Monitoring of Vital Events thro’ Leveraging
Innovations including Information Technology
(IT) Advances.
7th Africa Symposium on Statistics Development (ASSD)
18-23 January 2012.
Cape Town, South Africa.
Dr Mark Amexo, MD.
Health Metrics Network Secretariat,
W.H.O Headquarters. Geneva, Switzerland.
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Outline
1.
2.
3.
4.
5.
2
Rationale for "MoVE-IT"
The 3 Work Streams:
MoVE-IT Africa Initiative
Progress
Next Steps
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Why MoVE-IT?
1. HMN: Global Network for Country HIS
2. The Health Imperative in CRVS System
3. Information Needs: Evidence-based Decision &
Policy, Planning, Tracking, Results and
Accountability
4. HMN Commissioned MoVE Series in The
Lancet: Who Counts?; "Everybody Counts"
5. Needs for: MDGs, GF Impact Measurements
6. Advances and Availability of IT
7. Commission on Information and Accountability –
Mandate for Recommendation 1
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"Roadmap"
HMN Framework
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MoVE-IT …..
Promoting Health Imperative in CRVS syst.
 Smarter ways to Capture, Record Vital Events;
have these Certified.
 Compile and Use Vital Statistics – "Real Time"
 Consistent with UNSD Principles and Practices
 Empower National Govt. to Act and Lead
Evidence-based Decision and Actions
Improved Health Outcomes, Impact
IT use: Evade barriers, Quality/Efficiency
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Collaboration
Harmonization, Synergy
• Collaboration, Harmonised Action of
Partners (UN Agencies, Bilateral &
Multilateral Institutions, Academia and
Research, Country Systems/Sectors
• National Government Departments &
Sectors, Development Partners
• Local Authorities & Populations, CSOs,
NGOs
• Promote and Link Health Sector Actions to
Other Sectors in CRVS System.
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MoVE-IT: 3 Workstreams
Advocate for functional Civil Registration - Vital Statistics
systems in Countries
Regional and Country Policy processes, Resource Mobilization
Provide Standards and Tools: Assessment, Quality Control, Mobile
Devices for monitoring of vital events
Generate Evidence on what works: working with countries and
Partners by building upon existing work or systems
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Standards & Tools
• Reporting Variables:
Pregnancy Tracking, Birth,
Death
•Cause of Death (ICD, VAT)
• Data Quality and Analysis
• Data & Information
Dissemination and Use
•Resource Toolkit
Advocacy, Policy and
Resources
•Global and Regional Fora
•National Stakeholders,
Coordination Body, TWGs
•Best Practices Lessons
Learnt
•Partners' Funds, Technical
Resources
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MoVE IT
Strategy
Evidence Generation/
Country Implementation
•Community Events
Reporting
• Health Facility Reporting
•Data Management and
Quality Assurance
•Data & Information Use
•Country Case Studies
•Knowledge, Skills & Best
Practice Transfer
•Lessons Learnt
 Efficiency
Better Outcomes
Accountability
Standards
(refined/improved)
Tools and
Guidance
(refined/improved)
Evidence
Policy, Law
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Africa "MoVE-IT" Initiative.
TUNISIA
MOROCCO
General
Assessment
General assessment
Cause of death reporting
ALGERIA
WESTERN
SAHARA
LIBYA
EGYPT
Rd
Sea
MAURITANIA
Community reporting & IT
MALI
NIGER
ERITREA
SENEGAL
CHAD
THE
GAMBIA
SUDAN
DJIBOUTI
BURKINA
GUINEA
BISSAU
GUINEA
BENIN
SIERRA
LEONE
COTE
DTVOIRE
TOGO
NIGERIA
ETHIOPIA
CENTRAL
AFRICAN
REPUBLIC
GHANA
LIBERIA
CAMEROON
EQUATORIAL
GUINEA
GABON
General assessment
REP. OF
THE
CONGO
DEMOCRATIC
REPUBLIC
OF THE CONGO
(ZAIRE)
RWANDA
UGANDA
KENYA
SOMALIA
Case study
System building
& IT innovation
BURUNDI
Community
reporting study
System building
Lessons learnt SAVVY
and district SRS
TANZANIA
ANGOLA
MALAWI
ANGOLA
ZAMBIA
Global & Regional
Partnership/Network, Advocacy –
Ministerial Conference, ASSD,
Country Partnerships.
MOZAMBIQUE
BOTSWANA
LESOTHO
Analysis
existing data
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MADAGASCAR
ZIMBABWE
NAMIBIA
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SOUTH
AFRICA
PLUS
> 10 DSS sites in 10 countries
Analysis of existing data, with
focus on causes of death, and
maternal mortality & HIV
SWAZILAND
Hospital reporting
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Implementation Updates.
1. Advocacy and Policy
2. Standards Promotion and Tools
Development
3. Evidence Generation
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Update 1: Advocacy and Policy
1. National Level: National Stakeholders Forum
2. Regional: EGM and Ministerial Confab 2010, Mini,
6th ASSD, 7th ASSD now.
3. Global Level: Commission on Information and
Accountability (Geneva, Tanzania, Canada etc),
4. Others: CDC-WHO Meeting on Maternal Mortality
Surveillance in Atlanta, USA.
• International Expert Group on VA Instrument
Standardization (Item Reduction and Automation)
• WHO-FIC (Cape Town, 2011)
• Similarly in Asia-Pacific Region
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Update 2: Standards and
Tools
Data
Collection
Birth, Death,
Cause-of-Death
Pregnancy Tracking,
VA-automation.
Data
Analysis
1. Mortality Data
Quality Assessment,
2. Mortality Assessment
from Census
Technical
Resources
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MoVE-IT
Resource Tool Kit,
HIS sub-Account
in NHA
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Variables
ready for use.
Automated VAI
March 2012
ANACOD
available for use
In progress;
by March 2012
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Update 3: Evidence Generation
i.
ii.
iii.
iv.
Surveillance Data Use
Community Reporting System
Hospital Mortality Data Use
VR Data Use; even when less Perfect
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Update 3i:
Surveillance Data Use
1. INDEPTH-ALPHA Networks Collaboration:
20 HDSS sites 14 Countries; (first ever)
 Capacity Workshop for HDSS Experts on
Analysis and Data to Policy and Action
 Data Use Agreement Secured (All HDSS
Sites)
 Input to VA and IntervA Tools Revision
 Policy Paper on HIV and Maternal Mortality
2. Tanzania: Analysis of HDSS Data and
SAVVY Experience and Lessons
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Update 3ii:
Community Reporting
System
Ghana, Ethiopia, Rwanda and Kenya:
Design (Reporting Infrastructure, IT,
Resource Needs)
Training of Workers (Community and
Regular)
Events Reporting Pathways and
Responsibility
Applications
TWG, Coordination and Oversight
Ensuring Coordinated and Harmonized
Support for Country Strategies
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Update3iii:
Hospital Mortality Data
Use.
Mozambique: (CDC, PEPFAR and HMN support)
Improved Coverage and Quality of Hospital
Mortality and Cause-of-Death Statistics
(ICD-based) using SIS-ROH data mx system
1. Interagency Coordinating Group: MoH,
Home Affairs, NSO and University.
2. Capacity Building: SIS-ROH system upgrade
and Staff Training, and Study tour to South
Africa Institutions
3. In progress: System roll-out to other major
hospitals in provinces and districts
=> Improved Hospital Cause-of-Death
Statistics, and Use
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Update 3iv:
VR Data Use Even When
Less Perfect
i. Botswana:
Using Existing Country Data to Measure
Impact of HIV-TB programme
intervention; GF, UNAIDS, WHO, MoH, NSO
ii. South Africa:
Collaboration Home Affairs, NSO, MRC,
MoH, Universities etc
VR Data Used for Health Impact Indicators,
Differentials in Health Status, 2nd
National Burden of Disease.
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Next Steps
• 1st Interim Report; Review and Update
Strategy and Plans, if Indicated
• Platform and Opportunities for PIs and Key
Actors Knowledge Sharing, Guidance Update
• Coordination, Access to Resources and
Capacity Building
• Hubs for Health Information System
• Resource Kit; Act; Innovate; Update Kit
• Empower for COIA "Recommendation 1"
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Thank you.
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