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					           Health Metrics Network


Assessment Tool for Country Health Information Systems
                       Version 4.00
cs Network


Health Information Systems
4.00
I. Resources                                                                                 Return to Menu            Go to Results           Abbreviations               Glossary

  A. Policy and Planning
                                                                                                                                               Present but not
                                                                                              Highly adequate             Adequate                                     Not adequate at all    Rationale/
                                         Items                                                                                                     adequate
                                                                                                                                                                                              comments
                                                                                                       3                       2                        1                       0
I.A.1   The country has up-to-date legislation providing the framework for health            Legislation covering    Legislation covering    Legislation exists but     There is no such
        information covering the following specific components: vital registration;         all aspects exists and   some aspects exists        is not enforced            legislation
        notifiable diseases; private sector data including social insurance;                      is enforced          and is enforced
        confidentiality; and fundamental principles of official statistics


I.A.2   The country has up-to-date regulations and procedures for turning the         Yes, regulations and     Regulations and       Regulations and        No, there are no
        fundamental principles of official statistics into good practices, and for   procedures exist and procedures exist and procedures exist, but       written regulations
        ensuring the integrity of national statistical services (by ensuring         are fully implemented.        are widely           are not yet        and procedures for
        professionalism, objectivity, transparency and adherence to ethical            Integrity of national disseminated, but no   disseminated and      ensuring the integrity
        standards in the collection, processing and dissemination of health-related statistical services is regular assessment of      implemented        of national statistical
        data)                                                                          regularly assessed        the integrity of                                services
                                                                                                              national services is
I.A.3   There is a written HIS strategic plan in active use addressing all the major Yes, comprehensive The comprehensive           The strategic plan     There is no written
        data sources described in the HMN Framework (censuses, civil                    HIS strategic plan   strategic plan exists, exists, but it is not  HIS strategic plan
        registration, population surveys, individual records, service records and          exists and is     but the resources to   used or does not
        resource records) and it is implemented at the national level                     implemented        implement it are not emphasize integration
                                                                                                                    available


I.A.4   There is a representative and functioning national committee in charge of             Yes, a functional      There is a functional    There is a national      There is no national
        HIS coordination                                                                        national HIS             national HIS        HIS committee, but it       HIS committee
                                                                                              committee exists         committee, but          is not functional
                                                                                                                      without resources
I.A.5   The national statistics office and ministry of health have established              Yes, fully operational, Yes, but meets only        Yes in theory, but              No
        coordination mechanisms (e.g., a task force on health statistics); this              meets regularly and occasionally on an ad        these mechanisms
        mechanism may be multisectoral                                                        meets needs for       hoc basis or agenda       are not operational
                                                                                                coordination             is too full


I.A.6   There is a routine system in place for monitoring the performance of the             Yes, it exists and is   Yes, but it is seldom   Yes, but it is never              No
        HIS and its various subsystems                                                         used regularly                used                    used
I.A.7   It is official policy to conduct regular meetings at health-care facilities and     Yes, the policy exists   The policy exists, but The policy exits, but is    There is no policy
        health-administration offices (e.g., at national, regional/provincial or district       and is being           meetings are not       not implemented
        level) to review information on the HIS and take action based upon such                implemented                 regular
        information
  B. HIS institutions, human resources and financing
                                                                                                                                            Present but not
                                                                                            Highly adequate            Adequate                                    Not adequate at all       Rationale/
                                       Items                                                                                                   adequate
                                                                                                                                                                                             comments
                                                                                                    3                     2                          1                      0
I.B.1   The ministry of health has adequate capacity in core health information             Highly adequate            Adequate            Partially adequate         Not adequate
        sciences (epidemiology, demography, statistics, information and ICT)

I.B.2   The national statistics office has adequate capacity in statistics                  Highly adequate            Adequate            Partially adequate         Not adequate
        (demography, statistics, ICT)
I.B.3   There is a functional central HIS administrative unit in the ministry of health    HIS central unit is     HIS central unit is    HIS central unit has           There is no
        to design, develop and support health-information collection, management,           functional with       functional but lacks   very limited functional    functioning central
        analysis, dissemination and use for planning and management                       adequate resources      adequate resources         capacity and           HIS administrative
                                                                                                                                          undertakes few HIS-      unit in the ministry of
                                                                                                                                             strengthening                  health
                                                                                                                                                activities


I.B.4   There is a functional central HIS administrative unit responsible for               Central unit is          Central unit is      Central unit has very         There is no
        population censuses and household surveys that designs, develops and                functional with       functional but lacks     limited functional       functioning central
        supports health-information collection, management, analysis,                     adequate resources      adequate resources          capacity and         administrative unit in
        dissemination and use for planning and management                                                                                 undertakes few HIS-      the ministry of health
                                                                                                                                             strengthening
                                                                                                                                                activities


I.B.5   At subnational levels (e.g., regions/provinces and districts) there are           Yes – 100% of health Yes – more than 50%          Less than 50% of           No positions
        designated full-time health information officer positions and they are filled     offices at subnational   of health offices at      health offices at
                                                                                                level have a     subnational level have subnational level have
                                                                                          designated and filled      a designated and     a designated full-time
                                                                                              full-time health    filled full-time health   health information
                                                                                            information officer     information officer       officer position
                                                                                                   position               position
I.B.6    HIS capacity-building activities have taken place over the past year for HIS Sufficient capacity-     Sufficient capacity-         Limited capacity-             No
         staff of the ministry of health (statistics, software and database            building has taken      building, but largely             building
         maintenance, and/or epidemiology) at national and subnational levels        place as part of a long-   dependent upon
                                                                                       term government-       external (e.g., donor)
                                                                                         driven human           support and input
                                                                                            resources
                                                                                       development plan
I.B.7    Capacity-building activities have taken place over the past year for staff of     Sufficient capacity-    Sufficient capacity      Limited capacity-             No
         the national statistics office (statistics, and software and database             building has taken      building, but largely         building
         maintenance) at national and subnational levels                                 place as part of a long-   dependent upon
                                                                                           term government-       external (e.g., donor)
                                                                                             driven human           support and input
                                                                                                resources
                                                                                           development plan
I.B.8    HIS capacity-building activities have taken place over the past year for          Sufficient capacity-    Sufficient capacity-     Limited capacity-             No
         health-facility staff (on data collection, self-assessment, analysis and          building has taken      building, but largely         building
         presentation)                                                                   place as part of a long-   dependent upon
                                                                                           term government-       external (e.g., donor)
                                                                                             driven human           support and input
                                                                                                resources
                                                                                           development plan
I.B.9    Assistance is available to health and HIS staff at national and subnational           Excellent             Adequate, usually      Limited, does not        Not available
         levels in designing, managing and supporting databases and software                                           available for       meet the needs of
                                                                                                                   occasional assistance   staff for assistance
                                                                                                                       and back-up             and support


I.B.10   Acceptable rate of health-information staff turnover at national level in the    Low turnover, not a      Moderate turnover but      Turnover rate is       Turnover rate is
         ministry of health                                                                     problem                  manageable              problematic        unacceptably high
I.B.11   Acceptable rate of health information staff turnover at national level in        Low turnover, not a      Moderate turnover but      Turnover rate is       Turnover rate is
         national statistics office                                                             problem                  manageable              problematic        unacceptably high
I.B.12   There are specific budget-line items within the national budget for various     Yes, there are specific    National HIS budget- National HIS budget- There are no national
         sectors to provide adequately for a functioning HIS for all relevant data         budget-line items        line items are limited line items are limited HIS budget-line items
         sources in the ministry of health                                                 within the national     but allow for adequate and do not allow for     and the function of
                                                                                           budget to provide       function of all relevant adequate function of   most relevant data
                                                                                            adequately for a            data sources          all relevant data   sources is inadequate
                                                                                         functioning HIS for all                                   sources
                                                                                         relevant data sources
I.B.13   There are specific budget-line items within the national budget for various Yes, there are specific       National statistics   National statistics       There are no national
         sectors to provide adequately for a functioning statistics system for all data    budget-line items    budget-line items are budget-line items are        statistics budget-line
         sources in the national statistics office                                        within the national    limited but allow for   limited and do not       items and the function
                                                                                           budget to provide    adequate function of     allow for adequate        of most relevant data
                                                                                            adequately for a        all relevant data  function of all relevant   sources is inadequate
                                                                                         functioning statistics          sources            data sources
                                                                                        system for all relevant
                                                                                             data sources




  C. HIS Infrastructure
                                                                                                                                        Present but not
                                                                                          Highly adequate             Adequate                               Not adequate at all            Rationale/
                                        Items                                                                                               adequate
                                                                                                                                                                                            comments
                                                                                                  3                     2                        1                     0
I.C.1    Recording forms, paper, pencils and other supplies that are needed for         Yes, recording forms, Occasionally there are There are “stock-outs” The health service is
         recording health services and disease information are available                 paper, pencils and      “stock-outs” of       of recording forms,    not able to meet
                                                                                          other supplies are    recording forms,       paper, pencils and         reporting
                                                                                         always available for  paper, pencils and     other supplies which requirements due to a
                                                                                          recording required other supplies but this affect the recording of  lack of recording
                                                                                             information       does not affect the    required information forms, paper, pencils
                                                                                                              recording of required                          and other supplies
                                                                                                                   information

I.C.2    Recording forms, paper, pencils and supplies that are needed for reporting Yes, recording forms, Occasionally there are        There are “stock-outs”     Health service is not
         vital statistics are available                                              paper, pencils and      “stock-outs” of              of recording forms,     able to meet reporting
                                                                                      other supplies are    recording forms,              paper, pencils and      requirements due to a
                                                                                     always available for  paper, pencils and            other supplies which         lack of recording
                                                                                      recording required other supplies but this        affect the recording of    forms, paper, pencils
                                                                                         information       does not affect the           required information        and other supplies
                                                                                                          recording of required
                                                                                                               information
I.C.3   Computers are available at the relevant offices at national,                  Yes, all relevant      Some relevant district      Some relevant             No, only relevant
        regional/provincial and district levels to permit the rapid compilation of    offices at district,     offices and most        regional/provincial       national offices have
        subnational data                                                             regional/provincial         national and            offices and the          computers for this
                                                                                     and national levels      regional/provincial      majority of national            purpose
                                                                                     have computers for          offices have             offices have
                                                                                         this purpose         computers for this       computers for this
                                                                                                                    purpose                  purpose
I.C.4   A basic ICT infrastructure (telephones, internet access and e-mail) is in       Yes, basic ICT               Basic ICT               Basic ICT                Basic ICT
        place at national, regional/provincial and district levels                    infrastructure is in      infrastructure is in    infrastructure is in     infrastructure is in
                                                                                       place at national,    place at national level; place at national level; place only at national
                                                                                      regional/provincial       more than 50% at       but less than 50% at              level
                                                                                       and district levels      regional/provincial     regional/provincial
                                                                                                               level; but less than      and district levels
                                                                                                              50% at district level


I.C.5   Support for ICT equipment maintenance is available at national,              Yes, there is support    There is support for     There is support for      There is support for
        regional/provincial and district levels                                       for ICT equipment          ICT equipment            ICT equipment            ICT equipment
                                                                                        maintenance at           maintenance at           maintenance at           maintenance at
                                                                                            national,         national level; more    national level; but less    national level only
                                                                                      regional/provincial         than 50% at              than 50% at
                                                                                       and district levels     regional/provincial      regional/provincial
                                                                                                              level; but less than       and district levels
                                                                                                              50% at district level




                                      Categories                                       Maximum                     Score                        %

  A     Policy and Planning                                                                    0                      0.0               Not assessed

        HIS institutions, human resources and
  B                                                                                            0                      0.0               Not assessed
        financing
C   HIS Infrastructure   0   0.0   Not assessed


    Total                0   0.0   Not assessed
                                                Response from interviewees
                                                                                                                                  Average
Name1   Name2   Name3   Name4   Name5   Name6       Name7      Name8         Name9   Name10   Name11   Name12   Name13   Name14
                                                Response from interviewees
                                                                                                                                  Average
Name1   Name2   Name3   Name4   Name5   Name6       Name7      Name8         Name9   Name10   Name11   Name12   Name13   Name14
                                                Response from interviewees
                                                                                                                                  Average
Name1   Name2   Name3   Name4   Name5   Name6       Name7      Name8         Name9   Name10   Name11   Name12   Name13   Name14
II. Indicators                                                                             Return to Menu           Go to Results            Abbreviations              Glossary
                                                                                                                                              Present but not
                                                                                            Highly adequate             Adequate                                    Not adequate at all    Rationale/
                                         Items                                                                                                   adequate
                                                                                                                                                                                           comments
                                                                                                      3                      2                     1                      0
II.A.1   National minimum core indicators have been identified for national and             Yes, minimum core        Minimum core          Process initiated-   Process not initiated-
         subnational levels, covering all categories of health indicators                     indicators are          indicators are     Discussions are under      No minimum
         (determinants of health; health system inputs, outputs and outcomes; and          identified at national identified at national     way to identify   indicators nor data set
         health status)                                                                   and subnational levels and subnational levels essential indicators          identified
                                                                                               and cover all      but they do not cover
                                                                                                categories            all categories


II.A.2   There is a clear and explicit official strategy for measuring each of the              Yes, all the        Not all, but at least   At least one but less    None of the MDG
         health-related MDG indicators relevant to the country                             appropriate health-      50% of the health-        than 50% of the          health-related
                                                                                               related MDG             related MDG           appropriate MDG           indicators are
                                                                                              indicators are          indicators are            indicators are        included in the
                                                                                             included in the         included in the           included in the        minimum core
                                                                                             minimum core             minimum core              minimum core            indicator set
                                                                                               indicator set           indicator set             indicator set
II.A.3   Core indicators are defined in collaboration with all key stakeholders (e.g.,     Yes, all the relevant    Relevant ministries       Collaboration     No, each programme
         ministry of health (MoH), national statistics office (NSO), other relevant            stakeholders           and the NSO are     between the MoH, the     requests data
         ministries, professional organizations, subnational experts and major              collaborated in the      involved but more    subnational level and  according to own
         disease-focused programmes)                                                       selection of the core   external participation     some disease          requirements
                                                                                                 indicators         would be desirable     programmes but no
                                                                                                                                           involvement of the
                                                                                                                                                  NSO


II.A.4   Core indicators have been selected according to explicit criteria including           Yes, the core     Mostly – but not all    There are guidelines         There are no
         usefulness, scientific soundness, reliability, representativeness, feasibility   indicators have been criteria for selection       but they do not       guidelines or explicit
         and accessibility                                                                selected according to were clear and explicit include explicit criteria    criteria for the
                                                                                              explicit criteria                           for the selection of selection of indicators
                                                                                          including usefulness,                                indicators
                                                                                          scientific soundness,
                                                                                                 reliability
                                                                                           representativeness,
                                                                                              feasibility, and
                                                                                               accessibility
II.A.5   Reporting on the minimum set of core indicators occurs on a regular basis   Reporting is regular           Reporting is irregular   Reporting is very
                                                                                       (e.g., annual or               and incomplete             limited
                                                                                          biannual)




                                     Categories                                        Maximum              Score            %

II.      Indicators                                                                           0              0.0     Not assessed
                                                Response from interviewees
                                                                                                                                  Average
Name1   Name2   Name3   Name4   Name5   Name6       Name7      Name8         Name9   Name10   Name11   Name12   Name13   Name14
III. Data Sources                                                                        Return to Menu           Go to Results            Abbreviations             Glossary

A. Census
                                                                                                                                    Present but not
     Core                                                                                 Highly adequate             Adequate                           Not adequate at all              Rationale/
                                                Items                                                                                   adequate
  dimensions                                                                                                                                                                              comments
                                                                                                3                     2                     1                     0
III.A.1         A.1.1: Mortality questions were included in the last census:          Questions to estimate Questions to estimate   Only questions to   No mortality questions
Contents        • questions to estimate child mortality – children ever born and       child mortality and    child mortality and    estimate child
                children still alive;                                                 questions to estimate questions to estimate   mortality, or only
                • questions to estimate adult mortality – household deaths in the     adult mortality, paired   adult mortality   questions to estimate
                past 12 (or 24) months including sex of deceased and age-at-death         by questions                               adult mortality
                                                                                      concerning injury and
                Note: Skip this question if civil registration covers at least 90% of  pregnancy-related
                deaths                                                                       deaths



III.A.2         A.2.1: The country has adequate capacity to: (1) implement data         Adequate capacity for Adequate capacity for Adequate capacity for Adequate capacity for
Capacity &      collection; (2) process the data; and (3) analyse the data                     all 3               2 of the 3          only 1 of the 3       none of the 3
practices
                A.2.2: A census was carried out in the past 10 years                            Yes                                                                       No
                A.2.3: A Post enumeration survey (PES) has been completed and           PES undertaken and       PES undertaken and      PES undertaken but      No PES undertaken
                a written report is available and widely distributed                    report is available on     printed report is      no report available
                                                                                               the web                 available
                A.2.4: Evaluation of completeness of adult mortality data from the      Evaluation has been                               Evaluation has been       No evaluation
                last census has been undertaken and the results published along         undertaken and the                                 undertaken but the
                with the published mortality statistics                                   results published                              results have not been
                                                                                            along with the                                     published
                Note: Skip this question if the last census did not include              published mortality
                questions on adult mortality (household deaths)                                statistics


III.A.3         A.3.1: A report including descriptive statistics (age, sex, residence    All districts (lowest   All regions/provinces     Central/national         Not available
Dissemination   by smallest administrative level) from the most recent census is        administrative health         (intermediate      health officials have
                available and widely distributed (online or paper copy)                      offices) have       administrative health    immediate access
                                                                                         immediate access             offices) have
                                                                                                                  immediate access


                A.3.2: Lag between the time that data were collected and the time        Less than 2 years           2 or 3 years            4 or 5 years         No census results
                that descriptive statistics (age, sex, residence by enumeration                                                                                  available for at least
                area) were published                                                                                                                                   10 years
                A.3.3: Accurate population projections by age and sex are                 Accurate projections    Accurate projections   Accurate projections    No projections for
                available for small areas (districts or below) for the current year       are available for the     are available for      are available for       current year, or
                                                                                                smallest                districts         regions/provinces      projections are not
                Note: Skip this question if no census results available for more          administrative level                                                    considered to be
                than 10 years                                                                                                                                         accurate



                A.3.4: Microdata are available for public access                          Available on request    Available on request                              Not available
                                                                                                                    with restrictions
                Note: Skip this question if no census results available for more
                than 10 years


III.A.4         A.4.1: Population projections are used for the estimation of               Projections used by    Projections used by     Projections used at   Population projections
Integration &   coverage and planning of health services                                    most subdistricts        most districts         national and/or       are not used for
use                                                                                                                                       regional/provincial           health
                Note: Skip this question if no census results available for more                                                                 levels
                than 10 years




B. Vital statistics
                                                                                                                                           Present but not
     Core                                                                                   Highly adequate            Adequate                                  Not adequate at all     Rationale/
                                                 Items                                                                                        adequate
  dimensions                                                                                                                                                                             comments
                                                                                                  3                       2                        1                      0
III.B.1         B.1.1: There is a reliable source of nationwide vital statistics: civil     Nationwide civil      Sample Registration        Demographic         There is no reliable
Contents        registration; Sample Registration System (SRS); or Demographic               registration              System            Surveillance Systems          source
                Surveillance System (DSS)
                B.1.2: Coverage of deaths registered through civil registration               90% or more             70% - 89%               50% - 69%                 <50%
                B.1.3: Cause-of-death information is recorded on the death                    90% or more             70% - 89%               50% - 69%                 <50%
                registration form if civil registration is in place

                Note: Skip this item if civil registration is not in place

III.B.2         B.2.1: The country has adequate capacity to: (1) implement data           Adequate capacity for Adequate capacity for Adequate capacity for Adequate capacity for
Capacity &      collection; (2) process the data; and (3) analyse the data from civil            all 3               2 of the 3          only 1 of the 3       none of the 3
practices       registration or SRS or DSS
B.2.2: Frequency of the assessment of completeness of civil            Each time census is      Each time census is     Less periodically than    Never conducted or
registration                                                          conducted (every 5 to         conducted                 census                 do not know
                                                                           10 years)
B.2.3: The International Statistical Classification of Diseases and      ICD-10 detailed       Tabulation List ICD-10           ICD-9            No ICD used or ICD-8
Related Health Problems (ICD) is currently in use for cause-of-                                                                                   or earlier or there is
death registration                                                                                                                                 no cause-of-death
                                                                                                                                                      registration
Note: Score 0 if there is no cause-of-death registration


B.2.4: Proportion of all deaths coded to ill-defined causes (%)           Less than 5%               5% - 10%                11% - 19%               20% or more
(garbage codes)

Note: Skip this item if there is no cause-of-death registration



B.2.5: Published statistics from civil registration or SRS are                All 3                    2 of 3                   1 of 3           None of 3, or there is
disaggregated by: (1) sex; (2) age; and (3) geographical or                                                                                       no civil registration
administrative region (or urban/rural)                                                                                                               and no SRS

Note: Score 0 if there is no civil registration or SRS


B.2.6: Sample Registration System (SRS) developed and                      Nationally                                         Partially                  None
generating timely and accurate data                                      representative                                    representative

Note: Skip this item if there is no SRS

B.2.7: Demographic Surveillance System (DSS) sites developed                                          Partially          Non-representative              None
and generating timely and accurate data                                                          representative (at
                                                                                                least 1 urban and 2
Note: Skip this item if there is no DSS                                                             rural sites)


B.2.8: Verbal autopsy (VA) tool                                         VA tool validated;       VA tool validated        VA not validated        No verbal autopsy
                                                                      questionnaire publicly                                                     used by SRS and/or
Note: Skip this item if there is no DSS or SRS                            available and                                                                 DSS
                                                                         consistent with
                                                                          international
                                                                            standards
III.B.3         B.3.1: Lag between the time that data were collected and the time       Less than 3 years       3 years        4 or 5 years    More than 5 years or
Dissemination   that statistics from civil registration/SRS/DSS were published                                                                      statistics not
                                                                                                                                                published or no vital
                Note: Score 0 if there is no civil registration or SRS or DSS                                                                  statistics system (civil
                                                                                                                                                 registration, SRS,
                                                                                                                                                     DSS) exists
III.B.4         B.4.1: Information from civil registration/SRS/DSS on: (1) mortality    Both mortality rates   1 of 2 used                     Not used or statistics
Integration &   rates; and (2) causes of death is used for national and subnational     and cause-of-death                                      not published or no
use             analysis                                                               information are used                                    vital statistics system
                                                                                                                                                  (civil registration,
                Note: Score 0 if there is no civil registration or SRS or DSS                                                                    SRS, DSS) exists




C. Population-based surveys
                                                                                                                             present but not
     Core                                                                               Highly adequate        Adequate                         not adequate at all       Rationale/
                                               Items                                                                            adequate
  dimensions                                                                                                                                                              comments
                                                                                                3                  2               1                      0
III.C.1         C.1.1: In the past 5 years, a nationally representative survey has             Yes                                                       No
Contents        measured the percentage of the relevant population receiving key
                maternal and child health services (e.g., family planning, antenatal
                care, professionally attended deliveries, immunization)


                C.1.2: In the past 5 years, a nationally representative survey has             Yes                                                       No
                provided sufficiently precise and accurate estimates of infant and
                under-5 mortality
                C.1.3: In the past 5 years, nationally representative population-         Yes, nationally-       Surveys have not      In the past 5 years,    No population-based
                based survey(s) have measured the prevalence of some priority              representative         measured any          population-based        surveys have been
                noncommunicable diseases/health problems (e.g., disability,                 surveys have       additional biomarkers     surveys have not      organized in the past
                mental illness, hypertension, diabetes, accidents, violence) and       measured biomarkers but have measured              measured the                5 years
                leading risk factors (e.g., smoking, drug use, diet, physical          and at least 3 priority the prevalence of at     prevalence of any
                inactivity)                                                             noncommunicable           least 1 priority            priority
                                                                                          diseases/health       noncommunicable         noncommunicable
                “Biomarkers” – substance used as an indicator of a biologic state.       conditions or risk       disease/health          disease/health
                This includes screening for antibodies in blood and urine sample,              factors         problem or risk factor problem or risk factor
                for example.


III.C.2         C.2.1: The country has adequate capacity to: (1) conduct               Adequate capacity for Adequate capacity for Adequate capacity for Adequate capacity for
Capacity &      household surveys (including sample design and field work); (2)               all 3               2 of the 3          only 1 of the 3       none of the 3
practices       process the data; and (3) analyse the data
                C.2.2: Surveys follow international standards for consent,                      Yes                                                                     No
                confidentiality and access to personal data (e.g., OECD guidelines)

                C.2.3: The data allow disaggregation by age, sex and locality (e.g.            All 3                     2                      1                     None
                urban/rural, major geographical or administrative region)

                C.2.4: The data allow disaggregation by socioeconomic status: (1)            Yes, both                                  Only by education               No
                income; and (2) education
III.C.3         C.3.1: Metadata (design, sample implementation, questionnaires)          Publicly available                                                       Not available
Dissemination   are available from recent surveys

                C.3.2: Microdata are available from recent surveys                     Available on request    Available on request                               Not available
                                                                                                                 with restrictions

III.C.4         C.4.1: There are meetings and a multiyear plan to coordinate the       Yes, a coordination     Coordination group       Plan exists but is  Neither a coordination
Integration &   timing, key variables measured and funding of nationally               mechanism and plan      and long-term plan      incomplete and/or    group nor a long-term
use             representative population-based surveys that measure health               coordinate all       coordinate >75% of     coordination group is       plan exist
                indicators                                                                  nationally              nationally        unable to effectively
                                                                                         representative          representative        coordinate surveys
                                                                                             surveys           household surveys
                C.4.2: The health and statistical constituencies in the country work     Highly adequate            Adequate             Present, but not      Not adequate at all
                together closely on survey design, implementation and data                                                                  adequate
                analysis and use
D. Health and disease records (including disease surveillance systems)
                                                                                                                                     Present but not
     Core                                                                              Highly adequate            Adequate                               Not adequate at all          Rationale/
                                              Items                                                                                      adequate
  dimensions                                                                                                                                                                          comments
                                                                                                3                       2                    1                     0
III.D.1        D.1.1: For each of the key epidemic-prone diseases (e.g., cholera,       True for all key     True for all except 1 There are 3 or more      No system for
Contents       diarrhoea with blood, measles, meningitis, plague, viral                 epidemic-prone         or 2 key epidemic-    key diseases for      notification or a
               haemorrhage fevers, yellow fever, SARS, bird flu) and diseases            diseases and         prone diseases and which case definitions system that does not
               targeted for eradication and/or elimination (e.g., poliomyelitis,     diseases targeted for   diseases targeted for     remain to be     report on most of the
               neonatal tetanus, leprosy) appropriate case definitions have been       eradication and/or      eradication and/or    established or for     key diseases
               established and cases can be reported using the current reporting          elimination              elimination      which the reporting
               format                                                                                                              form is not adequate


               D.1.2: For health conditions of substantial public health importance True for all leading    True for most leading True for some leading No good surveillance
               other than those listed above in D.1.1 (e.g., leading causes of      causes of morbidity,     causes of mobidity,      causes of morbidity,     system exists other
               mortality, morbidity and disability such as pneumonia and           mortality and disability mortality and disability mortality and disability than epidemic-prone
               diarrhoea with dehydration in children less than 5 years of age,                                                                                     diseases
               malaria, tuberculosis, HIV/AIDS, sexually transmitted diseases,
               and noncommunicable diseases) a surveillance strategy exists


               D.1.3: Mapping of specific at-risk populations in place (e.g.,        Maps are up to date     Maps are up to date    Mapping of only a few No mapping of public
               populations with high levels of malnutrition and poverty) and of      and comprehensive        and reasonably         public health risks      health risks
               general population exposed to specific risks (e.g., vectors, and      and there is capacity    comprehensive
               environmental and industrial pollution)                               to promptly add new
                                                                                           features
III.D.2        D.2.1: The country has adequate capacity to: (1) diagnose and         Adequate capacity for Adequate capacity to Adequate capacity to Adequate capacity for
Capacity &     record cases of notifiable diseases; (2) report and transmit timely      all 3 activities   carry out activities (1) carry out activity (1) none of the 3 activities
practices      and complete data on these diseases; and (3) analyse and act                                       and (2)                   only
               upon the data for outbreak response and planning of public health
               interventions
               D.2.2: Percentage of health workers making primary diagnoses              90% or more              75% - 89%               25% - 74%                 <25%
               who can correctly cite the case definitions of the majority of
               notifiable diseases
               D.2.3: Percentage of health facilities submitting weekly or monthly       90% or more              75% - 89%               25% - 74%                 <25%
               surveillance reports on time to the district level
               D.2.4: Percentage of districts submitting weekly or monthly               90% or more              75% - 89%               25% - 74%                 <25%
               surveillance reports on time to the next-higher level
               D.2.5: Proportion of investigated outbreaks with laboratory results       90% or more              75% - 89%               25% - 74%                 <25%
                D.2.6: Use of facility-retained patient medical records to support          90% or more of     Records are usually    Essential patient   No system for patient
                quality and continuity of care                                            patient records are completed adequately information is usually  medical records in
                                                                                        completed adequately and can be retrieved not recorded and/or     most health facilities
                                                                                         and can be retrieved   for the majority of  records cannot be
                                                                                          for 90% or more of    patients in time to  retrieved for most
                                                                                           patients in time to   promptly inform           patients
                                                                                            promptly inform      clinical decision-
                                                                                           clinical decision-          making
                                                                                                 making


                D.2.7: International Statistical Classification of Diseases and            ICD-10 detailed        Tabulation list ICD-10             ICD-9         No ICD used or ICD-8
                Related Health Problems (ICD) is currently used for reporting                                                                                            or earlier
                hospital discharge diagnoses

                Note: Not applicable if there is no ICD coding of discharge
                diagnoses


III.D.3         D.3.1: Surveillance data on epidemic-prone diseases are                   Bulletin produced                                   Bulletin not produced No bulletin produced
Dissemination   disseminated and fed back through regularly published weekly,           regularly during past                                  regularly during past
                monthly or quarterly bulletins                                          year and available at                                 year or not distributed
                                                                                          all district health                                       to districts
                                                                                                offices


III.D.4         D.4.1: Integration of reporting for disease surveillance and other       A single form is used Although there are a                                  Health workers and
Integration &   focused public health programmes (e.g., maternal care, family            for notification of key number of reporting                                  managers face a
use             planning and growth monitoring)                                         diseases. Reporting of forms, there is good                                     heavy burden
                                                                                           other public health      coordination and                                   completing and
                                                                                          programmes is also efforts to integrate the                                reviewing separate
                                                                                             well integrated            reporting                                   reports for numerous
                                                                                                                 requirements of public                                 public health
                                                                                                                   health programmes                                    programmes



                4.D.2 Proportion of epidemics noted at regional/provincial or               At least 90% of           At least 75% of                                 Less than 75% of
                national level (through analysis of surveillance data) first detected     epidemics noted at       epidemics noted at                                epidemics noted at
                at district level                                                        regional/provincial or regional/provincial or                              regional/provincial or
                                                                                        national levels are first national levels are first                        national levels are first
                                                                                          detected at district      detected at district                             detected at district
                                                                                                  level                     level                                            level
E. Health service records
                                                                                                                                             Present but not
     Core                                                                                 Highly adequate              Adequate                                      Not adequate at all    Rationale/
                                                Items                                                                                             adequate
  dimensions                                                                                                                                                                                comments
                                                                                                   3                         2                         1                       0
III.E.1         E.1.1: There is a health service based information system that           Yes, it covers both      Integrated but covers     Covers few private       No data from private
Contents        brings together data from all public and private facilities              public and private        few private facilities facilities (e.g. only not-      facilities
                                                                                              facilities         (e.g. for-profit and not-         for-profit)
                                                                                                                         for-profit)


                E.1.2: There is a systematic approach to evaluating the quality of          There is both          There has been at       There is information    Records of findings
                services provided by health facilities. This includes both: (a)               systematic            least 1 nationally     on quality of services   from structured
                systematic standardized supervision with reporting of findings to           standardized         representative health        but only from a     supervision or health
                district and national levels; and (b) a health-facility survey of all     supervision with        facility survey in the   convenience sample facility surveys are not
                facilities or of a nationally representative sample at least once          reporting and a            past 5 years          of health facilities       available
                every 5 years                                                                 nationally-
                                                                                        representative health
                                                                                            facility survey


III.E.2         E.2.1: The health information system has a cadre of trained health         At least 75% of       10% - 74% of districts    1% - 9% of districts      Not in any district
Capacity &      information staff who have at least 2 years of specialized training            districts
practices       and are in place at the district level
                E.2.2: Health workers in health facilities (clinics and hospitals)      Most health workers         25–49% of health       5–24% of health        Less than 5% of
                receive regular training in health information that is either            have received such           workers have           workers have       health workers have
                integrated into continuing education or through in-service training     training in the past 5   received such training received such training received such training
                in the public sector                                                            years              in the past 5 years    in the past 5 years


                E.2.3: There are mechanisms in place at national and subnational          Highly adequate              Adequate              Present, but not       Not adequate at all
                levels for supervising, and receiving feedback on, information                                                                  adequate
                practices in the public sector
                E.2.4: There is a mechanism in place from district up through             Highly adequate              Adequate              Present, but not       Not adequate at all
                national level for verifying the completeness and consistency of                                                                adequate
                data from facilities
III.E.3         E.3.1: The time elapsed since an annual summary of health               Less than 2 years ago        2-3 years ago            4-5 years ago        6 years ago or more
Dissemination   service statistics was published with statistics disaggregated by
                major geographical or administrative region
                E.3.2: Degree to which districts or similar administrative units            Highly adequate              Adequate                Present, but not     Not adequate at all
                compile their own monthly/quarterly and annual summary reports,                                                                     adequate
                disaggregated by health facility
III.E.4         E.4.1: Degree to which vertical reporting systems (e.g., for                Highly adequate              Adequate                Present, but not     Not adequate at all
Integration &   tuberculosis or vaccination) communicate well with the general                                                                      adequate
use             health service reporting system
                E.4.2: Degree to which managers and analysts at national and                Highly adequate              Adequate                Present, but not     Not adequate at all
                subnational levels frequently use findings from surveys, civil                                                                      adequate
                registration (or other vital statistics systems) to assess the validity
                of clinic-based data
                E.4.3: Degree to which data derived from health service records               Yes, always            Yes, sometimes               Occasionally              Never
                are used to estimate the coverage of key services (e.g., antenatal
                care, delivery with a skilled attendant and immunization)




F. Resource records
1. Infrastructure and health services
                                                                                                                                                Present but not
     Core                                                                                   Highly adequate             Adequate                                      Not adequate at all    Rationale/
                                                 Items                                                                                             adequate
  dimensions                                                                                                                                                                                 comments
                                                                                                   3                         2                        1                        0
III.F.1         .1.1: There is a national database/roster of public and private-                  Yes                    There is a                                           No
Contents        sector health facilities. Each health facility has been assigned a                                  database/roster of
                unique identifier code that permits data on facilities to be merged                                public health facilities
                                                                                                                   with a coding system
                                                                                                                  that permits integrated
                                                                                                                    data management


                F.1.2: Global Positioning System (GPS) coordinates for each               True for 90% or more True for 90% or more             True for <90% of      Not adequate at all
                health facility are included in the database                              of public and private  of public facilities            public facilities
                                                                                                 facilities
III.F.2         F.2.1: There are human resources and equipment for maintaining              Highly adequate              Adequate                Present, but not     Not adequate at all
Capacity &      and updating the database and maps on health facilities and                                                                         adequate
practices       services
                F.2.2: Period since the national database of facilities was updated       Less than 2 years ago       2-3 years ago           More than 3 years ago   There is no national
                                                                                                                                                                           database
III.F.3         F.3.1: Maps are available in most districts showing the location of     Highly adequate           Adequate           Present, but not       Not adequate at all
Dissemination   health infrastructure, health staff and key health services                                                             adequate

III.F.4         F.4.1: Managers and analysts at national and district levels            Highly adequate           Adequate           Present, but not       Not adequate at all
Integration &   commonly evaluate physical access to services by linking                                                                adequate
use             information about the location of health facilities and health
                services to the distribution of the population




2. Human resources
                                                                                                                                     Present but not
     Core                                                                               Highly adequate           Adequate                                  Not adequate at all   Rationale/
                                                Items                                                                                    adequate
  dimensions                                                                                                                                                                      comments
                                                                                                 3                     2                     1                       0
III.F.5         F.5.1: There is a national human resources (HR) database that          Yes, the national HR    The national HR        he national HR          No national HR
Contents        tracks the number of health professionals by major professional          database tracks        database tracks     database does not           database
                category working in either the public or the private sector             numbers of health         numbers by         provide statistics
                                                                                         professionals by    professional category   disaggregated by
                                                                                      professional category but only those working professional category
                                                                                      in both the public and in the public sector
                                                                                          private sectors


                F.5.2: There is a national database that tracks the annual numbers            Yes                                  Numbers graduating               No
                graduating from all health-training institutions                                                                    from certain health
                                                                                                                                    training institutions
                                                                                                                                   (e.g. nursing; private
                                                                                                                                    institutions) are not
                                                                                                                                           tracked
III.F.6         F.6.2: Period since national HR database statistics were last           Highly adequate           Adequate           Present, but not       Not adequate at all
Capacity &      updated:                                                                                                                adequate
practices
                F.6.2: Period since national HR database statistics were last             0-1 year ago          2-3 years ago         4-5 years ago         6 years ago or more
                updated:
3. Financing and expenditure for health services
                                                                                                                                          Present but not
     Core                                                                              Highly adequate               Adequate                                     Not adequate at all     Rationale/
                                              Items                                                                                          adequate
  dimensions                                                                                                                                                                              comments
                                                                                               3                         2                      1                          0
III.F.7        F.7.1: Financial records are available on general government             All components,           Only public and           Only public               No system or
Contents       expenditure on health and its components (e.g., by ministry of          public and private        household out-of-          expenditure                incomplete
               health, other ministries, social security, regional and local                                    pocket expenditure
               governments, and extra budgetary entities) and on private
               expenditure on health and its components (e.g., household out-of-
               pocket expenditure, private health insurance, NGOs, firms and
               corporations)
               F.7.2: There is a system for tracking budgets and expenditure by      All sources of finance     Sources other than          Government             No tracking or only
               all the financial agents listed above in F.7.1 disaggregated by       are disaggregated by        household out-of-      budget/expenditure         tracking of national
               subnational or district level                                         subnational or district    pocket expenditure      plus at least 1 more           government
                                                                                              level              (e.g., government        source such as               expenditure
                                                                                                                  including social       donors but only at
                                                                                                                 security and local        national level
                                                                                                               government, donors,
                                                                                                               and health insurance)
                                                                                                                by subnational level


III.F.8        F.8.1: Adequate numbers of qualified, long-term staff are regularly            Yes                Adequate numbers         Adequate numbers        Ad hoc staff chosen
Capacity &     deployed to work on the National Health Account (NHA) whether or                                and skills but staff are but in need of external   when activity takes
practices      not they are employed by the ministry of health                                                   not employed long-      technical support or           place
                                                                                                               term by any in-country inadequate numbers
               Note: Not applicable if no NHA conducted                                                           agency or are not          of skilled staff
                                                                                                                regularly devoted to
                                                                                                                    work on NHA


               F.8.2: Periodicity and timeliness of routine NHA                       Estimates every year Estimates every year           Estimates every         Estimates every more
                                                                                         with 1-year lag       with 2-year lag               2-5 years             than 5 years or no
               Note: Not applicable if no NHA conducted                              between year reported between year reported                                       estimates
                                                                                      and publication year and publication year
                F.8.3: NHA routinely provides information on the following 4                      All 4                 Any 3                   Any 2             None or only 1
                classifications of financial flow: (1) financial sources; (2) financial
                agents; (3) providers; and (4) functions

                functions – the types of goods and services provided and activities
                performed

                Note: Not applicable if no NHA conducted


                F.8.4: NHA provides information on health expenditure by major    Health expenditure       Health expenditure          Estimates are                  None
                diseases, health programme areas, geographical or administrative     information is           information is            available of
                region and/or target populations (according to major policy      available for at least 2 available for at least 1 expenditure on some
                concerns)                                                            major disease            major disease            areas of policy
                                                                                   programmes and           programmes and            concern but they
                Note: Not applicable if no NHA conducted                         another area of policy another area of policy         exclude some
                                                                                        concern                  concern           important sources of
                                                                                                                                    finance (e.g. out-of-
                                                                                                                                          pocket)

III.F.9         F.9.1: NHA findings are widely and easily accessible                        NHA findings have      NHA findings have      NHA findings are    Written report on NHA
Dissemination                                                                                   been widely       been disseminated to   available within the findings not available
                Note: Not applicable if no NHA conducted                                   disseminated and are        the public        agency but have not
                                                                                            cited in a document                              been widely
                                                                                          that is accessible on a                           disseminated
                                                                                                   web site


III.F.10        F.10.1: NHA has been used for policy formulation and resource              There is at least one At least some findings Policy-makers and     There is no evidence
Integration &   allocation                                                                major policy document from the NHA have other stakeholders are that policy-makers are
use                                                                                           that has been            been used in       aware of the NHA aware of NHA findings
                Note: Not applicable if no NHA conducted                                       substantially          budgeting and     findings but there is
                                                                                            influenced by (or            planning         no evidence that
                                                                                            prominently cites)                          these findings have
                                                                                              NHA findings                               shaped policy and
                                                                                                                                              planning
4. Equipment, supplies and commodities
                                                                                                                                         Present but not
     Core                                                                                 Highly adequate             Adequate                                 Not adequate at all   Rationale/
                                                 Items                                                                                      adequate
  dimensions                                                                                                                                                                         comments
                                                                                                  3                       2                    1                        0
III.F.11        F.11.1: Each facility is required to report at least annually on the             Yes                                                                   No
Contents        inventory and status of equipment and physical infrastructure (e.g.,
                construction, maintenance, water supply, electricity and sewage
                system) in the public sector
                F.11.2: Each facility is required to report at least quarterly on its            Yes                                                                   No
                level of supplies and commodities (e.g., drugs, vaccines and
                contraceptives) in the public sector
III.F.12        F.12.1: There are sufficient and adequately skilled human                  Highly adequate            Adequate            Present, but not     Not adequate at all
Capacity &      resources to manage the physical infrastructure, and the logistics                                                           adequate
practices       of equipment, supplies and commodities in the public sector

                F.12.2: Periodicity and completeness of reporting on equipment           Complete quarterly        Complete annual      Incomplete reporting         None
                and physical infrastructure in the public sector                            reporting                 reporting
                F.12.3: Periodicity and completeness of reporting on supplies and        Complete, monthly        Complete, quarterly   Incomplete reporting         None
                commodities in the public sector                                            reporting                 reporting
III.F.13        F.13.1: Degree to which reporting systems for different supplies              Fully                    Partially            Somewhat            All supplies and
Integration &   and commodities are integrated in the public sector                                                                                               commodities
use                                                                                                                                                            separately reported

                F.13.2: Managers at national and subnational levels routinely           Routine reconciliation,      Occasionally             Rarely                 Never
                attempt to reconcile data on the consumption of commodities with               monthly
                data on cases of disease reported in the public sector
                                                Response from interviewees
                                                                                                                                  Average Score
Name1   Name2   Name3   Name4   Name5   Name6       Name7      Name8         Name9   Name10   Name11   Name12   Name13   Name14
                                                Response from interviewees
                                                                                                                                  Average Score
Name1   Name2   Name3   Name4   Name5   Name6       Name7      Name8         Name9   Name10   Name11   Name12   Name13   Name14
                                                Response from interviewees
                                                                                                                                  Average Score
Name1   Name2   Name3   Name4   Name5   Name6       Name7      Name8         Name9   Name10   Name11   Name12   Name13   Name14
                                                Response from interviewees
                                                                                                                                  Average Score
Name1   Name2   Name3   Name4   Name5   Name6       Name7      Name8         Name9   Name10   Name11   Name12   Name13   Name14
                                                Response from interviewees
                                                                                                                                  Average Score
Name1   Name2   Name3   Name4   Name5   Name6       Name7      Name8         Name9   Name10   Name11   Name12   Name13   Name14
                                                Response from interviewees
                                                                                                                                  Average Score
Name1   Name2   Name3   Name4   Name5   Name6       Name7      Name8         Name9   Name10   Name11   Name12   Name13   Name14
                                                Response from interviewees
                                                                                                                                  Average Score
Name1   Name2   Name3   Name4   Name5   Name6       Name7      Name8         Name9   Name10   Name11   Name12   Name13   Name14
                                                Response from interviewees
                                                                                                                                  Average Score
Name1   Name2   Name3   Name4   Name5   Name6       Name7      Name8         Name9   Name10   Name11   Name12   Name13   Name14
                                                Response from interviewees
                                                                                                                                  Average Score
Name1   Name2   Name3   Name4   Name5   Name6       Name7      Name8         Name9   Name10   Name11   Name12   Name13   Name14
IV. Data management                                                                     Return to Menu             Go to Results             Abbreviations              Glossary
                                                                                                                                          Present but not
                                                                                           Highly adequate            Adequate                                 Not adequate at all        Rationale/
                                      Items                                                                                                  adequate
                                                                                                                                                                                          comments
                                                                                                   3                      2                      1                      0
IV.1   There is a written set of procedures for data management including data            Yes, a written set of  Yes, a written set of  Yes, a written set of No written procedures
       collection, storage, cleaning, quality control, analysis and presentation for       procedures exists      data-management        data-management               exist
       target audiences, and these are implemented throughout the country               including all the steps procedures exists, but procedures exists, but
                                                                                         in data management these are only partially       these are not
                                                                                             and these are          implemented            implemented
                                                                                             implemented
                                                                                       throughout the country



IV.2   The HIS unit at national level is running an integrated data warehouse            Yes, there is a data       Yes, there is a data    Yes, there is a data      No national data
       containing data from all population-based and institution-based data            warehouse at national warehouse at national warehouse at national              warehouse exists
       sources (including all key health programmes) and has a user-friendly               level with a user-        level but it has a      level but it has no
       reporting utility accessible to various user audiences                          friendly reporting utility limited reporting utility    reporting utility
                                                                                            accessible to all
                                                                                        relevant government
                                                                                          and other partners



IV.3   At the subnational level a data warehouse equivalent to the national one         Yes, there is a data   Yes, there is a data     Yes, there is a data    No subnational data
       exists and has a reporting utility that is accessible to various users            warehouse at the       warehouse at the         warehouse at the        warehouse exists
                                                                                       subnational level with subnational level but it subnational level but it
                                                                                            a user-friendly   has a limited reporting has no reporting utility
                                                                                           reporting utility           utility
                                                                                       accessible to users at
                                                                                        all levels, including
                                                                                        users at the district


IV.4   A metadata dictionary exists which provides comprehensive definitions              Yes, there is a           Yes, there is a           Yes, there is a           No metadata
       about the data. Definitions include information in the following areas: (1)     metadata dictionary       metadata dictionary       metadata dictionary        dictionary exists
       data's use in indicators, (2) specification of collection methods used, (3)        which provides         but it only includes      but it only includes
       periodicity, (4) geographical designations (urban/rural), (5) analysis          definitions for all 6 of definitions for 3 to 5 of definitions for 1 to 2 of
       techniques used and (6) possible biases                                               the areas                  the areas                 the areas
IV.5   Unique Identifier codes are used in different databases or a complete       Unique identifier    Identifier codes are   Identifier codes are   Not available
       relational table is available to merge them                               codes are used in        used in different    available but do not
                                                                               different databases or databases and work is    match up between
                                                                               a complete relational required to harmonize     different databases
                                                                                table is available to      these across
                                                                                     merge them       databases or create a
                                                                                                         relational table to
                                                                                                       allow these to merge




                                  Categories                                     Maximum                   Score                       %

IV. Data management                                                                      0                    0.0              Not assessed
                                                Response from interviewees
                                                                                                                                  Average
Name1   Name2   Name3   Name4   Name5   Name6       Name7      Name8         Name9   Name10   Name11   Name12   Name13   Name14
 V. NATIONAL HIS DATA QUALITY:                                                         Return to Menu             Go to Results          Abbreviations               Glossary

 Health Status Indicators
                                                                                                                                         Present but not
                  Quality assessment                                                    Highly adequate              Adequate                                    Not adequate at all   Rationale/
     Indicators                                            Item                                                                             adequate
                        criteria                                                                                                                                                       comments
                                                                                                 3                       2                       1                       0
 Mortality
 A. Under-5       V.A.1                Data-collection method used for estimate       Vital registration of at    Birth history from   Other methods (such            No data
 mortality (all   Data-collection      published most recently or to be published     least 90% of under-5       household survey or   as indirect methods)
 causes)          method                                                                      deaths             Sample Registration   based on household
                                                                                                                       System          surveys or censuses


                  V.A.2                For the most recently published estimate,            0-2 years                 3-5 years              6-9 years            10 years or more
                  Timeliness           number of years since the data were
                                       collected
                  V.A.3                Number of times measured in past 10                  3 or more                    2                       1                     None
                  Periodicity          years
                  V.A.4                Datasets from major data sources                     No major             A few discrepancies Multiple discrepancies        Not applicable
                  Consistency          consistent during past 10 years                   discrepancies
                  V.A.5                Coverage of data upon which the most            All deaths (>90%)          Sample of deaths         Local studies           Not applicable
                  Representativeness   recently reported estimate is based
                  V.A.6                Most recent estimate disaggregated by                   All 3                     2                       1                     None
                  Disaggregation       demographic characteristics (e.g. sex, age)
                                       socioeconomic status (e.g. income,
                                       occupation, education of their parent) and
                                       locality (e.g. urban/rural, major
                                       geographical or administrative region)


                  V.A.7                In-country adjustments use transparent,                 Yes                                                                       No
                  Adjustment methods   well-established methods



 B. Maternal      V.B.1                Data-collection method used for estimate      Vital registration of at      Sample Vital        Direct methods from            No data
 mortality        Data-collection      that were published most recently or will be least 90% of deaths           Registration with    household survey or
                  method               published                                    and with good medical         Verbal Autopsy        censuses (such as
                                                                                     certification of cause                            sibling history, recent
                                                                                             of death                                    deaths with verbal
                                                                                                                                              autopsy)




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               V.B.2                For the most recently published estimate,          0-2 years               3-5 years                6-9 years           10 or more years
               Timeliness           number of years since the data were
                                    collected
               V.B.3                Number of times measured in past 10                3 or more                   2                        1                   No data
               Periodicity          years
               V.B.4                Data consistent over past 10 years                  No major          A few discrepancies Multiple discrepancies         Not applicable
               Consistency                                                           discrepancies
               V.B.5                Coverage of data upon which the most               All deaths          Sample of deaths           Local studies             No data
               Representativeness   recent estimate is based
               V.B.6                Estimate that was published most recently       Disaggregation          Disaggregation           Disaggregation        Disaggregation not
               Disaggregation       or will be published is disaggregated by       available for all 3      available for 2          available for 1            possible
                                    demographic characteristics (e.g. age),            elements                elements                 element
                                    socioeconomic status (e.g. income,
                                    occupation, education) and locality (e.g.
                                    urban/rural, major geographical or
                                    administrative region)


               V.B.7                In-country adjustments use transparent,               Yes                                                                      No
               Adjustment methods   well-established methods


 Morbidity
 C. HIV        V.C.1                Data-collection method used for estimate
 prevalence    Data-collection      published most recently or to be published
               method
                                    1.   If generalized epidemic
                                                                                 1. General population 1. ANC surveillance         1. HIV case-reporting   1. Any other method
                                                                                 survey + ANC
                                                                                 surveillance
                                    2.   If concentrated or low-level epidemic                                                     2. HIV case-reporting
                                                                                 2. Surveillance among 2. Surveillance among                               2. Any other method
                                                                                 population at high risk population at high risk
                                                                                 with random sampling with purposive
                                                                                                         sampling

               V.C.2                For the most recently published estimate,           <2 years                2 years                 3-4 years            5 years or more
               Timeliness           number of years since the data were
                                    collected
               V.C.3                Number of times measured in past 5 years               5                      3-4                       2                   1 or none
               Periodicity
               V.C.4                Data consistency over time during past 5            No major         Several discrepancies Multiple discrepancies        Not applicable
               Consistency          years                                            discrepancies




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                  V.C.5                Coverage of data upon which the most
                  Representativeness   recent estimate is based

                                       1. If generalized epidemic                    1. Nationally            1. Both urban and      1. Inadequate sample 1. Any other method
                                                                                     representative survey    rural ANC clinics      of clinics
                                                                                     + both urban and rural
                                                                                     ANC clinics
                                                                                     2. All major
                                       2. If concentrated or low-level epidemic      populations at high      2. At least one major 2. One high-risk        2. Any other method
                                                                                     risk with random         high-risk population in population in one
                                                                                     sampling                 multiple locations      location


                  V.C.6                Estimate that was published most recently        Disaggregation           Disaggregation          Disaggregation        Disaggregation not
                  Disaggregation       (or will be published) is disaggregated by:      available for 3          available for 2         available for 1            possible
                                       (1) demographic characteristics (e.g., sex,        elements –                elements                element
                                       age); (2) socioeconomic status (e.g.,              specifically,
                                       income, occupation, education); and (3)        prevalence among
                                       locality (e.g., urban/rural, major             15–24 year olds is
                                       geographical or administrative region)          estimated with an
                                                                                     adequate sample size



 Health System indicators
 D. Measles       V.D.1                Coverage can be estimated from routine          Yes. Administrative      Administrative           There is little     Measles vaccination
 vaccination      Data-collection      administrative statistics submitted by at     statistics are complete     statistics are        evaluation of the     coverage cannot be
 coverage by 12   method –             least 90% of immunizing health facilities.      (>90%) and quality        evaluated for         completeness or         estimated from
 months of age    administrative       These statistics are systematically               control is good;     completeness and          consistency of      administrative statistics
                  statistics           reviewed at each level for completeness              population           consistency;           administrative
                                       and consistency, and inconsistencies             denominators are           population        statistics or they are
                                       investigated and corrected. To calculate          based upon full       denominators are     submitted by less than
                                       coverage, reliable estimates of population          (>90%) birth           based upon           90% of relevant
                                       are available                                        registration     population projections     facilities, or no
                                                                                                                                    population projections
                                                                                                                                         are available




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               V.D.2                Coverage has been measured by at least 2    Yes, in the past 5  In the past 5 years             During the household No coverage estimate, or
               Data-collection      nationally representative household      years there have been    there has been 1               survey, immunization   estimate based on a
               method               surveys in the past 5 years and           at least 2 nationally       nationally                 cards were shown for household survey more
               - household survey   immunization cards were shown during          representative        representative              less than two thirds of   than 5 years old
               statistics           each survey for at least two thirds of     household surveys     household survey                      children
                                    children                                  measuring measles     measuring measles
                                                                             vaccination coverage, vaccination coverage,
                                                                               during which cards   during which cards
                                                                               were shown for at     were shown for at
                                                                                least two thirds of  least two thirds of
                                                                                     children              children




               V.D.3                For the most recently published estimate,          0-11 months             12-17 months             18-29 months            30 months or more
               Timeliness           number of months since the data were
                                    collected
               V.D.4                Number of times in the past 5 years that an           5 times                3–4 times              Once or twice                  None
               Periodicity          annual estimate was published based on
                                    administrative statistics
               V.D.5                Data consistent between recent surveys                 No major        Several discrepancies Multiple discrepancies            Not applicable
               Consistency          and reports                                         discrepancies
               V.D.6                Coverage of data upon which the most           (1) Data from at least    Data from at least      Data from less than       Anything less than this
               Representativeness   recent estimate is based                      90% of health facilities 80% of health facilities 80% of health facilities
                                                                                     and outreach sites      and outreach sites       and outreach sites
                                                                                       that immunize           that immunize            that immunize
                                                                                   children including all         children                 children
                                                                                    major hospitals and
                                                                                       both public and
                                                                                    private sector; or (2)
                                                                                          nationally
                                                                                       representative
                                                                                     household sample


               V.D.7                Estimate that was published most recently        Disaggregation           Disaggregation           Disaggregation           Disaggregation not
               Disaggregation       (or will be published) is disaggregated by:     available for all 3       available for 2          available for 1               possible
                                    (1) demographic characteristics (e.g., sex,         elements                 elements                 element
                                    age); (2) socioeconomic status (e.g.,
                                    income, occupation, education of parents);
                                    and (3) locality (e.g., urban/rural, major
                                    geographical or administrative region)




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 E. Deliveries    V.E.1                The percentage of deliveries attended by a     Yes. Administrative      Administrative            There is little       The percentage of
 attended by      Data-collection      skilled health professional can be           statistics are complete     statistics are        evaluation of the     deliveries attended by a
 skilled health   method               estimated from routine administrative          (>90%) and quality        evaluated for         completeness or             skilled health
 professionals    - administrative     statistics submitted by at least 90% of          control is good;     completeness and           consistency of      professional cannot be
                  statistics           relevant health facilities. These statistics        population           consistency;            administrative           estimated from
                                       are systematically reviewed at each level       denominators are           population        statistics, or they are administrative statistics
                                       for completeness and consistency, and            based upon full       denominators are     submitted by less than
                                       inconsistencies are investigated and               (>90%) birth           based upon            90% of relevant
                                       corrected. To calculate coverage, reliable          registration     population projections     facilities, or no
                                       estimates of population are available                                                       population projections
                                                                                                                                         are available


                  V.E.2                The percentage of deliveries attended by a       Yes. In the past 5     n the past 5 years                           No coverage estimate, or
                  Data collection      skilled health professional has been              years at least 2      there has been 1                               estimate based on a
                  method               measured by at least 2 nationally                    nationally             nationally                                household survey more
                  - household survey   representative household surveys in the            representative         representative                                 than 5 years old
                  statistics           past 5 years                                    household surveys       household survey
                                                                                         have measured        measuring coverage
                                                                                            coverage
                  V.E.3                For the most recently published estimate,          0-11 months            12-17 months           18-59 months           60 months or more
                  Timeliness           number of months since the data were
                                       collected
                  V.E.4                Number of times measured in past 10                  3 or more                  2                      1                       None
                  Periodicity          years
                  V.E.5                Datasets consistent between recent                    No major        Several discrepancies Multiple discrepancies        Not applicable
                  Consistency          surveys and reports                                discrepancies
                  V.E.6                Coverage of data upon which the most             Data from at least        Nationally           Local studies;                 None
                  Representativeness   recent estimate is based                       90% of professionally     representative     incomplete reporting
                                                                                      supervised deliveries   household sample       on professionally
                                                                                        and from complete                          supervised deliveries
                                                                                      (>90%) registration of                         with limited or no
                                                                                               births                                   evaluation of
                                                                                                                                       completeness


                  V.E.7                Most recent estimate disaggregated by: (1)        Disaggregation         Disaggregation         Disaggregation          Disaggregation not
                  Disaggregation       demographic characteristics (e.g., age); (2)     available for all 3     available for 2        available for 1              possible
                                       socioeconomic status (e.g., income,                  elements               elements               element
                                       occupation, education); and (3) locality
                                       (e.g., urban/rural, major geographical or
                                       administrative region)




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 F. Tuberculosis   V.6.1                Source of data and method used for most           Clinic reports with    District reports with  National reports with         None
 (TB) treatment    Data-collection      recent data                                     evaluation of reporting evaluation of reporting limited evaluation of
 success rate      method                                                                         rate                    rate              reporting bias
 under DOTS
                   V.6.2                For the most recently published estimate,               1 year                 2 years               3-4 years           5 or more years
                   Timeliness           number of years since the data were
                                        collected
                   V.6.3                Number of times measured in the past year                 4                                              <4                   None
                   Periodicity          (should be quarterly)
                   V.6.4                Consistency of treatment success rates                 No major        Several discrepancies Multiple discrepancies       Not applicable
                   Consistency          during past 10 years (fluctuation due to non-       discrepancies
                                        standardized data collection procedure,
                                        definitions, etc.)
                   V.6.5                Coverage of data upon which the most                  Over 90%               75% - 89%               50% - 75%           Less than 50%
                   Representativeness   recent estimate is based -- % of
                                        subnational DOTS quarterly reports
                                        received by national TB programme in most
                                        recent year
                   V.6.6                Estimate that was published most recently          Disaggregation          Disaggregation         Disaggregation        Disaggregation not
                   Disaggregation - 1   or will be published is disaggregated by           available for 3         available for 2        available for 1            possible
                                        demographic characteristics (e.g. age),               elements                elements               element
                                        socioeconomic status (e.g. income,
                                        occupation, education) and locality (e.g.
                                        urban/rural, major geographical or
                                        administrative region)


                   V.6.7                Most recent estimate disaggregated by HIV         Disaggregated by     Disaggregated by 1 of                                 Neither
                   Disaggregation - 2   status and by drug resistance                           both                  these




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 G. General          V.G.1               Data-collection method used for most           Data compiled using   Data compiled from    Data imputed from                 No data
 government          Data-collection     recent data                                      National Health   administrative sources secondary sources
 health              method                                                              Accounts (NHA)      (i.e. primary sources (e.g. report from third
 expenditure                                                                               methodology       of each component)             party)
 (GGHE) per
 capita (ministry of
 health, other
 ministries and
 social security,
 regional and local
 governments,
 extra budgetary
 entities)


                    V.G.2                For the most recently published estimate,           0-1 years               2 years             3 or more years                None
                    Timeliness           number of years since the data were
                                         collected
                    V.G.3                Periodicity                                          Yearly             Every 1-2 years       More than every 2              No data
                    Periodicity                                                                                                              years
                    V.G.4                Consistency of definitions of expenditure on Single source with no    Various sources that   Various sources that              None
                    Consistency          health across components (ministry of           break in series         are harmonized       are not harmonized
                                         health, other ministries and social security,
                                         regional and local governments, extra
                                         budgetary entities) and over time


                    V.G.5                Components represented                           All components:       Ministry of health,    Ministry of health as Only ministry of health (or
                    Representativeness                                                   ministry of health,    regional and local    well as social security          none)
                                                                                        other ministries and    governments and
                                                                                           social security,       social security
                                                                                         regional and local
                                                                                        governments, extra
                                                                                         budgetary entities
                    V.G.6                Availability of disaggregated estimates of       All components:       Ministry of health,    Ministry of health as Only ministry of health (or
                    Disaggregation - 1   general government expenditure (all             ministry of health,    regional and local    well as social security          none)
                                         components: ministry of health, other          other ministries and    governments and
                                         ministries and social security, regional and      social security,       social security
                                         local governments, extra budgetary              regional and local
                                         entities) by subnational or district level     governments, extra
                                                                                         budgetary entities




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                    V.G.7                Availability of disaggregated estimates of       Disbursed external         Disbursed external     Committed external               None
                    Disaggregation - 2   externally funded government expenditure           resources from             resources from         resources from
                                         by source of funding (i.e. multilateral,        multilateral, bilateral,     multilateral and       multilateral and
                                         bilateral, private foundations, NGOs,           private foundations,             bilateral              bilateral
                                         others)                                             NGOs, others
                    V.G.8                Availability of detailed information on         Resulting estimates            Based on the           Based on the          Resulting estimates are
                    Adjustment methods   sources and statistical methodologies, and         are completely          available information, available information,        not replicable
                                         recording of any departures from                 replicable through         resulting estimates    resulting estimates
                                         international guidelines, for all adjustments      data audit trail        are replicable at 75% are replicable at 50%
                                         carried out and their resulting estimates



 H. Private         V.H.1                Data-collection method used for most            Data compiled using Data compiled using 1 Data compiled using 1                    No data
 expenditure on     Data-collection      recent data                                       National Health   household survey for household survey for
 health per capita method                                                                 Accounts (NHA)        out-of-pocket, a     out-of-pocket and
 (households' out-                                                                          methodology       survey for at least 1 imputations for the
 of-pocket, private                                                                                          other component, and    other components
 health insurance,                                                                                              imputations for
 NGOs, firms and                                                                                                   remaining
 corporations)                                                                                                    components




                    V.H.2                For the most recently published estimate,             0-1 years                   2 years               3-4 years                   None
                    Timeliness           number of years since the data were
                                         collected
                    V.H.3                Periodicity                                         Data for all             All components             Households                 No data
                    Periodicity                                                          components available        surveyed at least     expenditure surveyed
                                                                                               yearly               once in past 5 years   at least once in past 5
                                                                                                                                                    years


                    V.H.4                Consistency of definitions of expenditure on Single source with no         Various sources that   Various sources that             No data
                    Consistency          health across components (households' out-      break in series              are harmonized       are not harmonized
                                         of-pocket, private health insurance, NGOs,
                                         firms and corporations) and over time




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                    V.H.5                Coverage of population                                 Nationally-           Nationally-             Nationally-              Local studies or
                    Representativeness                                                        representative    representative only for representative only for           otherwise
                                                                                               including all      households' out-of- the households' out-of-
                                                                                               components:        pocket plus 1 other          pocket
                                                                                            households' out-of-      component
                                                                                              pocket, private
                                                                                            insurance, NGOs,
                                                                                         firms and corporations


                    V.H.6                Availability of disaggregated estimates of          All components:        Households' out-of-     Households' out-of-     No disaggregated data
                    Disaggregation - 1   private expenditure (all components:               households' out-of-     pocket and 1 other         pocket only
                                         households' out-of-pocket, private health            pocket, private          component
                                         insurance, NGOs, firms and corporations)           insurance, NGOs,
                                         by subnational or district level                firms and corporations


                    V.H.7                Availability of disaggregated estimates of       Disbursed external         Disbursed external     Committed external             No data
                    Disaggregation - 2   private expenditure by source of funding           resources from             resources from         resources from
                                         (i.e. multilateral, bilateral, private          multilateral, bilateral,     multilateral and       multilateral and
                                         foundations, NGOs, others)                      private foundations,             bilateral              bilateral
                                                                                             NGOs, others
                    V.H.8                Availability of detailed information on          Resulting estimates           Based on the           Based on the         Resulting estimates are
                    Adjustment methods   sources and statistical methodologies, and          are completely         available information, available information,       not replicable
                                         recording of any departures from                  replicable through        resulting estimates    resulting estimates
                                         international guidelines, for all adjustments       data audit trail       are replicable at 75% are replicable at 50%
                                         carried out and their resulting estimates



 I. Density of      V.I.1                Routine administrative records are              Routine administrative Administrative records      Only administrative            No data
 health workforce   Data-collection      validated with findings from a regularly        records validated with validated with either         records without
 (total and by      method               conducted health facility survey/census,          population census,        health facility         validation by any
 professional                            labour-force survey and the population           labour-force surveys,   census/surveys or          census or survey
 category) by                            census                                               health facility    labour-force surveys
 1,000 population                                                                          census/surveys and
                                                                                         administrative records




                    V.I.2                For the most recently published estimate,            0-5 months                6-11 months         12 or more months              No data
                    Timeliness           number of months since the data were
                                         collected




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                    V.I.3                Number of times measured in past 5 years             5 or more                   3-4                      1-2                   No data
                    Periodicity
                    V.I.4                Variables and data definitions and                All sources are       Most of the sources Only some of the main The main sources are not
                    Consistency          classifications consistent over time and          consistent. The        are consistent. The     sources are        consistent; definitions/
                                         across different sources                        variables have the       variables have the       consistent      classification of variables
                                                                                          same definitions/        same definitions/                          vary across sources
                                                                                         classification in all   classification in most
                                                                                               sources              of the sources


                    V.I.5                Categories of health workers                        15 or more          4-14 occupations or      Less than 4 or ISCO 2         Otherwise
                    Disaggregation- 1                                                   occupations or ISCO        ISCO 3 digits or         digits or national
                                         ISCO: International Standard Classification     4 digits or national    national equivalent            equivalent
                                         of Occupations                                      equivalent


                    V.I.6                Estimate that was published most recently         The data allow            The data allow           The data allow           The data allow
                    Disaggregation - 2   or will be published is disaggregated by (1)   disaggregation by all     disaggregation by 3      disaggregation by 2     disaggregation only by
                                         gender, (2) urban/rural, (3) major                  4 variables         variables (excluding      variables (excluding         gender or no
                                         geographical or administrative region and                               public/private sector)     public/private and    disaggregation possible
                                         (4) public/private sector                                                                             urban/rural)


 Risk Factor Indicators
                                                                                                                                            Present but not
                    Quality assessment                                                    Highly adequate             Adequate                                     Not adequate at all      Rationale/
    Indicators                                             Results                                                                             adequate
                          criteria                                                                                                                                                          comments
                                                                                                  3                        2                      1                         0
 J. Smoking         V.J.1                Data-collection method used for most             Population-based                                                               No data
 prevalence (15     Data-collection      recent data                                      survey with self-
 years and older)   method                                                              report, daily smokers
                                                                                        over previous month


                    V.J.2                For the most recently published estimate,            0-2 years                3-5 years             6 or more years              None
                    Timeliness           number of years since the data were
                                         collected
                    V.J.3                Number of times measured in past 10                  3 or more                    2                        1                     None
                    Periodicity          years
                    V.J.4                Data consistent over time                             No major       A few discrepancies Multiple discrepancies      Not applicable
                    Consistency                                                             discrepancies
                    V.J.5                Type of sample upon which most recent                Nationally-      Purposive or other      Local studies     Any other method apart
                    Representativeness   estimate is based                              representative sample non-random national                          from those already
                                                                                                                   sampling                                    mentioned




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                  V.J.6                Estimate that was published most recently      Disaggregation       Disaggregation    Disaggregation    Disaggregation not
                  Disaggregation       (or will be published) is disaggregated by:   available for all 3   available for 2   available for 1        possible
                                       (1) demographic characteristics (e.g., sex,       elements             elements          element
                                       age); (2) socioeconomic status (e.g.,
                                       income, occupation, education of parents);
                                       and (3) locality (e.g., urban/rural, major
                                       geographical or administrative region)




 Additional selected indicators
 Additional       Data-collection      Data-collection method used for most
 Indicator number method               recent data
 1
                  Timeliness           For the most recently published estimate,
                                       number of years since the data were
                                       collected
                  Periodicity          Number of times measured in past 10
                                       years
                  Consistency          Revisions consistent over time, and
                                       datasets between major sources during
                                       past 10 years
                  Representativeness   Coverage of data upon which the most
                                       recently reported estimate is based
                  Disaggregation       Most recent estimate disaggregated by                All 3                2                 1                 None
                                       demographic characteristics (e.g. sex, age)
                                       socioeconomic status (e.g. income,
                                       occupation, education of their parent) and
                                       locality (e.g. urban/rural, major
                                       geographical or administrative region)


                  Estimation methods   Estimates use transparent, well-established
                                       methods

 Additional       Data-collection      Data-collection method used for most
 Indicator number method               recent data
 2
                  Timeliness           For the most recently published estimate,
                                       number of years since the data were
                                       collected




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                  Periodicity          Number of times measured in past 10
                                       years
                  Consistency          Revisions consistent over time, and
                                       datasets between major sources during
                                       past 10 years
                  Representativeness   Coverage of data upon which the most
                                       recently reported estimate is based
                  Disaggregation       Most recent estimate disaggregated by         All 3   2   1   None
                                       demographic characteristics (e.g. sex, age)
                                       socioeconomic status (e.g. income,
                                       occupation, education of their parent) and
                                       locality (e.g. urban/rural, major
                                       geographical or administrative region)


                  Estimation methods   Estimates use transparent, well-established
                                       methods

 Additional       Data-collection      Data-collection method used for most
 Indicator number method               recent data
 3
                  Timeliness           For the most recently published estimate,
                                       number of years since the data were
                                       collected
                  Periodicity          Number of times measured in past 10
                                       years
                  Consistency          Revisions consistent over time, and
                                       datasets between major sources during
                                       past 10 years
                  Representativeness   Coverage of data upon which the most
                                       recently reported estimate is based
                  Disaggregation       Most recent estimate disaggregated by         All 3   2   1   None
                                       demographic characteristics (e.g. sex, age)
                                       socioeconomic status (e.g. income,
                                       occupation, education of their parent) and
                                       locality (e.g. urban/rural, major
                                       geographical or administrative region)


                  Estimation methods   Estimates use transparent, well-established
                                       methods




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 Additional       Data-collection      Data-collection method used for most
 Indicator number method               recent data
 4
                  Timeliness           For the most recently published estimate,
                                       number of years since the data were
                                       collected
                  Periodicity          Number of times measured in past 10
                                       years
                  Consistency          Revisions consistent over time, and
                                       datasets between major sources during
                                       past 10 years
                  Representativeness   Coverage of data upon which the most
                                       recently reported estimate is based
                  Disaggregation       Most recent estimate disaggregated by         All 3   2   1   None
                                       demographic characteristics (e.g. sex, age)
                                       socioeconomic status (e.g. income,
                                       occupation, education of their parent) and
                                       locality (e.g. urban/rural, major
                                       geographical or administrative region)


                  Estimation methods   Estimates use transparent, well-established
                                       methods

 Additional       Data-collection      Data-collection method used for most
 Indicator number method               recent data
 5
                  Timeliness           For the most recently published estimate,
                                       number of years since the data were
                                       collected
                  Periodicity          Number of times measured in past 10
                                       years
                  Consistency          Revisions consistent over time, and
                                       datasets between major sources during
                                       past 10 years
                  Representativeness   Coverage of data upon which the most
                                       recently reported estimate is based




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               Disaggregation       Most recent estimate disaggregated by         All 3   2   1   None
                                    demographic characteristics (e.g. sex, age)
                                    socioeconomic status (e.g. income,
                                    occupation, education of their parent) and
                                    locality (e.g. urban/rural, major
                                    geographical or administrative region)


               Estimation methods   Estimates use transparent, well-established
                                    methods




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                                                             Response from interviewees
                                                                                                                                               Average
    Name 1    Name2     Name3    Name4     Name5     Name6       Name7      Name8         Name9   Name10   Name11   Name12   Name13   Name14




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                                                             Response from interviewees
                                                                                                                                               Average
    Name1     Name2     Name3    Name4     Name5     Name6       Name7      Name8         Name9   Name10   Name11   Name12   Name13   Name14




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VI. Dissemination and use                                                                     Return to Menu              Go to Results            Abbreviations               Glossary

 A. Analysis and use of information
                                                                                                                                                    Present but not
                                                                                               Highly adequate                Adequate                                     Not adequate at all     Rationale/
                                          Items                                                                                                         adequate
                                                                                                                                                                                                   comments
                                                                                                        3                         2                          1                       0
VI.A.1   Senior managers and policy-makers demand complete, timely, accurate,                          Yes              Yes, but they do not          Demand from           Negligible demand
         relevant and validated HIS information                                                                          have the skills to       managers is ad-hoc,        from managers
                                                                                                                               judge              usually as a result of
                                                                                                                                                    external pressure
                                                                                                                                                  (e.g., questions from
                                                                                                                                                    politicians or the
                                                                                                                                                          media)


VI.A.2   Graphs are widely used to display information at subnational health                   True at all levels       True at health offices          True at              No graphs used
         administrative offices (e.g., regional/provincial, district) and health facilities. (regional/provincial,       (regional/provincial,     regional/provincial
         They are up to date and clearly understood                                          district health offices,     district), but not at    health offices only
                                                                                                health facilities)          health facilities


VI.A.3   Maps are widely used to display information at subnational health                     True at all levels       True at health offices          True at               No maps used
         administrative offices (e.g., regional/provincial, district) and health facilities. (regional/provincial,       (regional/provincial,     regional/provincial
         They are up to date and clearly understood                                          district health offices,     district), but not at    health offices only
                                                                                                health facilities)          health facilities




  B. Information use for policy and advocacy
                                                                                                                                                   Present but not
                                                                                               Highly adequate                Adequate                                     Not adequate at all     Rationale/
                                          Items                                                                                                       adequate
                                                                                                                                                                                                   comments
                                                                                                       3                           2                       1                         0
VI.B.1   Integrated HIS summary reports including information on a minimum set of             Regular integrated         Regular integrated       Occasional reports,      No integrated reports
         core indicators (including those used to measure progress towards                      reports at least            reports at least       but not annually
         achieving the MDGs and those used by Global Health Partnerships, if                  annually to national           annually, but
         applicable) are distributed regularly to all relevant parties                         and local relevant       distributed only to the
                                                                                                    partners              ministry of health
  C. Information use for planning and priority setting
                                                                                                                                        Present but not
                                                                                           Highly adequate          Adequate                                  Not adequate at all   Rationale/
                                        Items                                                                                              adequate
                                                                                                                                                                                    comments
                                                                                                   3                      2                     1                     0
VI.C.1   Health information (population health status, health system, risk factors) is    Yes, systematically   Commonly used for     Health information is       Never used
         demonstrably used in the planning and in the resource allocation                 used with methods    diagnostic purposes     occasionally used
         processes (e.g. for annual integrated development plans, medium-term             and targets aligned    to describe health
         expenditure frameworks, long-term strategic plans, and annual health              between different  problems/ challenges,
         sector reviews)                                                                 planning frameworks but no synchronised
                                                                                                                    use of health
                                                                                                               information between
                                                                                                                 different planning
                                                                                                                     frameworks




  D. Information use for resource allocation
                                                                                                                                      Present but not
                                                                                           Highly adequate          Adequate                               Not adequate at all      Rationale/
                                        Items                                                                                             adequate
                                                                                                                                                                                    comments
                                                                                                   3                     2                    1                     0
VI.D.1   HIS information is widely used by district and subnational management              The majority of    Some targets/budget Few targets/budget          None of the
         teams to set resource allocations in the annual budget processes                   targets/budget     proposals are backed proposals are backed     targets/budget
                                                                                         proposals are backed up by HIS information up by HIS information proposals are backed
                                                                                         up by HIS information                                            up by HIS information
VI.D.2   HIS information is used to advocate for equity and increased resources to           HIS information is       HIS information is       HIS information is     Not used for equity
         disadvantaged groups and communities (e.g., by documenting their                  systematically used to     regularly used to         used for equity            purposes
         disease burden and poor access to services)                                          promote equity           promote equity         purposes only on an
                                                                                                                                                 ad hoc basis




  E. Information use for implementation and action
                                                                                                                                                Present but not
                                                                                             Highly adequate              Adequate                                    Not adequate at all     Rationale/
                                         Items                                                                                                      adequate
                                                                                                                                                                                              comments
                                                                                                       3                    2                           1                     0
VI.E.1   Managers at health administrative offices at all levels (national,                 Health information is Health information is       All key decisions are   HIS information is
         regional/provincial, district) use health information for health service          used by managers at used by managers at             centralized to the     occasionally used
         delivery management, continuous monitoring and periodic evaluation                  all levels for health    national and                national level
                                                                                               service delivery    regional/provincial
                                                                                                management,         levels but not at
                                                                                           continuous monitoring      district level
                                                                                                  and periodic
                                                                                                   evaluation


VI.E.2   Care providers at all levels (national, regional/provincial, district hospitals    Health information is Health information is       Health information is Care providers other
         and health centres) use health information for health service delivery                 used by care           used by care               used by care       than those at national
         management, continuous monitoring and periodic evaluation                         providers at all levels providers at national,     providers at national     level do not use
                                                                                             for health service     regional/provincial                 and          health information for
                                                                                           delivery management, and district hospitals         regional/provincial      service delivery
                                                                                           continuous monitoring     but not at health         hospitals but not at      management,
                                                                                                and periodic              centres              district hospitals or       continuous
                                                                                                 evaluation                                      health centres      monitoring or periodic
                                                                                                                                                                           evaluation


VI.E.3   Information on health risk factors is systematically used to advocate for the      Such indicators are       Such indicators are     Only used on an ad           Not used
         adoption of lower-risk behaviours by the general public and by targeted           systematically used        regularly used, but          hoc basis
         vulnerable groups                                                                 and tailored to fit the   generally not tailored
                                                                                               risk profile and       to each vulnerable
                                                                                           situation facing each            group
                                                                                             vulnerable group
                     Categories                 Maximum   Score        %

A   Analysis and use of information                0       0.0    Not assessed


B   Information use for policy and advocacy        0       0.0    Not assessed

    Information use for planning and priority
C                                                  0       0.0    Not assessed
    setting
D   Information use for resource allocation        0       0.0    Not assessed

    Information use for implementation and
E                                                  0       0.0    Not assessed
    action
    TOTAL                                          0       0.0    Not assessed
                                                Response from interviewees
                                                                                                                                  Average
Name1   Name2   Name3   Name4   Name5   Name6       Name7      Name8         Name9   Name10   Name11   Name12   Name13   Name14




                                                Response from interviewees
                                                                                                                                  Average
Name1   Name2   Name3   Name4   Name5   Name6       Name7      Name8         Name9   Name10   Name11   Name12   Name13   Name14
                                                Response from interviewees
                                                                                                                                  Average
Name1   Name2   Name3   Name4   Name5   Name6       Name7      Name8         Name9   Name10   Name11   Name12   Name13   Name14




                                                Response from interviewees
                                                                                                                                  Average
Name1   Name2   Name3   Name4   Name5   Name6       Name7      Name8         Name9   Name10   Name11   Name12   Name13   Name14
                                                Response from interviewees
                                                                                                                                  Average
Name1   Name2   Name3   Name4   Name5   Name6       Name7      Name8         Name9   Name10   Name11   Name12   Name13   Name14
I. Resources
           Categories           Result
                             Not assessed
Policy and Planning
                                  ---
HIS institutions, human      Not assessed
resources and financing           ---
                             Not assessed
HIS Infrastructure
                                  ---
                             Not assessed
Overall
                                  ---


II. Indicators
           Categories           Result
                             Not assessed
Indicators
                                  ---


III. Data Sources
          Data Source          Contents     Capacity & Practices   Dissemination   Integration and use      Total
                             Not assessed      Not assessed        Not assessed      Not assessed        Not assessed
Census
                                  ---               ---                 ---               ---                 ---
                             Not assessed      Not assessed        Not assessed      Not assessed        Not assessed
Vital statistics
                                  ---               ---                 ---               ---                 ---
                             Not assessed      Not assessed        Not assessed      Not assessed        Not assessed
Population-based surveys
                                  ---               ---                 ---               ---                 ---
Health and disease records   Not assessed      Not assessed        Not assessed      Not assessed        Not assessed
(incl. surveillance)              ---               ---                 ---               ---                 ---
                             Not assessed      Not assessed        Not assessed      Not assessed        Not assessed
Health service records
                                  ---               ---                 ---               ---                 ---
                             Not assessed      Not assessed        Not assessed      Not assessed        Not assessed
Resource records
                                  ---               ---                 ---               ---                 ---
                                                                                                         Not assessed
Total
                                                                                                              ---


IV. Data Management
           Categories           Result
                             Not assessed
Data management
                                  ---
V. Information Products
          Categories               Overall
                                 Not assessed
Information Products
                                      ---


VI. Dissemination and Use
          Categories                Result
Analysis and use of              Not assessed
information                           ---
Information use for policy and   Not assessed
advocacy                              ---
Information use for planning     Not assessed
and priority setting                  ---
Information use for resource     Not assessed
allocation                            ---
Information use for              Not assessed
implementation and action             ---
                                 Not assessed
Overall
                                      ---
       Component                 Summary of comments
1. HIS Resources
A. Policy and Planning   A1:
                         A2:
                         A3:
                         A4:
                         A5:
                         A6:
                         A7:

B. HIS institutions,     B1:
human resources and      B2:
financing                B3:
                         B4:
                         B5:
                         B6:
                         B7:
                         B8:
                         B9:
                         B10:
                         B11:
                         B12:
                         B13:

C. HIS infrastructure    C1:
                         C2:
                         C3:
                         C4:
                         C5:

2. Indicators
                         A1:
                         A2:
                         A3:
                         A4:
                         A5:

3. Data sources
A. Census                A1.1:
                         A2.1:
                         A2.2:
                         A2.3:
                         A3.1:
                         A3.2:
                         A3.3:
                         A3.4:
                         A4.1:

B. Vital registration    B1.1:
                         B1.2:
                         B1.3:
                         B2.1:
                         B2.2:
                         B2.3:
                         B2.4:
                         B2.5:
                         B2.6:
                         B2.7:
                         B2.8:
                         B3.1:
                         B4.1:

C. Population-based      C1.1:
surveys                  C1.2:
                         C1.3:
      Component                                                  Summary of comments
                         C2.1:
                         C2.2:
                         C2.3:
                         C2.4:
                         C3.1:
                         C3.2:
                         C4.1:
                         C4.2:

D. Health & disease      D1.1:
records                  D1.2:
                         D1.3:
                         D2.1:
                         D2.2:
                         D2.3:
                         D2.4:
                         D2.5:
                         D2.6:
                         D2.7:
                         D3.1:
                         D4.1:
                         D4.2:

E. Health service records E1.1:

                         E1.2:
                         E2.1:
                         E2.2:
                         E2.3:
                         E2.4:
                         E3.1:
                         E3.2:
                         E4.1:
                         E4.2:
                         E4.3:

F. Resource records      1. Infrastructure and health services
                         F1.1:
                         F1.2:
                         F2.1:
                         F2.2:
                         F3.1:
                         F4.1:

                         2. Human resources
                         F1.3:
                         F1.4:
                         F2.3:
                         F2.4:

                         3. Financing and expenditure
                         F1.5:
                         F1.6:
                         F2.5:
                         F2.6:
                         F2.7:
                         F2.8:
                         F3.2:
                         F4.2:

                         4. Equipment, supplies and commodities
                         F1.7:
                         F1.8:
                         F2.9:
       Component                                                Summary of comments
                           F2.10:
                           F2.11:
                           F4.3:
                           F4.4:

4. Data management
                           A1:
                           A2:
                           A3:
                           A4:
                           A5:

5. Information Products

A. Health status indicators 1. Under-5 mortality

 - Mortality               A1.1:
                           A1.2:
                           A1.3:
                           A1.4:
                           A1.5:
                           A1.6:
                           A1.7:

                           2. Maternal mortality
                           A2.1:
                           A2.2:
                           A2.3:
                           A2.4:
                           A2.5:
                           A2.6:
                           A2.7:

 - Morbidity               3. HIV prevalence
                           A3.1:
                           A3.2:
                           A3.3:
                           A3.4:
                           A3.5:
                           A3.6:

B. Health System           4. Measles coverage
indicators
                           B4.1:
                           B4.2:
                           B4.3:
                           B4.4:
                           B4.5:
                           B4.6:
                           B4.7:

                           5. Deliveries attended by skilled health profesionals
                           B5.1:
                           B5.2:
                           B5.3:
                           B5.4:
                           B5.5:
                           B5.6:
                           B5.7:

                           6. Tuberculosis (TB) treatment success rate under DOTS
                           B6.1:
                           B6.2:
                           B6.3:
       Component                                                Summary of comments
                            B6.4:
                            B6.5:
                            B6.6:
                            B6.7:

                            7. General government expenditure on health per capita
                            B7.1:
                            B7.2:
                            B7.3:
                            B7.4:
                            B7.5:
                            B7.6:
                            B7.7:
                            B7.8:

                            8. Private expenditure on health per capita
                            B8.1:
                            B8.2:
                            B8.3:
                            B8.4:
                            B8.5:
                            B8.6:
                            B8.7:
                            B8.8:

                            9. Density of health workforce
                            B9.1:
                            B9.2:
                            B9.3:
                            B9.4:
                            B9.5:
                            B9.6:

C. Risk factors             10. Smoking prevalence
                            C10.1:
                            C10.2:
                            C10.3:
                            C10.4:
                            C10.5:
                            C10.6:

Additional indicators




6. Dissemination and use
A. Analysis and use of   A1:
information              A2:
                         A3:
                         A4:

B. Information use for      B1:
policy and advocacy

                            C1:
C. Information use for planning and priority setting

D. Information use for      D1:
resource allocation         D2:

E. Information use for      E1:
implementation and          E2:
actions                     E3:
                                                                                                                    Overall HIS

Resources                                    Not assessed                   Resources
 Policy and planning                          Not assessed                   Indicators
 Institutions, human resources & financing    Not assessed
 Infrastructure                               Not assessed               Data sources

                                                                    Data management
Indicators                                   Not assessed         Information products

                                                                  Dissemination & use
Data sources                                 Not assessed
                                                                                            0%              25%            50%         75%    100%
 Census                                       Not assessed
 Vital statistics                             Not assessed
 Population-based surveys                     Not assessed                                                              Resources
 Health & diseases records                    Not assessed
 Health service records                       Not assessed                                   Overall
 Resource records                             Not assessed

                                                                             Policy and planning
Data management                              Not assessed
                                                                   Institutions, HR and financing

Information products                         Not assessed
                                                                                    Infrastructure

Dissemination & use                          Not assessed                                              0%         25%            50%    75%   100%



                                                                                                                    Data sources
                                                                                Overall
                                                                                Census
                                                                         Vital statistics
                                                             Population-based surveys
                                                             Health & diseases records
                                                                Health service records
                                                                     Resource records

                                                                                            0%              25%            50%         75%    100%
                                                            Return to Menu
                                  Overall HIS



         Resources




          Indicators




       Data sources




  Data management




Information products




Dissemination & use



                       0%   25%                 50%   75%
                                                                    Return to Menu
                                            Resources




                      Overall




          Policy and planning




Institutions, HR and financing




                Infrastructure




                                 0%   25%               50%   75%
                                                                    Return to Menu
                                         Data sources


                  Overall




                  Census




           Vital statistics




Population-based surveys




Health & diseases records




   Health service records




        Resource records


                              0%   25%                  50%   75%
Abbreviations and acronyms

 ANC       Antenatal care
 DHS       Demographic Health Survey
 DOTS      The internationally recommended strategy for tuberculosis control. DOT stands for directly
           observed treatment
 DSS       Demographic Surveillance System
 GAVI      Global Alliance for Vaccines and Immunization
 GHP       Global health partners
 GPS       Global Positioning Satellite
 HIS       Health Information System
 HMIS      Health Management Information System
 HMN       Health Metrics Network
 HR        Human resources
 ICD       International Statistical Classification of Diseases and Related Health Problems
 IDSR      Integrated Disease Surveillance and Response
 ICT       Information and Communications Technology
 ISCO      International Standard Classification of Occupations
 IHR       International Health Regulations
 IMF       International Monetary Fund
 LSMS      Living Standard Measurement Study
 MDG       Millennium Development Goals
 MICS      Multiple Indicator Cluster Surveys
 MoH       Ministry of Health
 NGO       Non-governmental organization
 NHA       National Health Accounts
 NSO       National Statistics Office
 OECD      Organisation for Economic Co-operation and Development
 PARIS21   Partnership in Statistics for Development in the 21st Century
 PES       Post enumeration survey
 SARS      Severe Acute Respiratory Syndrome
 SAVVY     Sample Vital Registration with Verbal Autopsy
 SPA       Service Provision Assessment
 SRS       Sample Registration System
 TB        Tuberculosis
 UNDP      United Nations Development Programme
 UNFPA     United Nations Population Fund
 UNICEF    United Nations Children’s Fund
 VA        Verbal Autopsy
 WHO       World Health Organization
Glossary for Statistics and Data Management
 Causes of death                The causes of death to be entered on the medical certificate are defined as “all those diseases, morbid conditions or
                                injuries which either resulted in or contributed to death and the circumstances of the accident or violence which produced
                                any such injuries”
 Civil registration             As defined by the UN: “the continuous, permanent, compulsory and universal recording of the occurrence and
                                characteristics of vital events (live births, deaths, foetal deaths, marriages and divorces) and other civil status events
                                pertaining to the population as provided by decree, law or regulation, in accordance with the legal requirements in each
                                country. It establishes and provides legal documentation of such events. These records are also the best source of vital
                                statistics.”
 Data management                A set of procedures to collect, store, analyse and distribute data. Once data are collected, a sound management approach
                                is essential. Firstly, a metadata dictionary is necessary to accurately describe the data elements. Next, effective data-
                                storage procedures require a well-designed logical structure to permit data retrieval and analysis. Data analysis and
                                presentation include calculating indicators and preparing tables and graphs. Finally, the data should be made available to
                                all those who can use and act upon them.
 Data warehouse                 An integrated information-storage area that consists of a data repository bringing together multiple databases from various
                                data sources, and a report-generating facility.
 DSS: Demographic               The longitudinal enumeration of all demographic events, including cause of death via verbal autopsy, in a geographically
 surveillance system            defined population.
 Enumeration                    Distinct from registration; the means by which the presence of individuals in a household or other group is recorded;
                                normally used in reference to a census or survey. Enumeration is anonymous and does not provide any direct benefit to the
                                individual.
 ICT: Information and           Includes the computers, software, data-capture devices, wireless communication devices, and local and wide area
 Communications                 networks that move information, and the people that are required to design, implement and support these systems.
 Technology
 ISCO: International            One of the main international classifications, for which ILO is responsible. ISCO is a tool for organizing jobs into a clearly
 Standard Classification of     defined set of groups according to the tasks and duties undertaken.
 Occupations
 ICD: International Statistical A classification maintained by WHO for coding diseases, signs, symptoms and other factors causing morbidity and
 Classification of Diseases     mortality; used world-wide for morbidity and mortality statistics and designed to promote international comparability
 and Related Health             collection, processing, classification, and presentation of statistics.
 Problems
 Medical certification of       Medical practitioners or other qualified certifiers use their clinical judgement to diagnose the cause(s) of death to be
 cause of death                 entered on the medical certificate.
 Metadata (dictionary)        Metadata is “data about data”. To relate data from multiple sources, it is essential to develop common definitions and
                              understand the characteristics of each data element. The tool for achieving this is the metadata dictionary. It covers
                              definitions of data elements/variables, their use in indicators, data-collection method, time period of data-collection,
                              analysis techniques used, estimation methods and possible data biases.
 Microdata                    Nonaggregated data about the units sampled. In the case of population and household censuses and surveys, microdata
                              consists of records of the individuals and households interviewed.
 Mortality rate               The ratio of the number of people dying in a year to the total mid-year population in which the deaths occurred. This rate is
                              also called the crude death rate. The mortality rate may be standardized when comparing mortality rates over time (or
                              between countries) to take account of differences in the population. This rate is then called the age-standardized death
                              rate.
 SRS: Sample (vital)          Longitudinal enumeration of demographic events including cause of death via verbal autopsy, in a nationally representative
 registration system          sample of clusters such as exists in China and India.
 Underlying cause of death    (a) the disease or injury which initiated the train of morbid events leading directly to death; or (b) the circumstances of the
                              accident or violence which produced the fatal injury.
 Verbal autopsy               A structured interview administered to care-givers or family members of households after a death occurs; used to
                              determine probable cause(s) of death where most deaths occur outside of health facilities and direct medical certification is
                              rare.
 Vital registration           All sanctioned modes of registering individuals and reporting on vital events.
 Vital statistics             Data on vital events drawn from all of sources of vital events data. Particularly in developing country settings, where civil
                              registration functions poorly or not at all, the UN acknowledges that a variety of data sources and systems are used to
                              derive estimates of vital statistics.
 Vital statistics system      As defined by the UN: “the total process of (1) collecting information by civil registration or enumeration on the frequency of
                              occurrence of specified and defined vital events as well as relevant characteristics of the events themselves … and (2) of
                              compiling, processing, analysing, evaluating, presenting and disseminating these data in statistical form”.



Glossary for National Health Accounts (NHA)
 Audit                       The legal requirement for a corporation to have its balance sheet, financial statement, and underlying accounting system
                             and records examined by a qualified auditor so as to enable an opinion to be formed as to whether the financial statement
                             accurately represent the company's financial condition and whether they comply with relevant statutes.

 Entity                       An economic actor in the health system. Entities can be governments, businesses, organizations, individuals, families, etc.
(Expenditure on health by)   The sum of resources channelled towards health by all non-resident entities that enter into transactions with resident
external resources           entities, or have other economic links with resident units, explicitly labelled or not to health, to be used as means of
                             payments of health goods and services by financing agents in the government or private sectors. Includes donations and
                             loans, in cash and in-kind resources.
(Expenditure on health by)   Extra-budgetary funds comprise publicly funded schemes that operate autonomously, such as university hospitals,
extrabudgetary entities      foundations dealing with specific health risks etc.
(Expenditure on health by)   Expenditure on health services by all resident corporations and quasi-corporations not controlled by government, additional
firms and corporations       to those channelled through social security and private medical insurance. Comprises direct outlays to medical care
                             providers and to suppliers of medical goods as well as reimbursements to households and the supply of services in kind to
                             the employees and sometimes their relatives. The WHO does not report parastatals expenditure on health under private
                             expenditure but under general government expenditure on health.
Financial agents             Institutions or entities that channel the funds provided by financing sources and use those funds to pay for, or purchase, the
                             activities inside the health accounts boundary.
Financing sources            Institutions or entities that provide the funds used in the system by financing agents.

Functions                    The types of goods and services provided and activities performed within the health accounts boundary.

General government           The sum of outlays for health maintenance, restoration or enhancement paid for in cash or supplied in kind by government
expenditure on health        entities, such as the Ministry of Health, other ministries, parastatal organizations, social security agencies, (without double-
                             counting the government transfers to social security and to extra-budgetary funds). Includes transfer payments to
                             households to offset medical care costs and extra-budgetary funds to finance health services and goods. The revenue
                             base of these entities may comprise multiple sources, including external funds.
Imputation                   Making an informed guess about a missing value using logical edits or statistical procedures.

National Health Accounts     A tool for the systematic, comprehensive and consistent monitoring of resource flows in a national health system. It
(NHA)                        provides a framework with standard definitions, boundaries, classifications and a set of interrelated tables for standard
                             reporting of expenditures on health and its financing. NHAs are designed to capture the resource flows for the main
                             functions of health-care financing: namely, resource mobilization and allocation; pooling and insurance; purchasing and
                             providing of care; and the distribution of expenditures by disease, socioeconomic characteristics and geopolitical areas.


(Expenditure on health by)   Expenditure on health by non-profit institutions serving households (NPISHs), which are not predominantly financed and
NGOs                         controlled by government, that provide goods or services to households free or at prices that are not economically
                             significant.
(Expenditure on health by)   Expenditure on health by households as direct payments, discretionary, made to health practitioners and suppliers of
households' out-of-pocket    pharmaceuticals, therapeutic appliances, and other goods and services whose primary intent is to contribute to the
                             restoration or to the enhancement of the health status of individuals or population groups. A household is an individual or a
                             group of persons sharing the same living accommodation, which pool some, or all, of their income and wealth and which
                             consume certain types of goods and services collectively, mainly housing and food.

Private expenditure on       The sum of outlays for health by private entities, such as commercial or mutual health insurance, non profit institutions
health                       serving households, resident corporations and quasi-corporations not controlled by government with a health services
                             delivery or financing, and households.

(Expenditure on health by)   Expenditure on health by private insurance institutions. Private insurance enrolment may be contractual or voluntary, and
private health insurance     conditions and benefits or basket of benefits are agreed under voluntary basis between the insurance agent and the
                             beneficiaries. They are thus, not controlled by government units for the purpose of providing social benefits to members.


Providers                    Entities that receive money in exchange for or in anticipation of producing the activities inside the health accounts
                             boundary.

(Expenditure on health by)   Expenditure on health by social security institutions. Social security or National health insurance schemes are imposed and
social security              controlled by government units for the purpose of providing social benefits to members of the community as a whole, or to
                             particular segments of the community. Comprises direct outlays to medical care providers and to suppliers of medical
                             goods as well as reimbursements to households and the supply of services in kind to the enrolees.
                   Health Metrics Network
Assessment Tool for Country Health Information Systems - Version 3.00


                Distribution Version for Round 1 Countries



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