The Case for a National Health Information System Architecture ; a Missing Link to Guiding National Development and Implementation

Developing countries and the global network of donors, programs and nongovernmental organizations (NGOs) have agreed that health systems need to become stronger if gains in health are to be achieved and sustained. Existing data collection and use is fragmented, disease specific, inconsistent and often of poor quality. A major factor contributing to this current situation is that the burden of data collection falls to health workers and that this burden is excessive. What is needed is a national health information system that is capable of supporting day-to-day management, long-term planning, and policy development for the entire national health system. Front line health workers who bear the burden of data collection should benefit from the availability of information for decision making in a well designed health information system. A health information system is comprised of multiple and diverse functions and applying what has been learned from other sectors is valuable. One such practice developed over the past 20 years to guide planning, development and management of complex systems in all sectors including, government, commercial, and NGOs is the development of enterprise architecture. The enterprise architecture is the next level of elaboration of the HMN Framework where general lessons, standards, and processes can be aggregated and documented for knowledge sharing. A well thought-out and collaboratively supported architecture enables systems to be built and implemented using consistent standards for data collection, management, reporting and use. The components of the enterprise architecture will be adapted from or collaboratively generated with the global disease programs whose buy in and endorsement is crucial to its success. Investments in health information systems can be aligned and leveraged around such an architecture to build stronger core health information systems supporting better local health services management, health policy and ultimately stronger health systems.