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PAHO and the IS4H programme; a model for strengthening health information systems

This project took its first steps in 2016, with a high-level meeting with Caribbean countries.

The premise of the IS4H (Information Systems For Health) initiative suggests that IS4H is a tool for assessing organizational capacity related to governance, data management, digital transformation, innovation and knowledge management.

According to PAHO's official definition, health information systems or IS4H are a mechanism for managing interoperable open data systems from different sources of ethical use, using effective ICT tools, in order to generate strategic information for the good of public health.

Following the meeting in 2016, two others were held in Central and South America in 2017 and 2018 respectively. These meetings worked to introduce a vision that would help establish a general framework of operation and a general understanding of IS4H components.

Reports for these meetings are available at: https://www.paho.org/ish/index.php/es/

According to Marcelo D'Agostino, senior advisor at PAHO/WHO, IS4H is a work programme that was built with and for countries seeking to strengthen their information systems, improve data management processes, create methods of analysis, scenario production, public policy formulation and informed decision-making, among others, all for public health development. D'Agostino mentioned that "to have health policies and informed decisions it is necessary to have a holistic view of the subject and it is essential to be able to have access to data, structured and unstructured that come from all sectors and that may be of interest to the health sector".

As the name implies, IS4Hs are not only information systems directly focused on health but information systems that can be properly implemented to health systems.

The main goal of IS4H is to implement a better mechanism for public policy-making based on good decision-making practices through health systems that ensure free and timely universal access to data and strategic information, employing digital and ICT tools with greater cost-benefit.

Some of the principles of these systems are: the management of vital statistics, the standardization of methods, the digitization of governments, the promotion of data as a factor for success, and the use of structured and unstructured data.

The implementation of IS4H opens up endless possibilities for governments in data management and the discovery of new public health challenges. PAHO guides the Maturity Model (IS4H-MM), in D'Agostino's words, "a set of tools and methods that enable countries to work together to define not only the maturity level of their health information systems, but, more importantly, develop a solid evidence-based action plan and roadmap."

IS4H-MM are classified into five levels that handle different tasks and challenges. The IS4H-1 Initiated,its main feature is the available data and focuses on awareness. The second level IS4H-2 Developing, has as its characteristic the information in health is managed, and focuses on the implementation of best practices, For the IS4H-3 Defined, it seeks decisions based on quality health information and focuses on process standardization and continuous improvement. The IS4H-4 Optimizedis characterized by governance and integration of IS4H, and focuses on integration and alignment. The last level, IS4H-5 Innovation, refers to when all system components are fully deployed and focuses on continuous innovation of these components.

 D'Agostino explains that these systems are aimed at the Ministers of Health of the Americas, for the work of disaggregated data at the subnational level, which is what is needed for the measurement of the progress of the Sustainable Development Goals (SDGs).

The application of complex Digital Health tools involving large-scale data management and analysis seeks to strengthen institutions to promote well-founded policies. And they also seek to generate tools for public health data management such as electronic health records, digital vaccination cards, information classification thanks to the technological infrastructure of massive data analysis such as Big Data. In addition to promoting transparency and open government through the digitization of it.

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