Chapter 6: Health Information
White Paper for the Transformation of the Health System in South Africa

1. Background and Introduction

The lack of reliable health information is one of the major obstacles to the effective planning of health services in South Africa. Existing information systems were found to be fragmented, un-coordinated and technologically outdated.

In 1994, the Minister of Health established a committee to set up a comprehensive National Health Information System for South Africa (NHISSA). The NHISSA aims to enhance the planning, management and evaluation of the health services through an improved flow of information.

2. The Main Objectives of NHISSA

One of the principle objectives of NHISSA is to ensure the availability of information on costs, efficiency, volume and coverage of South Africa’s health system. This will enable efficient measuring of the population’s health status. To do this effectively, it will be important to:

• develop a comprehensive national health information system;
• provide training at provincial level, to ensure the optimal use of information; and
• identify and create, where necessary, national data sources against which to measure the national health objectives.

3. Guiding principles

The NHISSA will be based on the following principles:

• To support the effective delivery of health services at all levels, the co-ordination of NHISSA will happen at the national level;
• The NHISSA should be used to monitor the implementation and success of health priority programmes, including those identified by the Reconstruction and Development Programme (RDP)
• Reporting of NHISSA data at all levels should be timeous, accurate and complete.

4. Implementation strategies

4.1. Establishment of a comprehensive national health information system

A comprehensive NHISSA will be set up as an overall parent system, consisting of various components, which will provide various types of information.

At the national level: a National Health Information System Advisory Team will be established to deepen stakeholders' involvement in the development and implementation of the NHISSA. The NHISSA will be piloted nationally on an incremental basis.

At the provincial and district levels: committees will be established to facilitate the implementation of a streamlined health information system, based on national guidelines. The provinces will play an instrumental role in improving the flow of information, particularly for the planning of health services. They will also be responsible, in consultation with NGOs, for the development of a district health information system.

At the community level: District health teams will assist communities to develop the capacity to assess their own problems and identify appropriate interventions. Community level surveillance will be developed and implemented with the communities' active participation.

The Private sector: System developers will ensure that the private sector's information systems are included in the NHISSA.

4.3. Use of the NHISSA to monitor the implementation and success of health priority programmes

• The National Nutrition Surveillance System will be implemented as part of the NHISSA. At community level, a research strategy and surveillance system will be used for growth monitoring, particularly focussing on the status of women and children. This will be a key area for measuring progress on RDP projects.
• Mortality and morbidity data will be gathered and published widely.
• NHISSA data will be fed back and used at all levels to bring about greater equity and influence the allocation of resources.Regular NHISSA bulletins will be published at the national level. Mechanisms for data dissemination will be established at the provincial and district levels.

4. Indicators of success

The successful implementation of the NHISSA will be evaluated according to:

• The availability of national health status/vital statistics data sets, including information on health care.
• The existence of notifiable and non-notifiable disease surveillance data;
• Accurate demographic and population statistics;
• Training programmes in information management, data analysis and epidemiology.

For more information, please contact Jane Mathieson or Bea Abrahams by telephone @ 021-6964954 or by fax @ 021 - 6969308 or by e-mail at philaw@wn.apc.org . The PHILA programme is funded by a grant from the Henry J. Kaiser Family Foundation.

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