information System (HIS) experience in Peru is unique as the development of the system is being worked simultaneously within the decentralization process.

From May 2008 to March 2009, Peru adopted the Health Metrics Network (HMN) diagnostic tool and the Performance of Routine Information System Management (PRISM) framework in order to assess its HIS. During the initial process, the PAHO/USAID project and MEASURE Evaluation provided technical assistance to the team in Peru in the application and use of both the HMN and PRISM tools. Best practices in the tool application in Paraguay were used to support the process. The technical team in Peru later adopted the tools and fine tuned them to the country specific situation. The team developed a roadmap consisting of four stages to applying the HMN and PRISM frameworks and standards for the development of their country HIS.

The HMN assessment was applied at the national level with the participation of 42 institutions. The PRISM tools were first applied in 7 regions of Peru (Cusco, Ayacucho, Junin, Pasco, Huanuco, Ucayali and San Martin). These are regions in which USAID/Peru through the Health Policy Initiative project is providing some type of technical cooperation and already has some presence. Later 2 other regions were added, Lima and Callao. The General Office of Epidemiology then financed 7 other regions to extend the sample and offered resources for implementation (Madre de Dios, Apurimac 1 and 2, Huancavelica, Cajamarca and Loreto). Additionally, PAHO/Peru financed the application of the PRISM tools in the northern part of Peru (Trujillo) as well as in the south (Arequipa) in order to have complete coverage at the national level.

Approximately 180 local facilitators were trained by the technical team in Peru in using the PRISM tools in the first 7 regions where USAID has a presence. Approximately 20 micro-networks (health facilities at the local level) and hospitals in the regions of San Martin, Cusco, Ucayali, Huanaco, Ayacucho and Junin have been completely assessed. There are regional assessment reports available as well as 80 local action plans of continual improvement of HIS performance. In Lima and Callao, 150 facilitators were trained and assessment carried out.

Dissemination of results and the process for improving HIS in Peru culminated in a national workshop which took place in Lima on March 17, 2009. Representatives from all the regions were present. Next steps include the elaboration of a National Health Information System Strategic Plan that will reflect all of the local action plans that have been already developed. Key outcomes of the PRISM application were: a) registry of health personnel for HIS; b) inventory of human and physical resources available in the current HIS; c) local strategies and action plans; and d) evaluation of human resources deficiencies, in terms of actual abilities, at the national and regional level.

It was also positive to see the response of the representatives from the sub national levels in feeling empowered by their own diagnosis and how this inspired other regions to strongly advocate for their participation in follow-up activities to assess their own situation in the development of a national strategic plan that includes/reflects the unmet needs at the local level.

Last Updated on Tuesday, 11 January 2011 11:59

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